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DENTAL BENEFITS: INQUIRIES AND GRIEVANCE PROCEDURES Routine Questions About Dental Benefits If You have any questions about dental benefits provided by the group contract, please call Us at (800) 880- 1600. Grievance Procedures If You or Your dependents have a grievance with Us or Your Selected General Dentist, You may submit such grievance by calling Our customer service department at (800) 880-1800. When You call, You may: • submit the grievance orally, or • request a grievance form to submit the grievance in Writing. To submit the grievance in Writing, complete the grievance form, or provide a detailed summary of Your grievance to: SafeGuard c/o Quality Management Department PC Box 3532 Laguna Hills, CA 82654-3532 You may also file a Written grievance via our website at www.metlife,com/mybeneflts. Please click on Members, then "Forms to Print," and then "Grievance Forms". In all Written correspondence, please be sure to Include at least the following information: • Your name, • Name of the Plan, • Identification Number of the person You are Writing about; and • Facility (or Selected General Dental Office) name and number. We agree to Investigate and try to resolve complaints received. We will confirm receipt of Your complaint in writing within five (5) calendar days of receipt. We will resolve the complaint and communicate the resolution in writing within thirty (30) calendar days, A grievance must be filed within one hundred and eighty (180) days of the occurrence or incident that is the subject of the grievance. If Your grievance involves an Imminent and serious threat to Your health, including but not limited to severe pain, potential loss of life, limb or major bodily function, You or Your provider may request an expedited review, and if Your grievance qualifies as an urgent grievance, We will process Your grievance within three (3) calendar days from receipt of Your request. You are not required to file a grievance with SafeGuard before asking the California Department of Managed Health Care ("Department") to review Your case on an expedited basis. The Department may be contacted at (1-888-HMO.2219), TDD line (1-877-688-8891) for the hearing and speech impaired, or http:flwww.hmohelp.ca.gov. The California Department of Managed Health Care ("Department") is responsible for regulating health care service plans. If You have a grievance against Your health plan, You should first telephone Your health plan at (800) B80-1800 and use Your health plan's grievance process before contacting the Department. Using this grievance procedure does not prohibit any potential legal rights or remedies that may be available to You. If You need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by Your health plan, or a grievance that has remained unresolved for more than sixty (60) days, You may call the Department for assistance. You may also be eligible for an Independent Medical Review ("IMR"). If You are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services. The Department also has a toll-free telephone number (1 -888 -HMO -2219) and a TDD line (1- GCERT2011-DHMO-EOC •L5C-27 13