Dental, Vision & Hearing

A plan with choices for you and your family

Dental, Vision and Hearing Insurance

The Importance of Dental | Vision | Hearing

• Quality of Life • Unforeseen situations that are painful, inconvenient and expensive • Basic Medicare does not cover dental, vision or hearing expenses

Protect Your Smile and Smile Brighter!

PRODUCTS HIGHLIGHTS

• Choose your dentist - In network or out of network • Family Rates (includes a maximum of 3 children) • Individual 18 - 85 • $1,000 - $5,000 policy year benefit option available • Guaranteed Issue • Guaranteed renewable for life* * Subject to our right to change premiums. NEW! Careington Network Clients can now access the Careington Maximum Care PPO Dental Network. Use of network completely optional. • Policyholders can now use, if they choose, a dental provider from the Careington Dental network. • Policyholders can also use the dentist of their choice, even if not part of the dental network. • Network discounts may help extend the policy year maximum with reduced charges. • Careington can be contacted at (800) 290-0523.

Protect Your Sight and See Clearer!

Protect Your Hearing and Hear Better!

This is a Limited Benefit Insurance Policy for Dental, Vision and Hearing Expenses Underwritten by ManhattanLife Insurance and Annuity Company

Not available in all states

DVH7016-BR 0823

PLAN BENEFITS 1

INDIVIDUAL MONTHLY PREMIUM Age $1,000 $1,500 $3,000 $5,000 18 - 39 $30.24 $39.98 $48.15 $60.64 40 - 54 $32.74 $42.40 $52.23 $65.56 55 - 64 $35.07 $45.98 $59.56 $73.72 65 - 74 $37.57 $49.65 $64.39 $78.97 75 - 85 $43.15 $57.06 $74.05 $88.63 FAMILY MONTHLY PREMIUM * Age $1,000 $1,500 $3,000 $5,000 18 - 39 $96.79 $127.70 $154.19 $199.09 40 - 54 $101.63 $132.61 $159.85 $208.92 55 - 64 $106.54 $139.86 $172.60 $225.24 65 - 74 $111.37 $147.11 $190.59 $235.74 75 - 85 $128.03 $169.18 $219.50 $255.06 CHILD MONTHLY PREMIUM * Age $1,000 $1,500 $3,000 $5,000 3 - 17 $22.74 $29.99 $36.15 $48.65 * Family rates include up to three children. Additional children are charged the age 3 - 17 rate per person. Premiums are subject to change. Premium rates based on $1,000, $1,500, $3,000 or $5,000 Policy Year Maximum. Use the age of the oldest applicant. Benefit exclusions and limitations apply.

Eligibility

Anyone age 18 - 85 $1,000, $1,500, $3,000 o $5,000 (choose one) $100 per person

Policy Year Maximum Benefit

Policy Year Deductible

Dental Coverage Preventive Services Semi-Annual exams, cleaning and x-rays

Year 1 - 60% Year 2 - 70% Year 3 and thereafter - 80%

Waiting Period

None

Year 1 - 60% Year 2 - 70% Year 3 and thereafter - 80%

Basic Services Including x-ray, fillings and extractions (other than “full mouth”)

Waiting Period

None

Major Services Including bridges, crowns, full dentures or partials, full mouth extractions, and root canals

Year 1 - 0% Year 2 - 70% Year 3 and thereafter - 80%

Waiting Period

12 months

Vision Coverage Basic eye exam, eye refraction, including the cost of eye glasses or contact lenses

Year 1 - 60% Year 2 - 70% Year 3 and thereafter - 80% 6 months on eyeglasses and contact lenses Year 1 - 60% Year 2 - 70% Year 3 and thereafter - 80% 12 months new hearing aids and existing hearing aid repairs

Waiting Period

Hearing Coverage

Exam, hearing aid and necessary repairs or supplies

Waiting Period

Policy Form Numbers: AK7016, AK7016-ID, AK7016-LA, AK7016-MT, AK7016-OK, AK7016-TX (including state variations)

1 Refer to your policy for a complete description of limitations and exclusions.

Underwritten by: ManhattanLife Insurance and Annuity Company 10777 Northwest Freeway, Houston, TX 77092 Toll Free Telephone: 800-669-9030

This is not a complete disclosure of plan qualifications and limitations. Please access our website to obtain a completed list for the Dental, Vision and Hearing product at disclosure.manhattanlife.com . Please review this information before applying for coverage. The amounts of benefits provided depend on the plan selected. Premiums will vary according to the selection made.

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