Dental, Vision & Hearing Select

Underwritten by: ManhattanLife Insurance and Annuity Company Administrative Office: 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 . 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. Policy Form Numbers: AK7034 (including state variations) Rider Form Numbers: AK7034HR, AK7034VR (including state variations)

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