Hughston MetLife Plan Materials

METLIFE Dental, Vision, Life and Disability

TABLE OF CONTENTS

MetLife

Dental Plan Summary

Find a Dental Provider

Dental Flyers

Vision Plan Summary

Basic Life and AD&D Plan Summary

Supplemental Term Life Summary

Life Insurance Flyers

Long-Term Disability Plan Summary

Long-Term Disability Flyers

Employee Assistance Program

Dental

Metropolitan Life Insurance Company

Plan Design for: Hughston Medical Management Group Original Plan Effective Date: January 1, 2023 Network: PDP Plus

The Preferred Dentist Program was designed to help you get the dental care you need and help lower your costs. You get benefits for a wide range of covered services — both in and out of the network. The goal is to deliver cost-effective protection for a healthier smile and a healthier you.

In-Network 1

Out-of-Network 1

High Plan

In-Network % of Negotiated Fee 2

Out-of-Network 1 % of R&C Fee 4

Coverage Type:

Type A - Preventive

100%

Type B - Basic Restorative Type C - Major Restorative

80%

50%

Type D – Orthodontia

50%

Deductible 3 Individual

$50

Family

3 Individual Deductibles

Annual Maximum Benefit: Per Individual

$3000

Ortho applies to Child Only Up to dependent age limit

Orthodontia Lifetime Maximum

$1500 per Person

Dependent Age:

Eligible for benefits until the end of the month that he or she turns 26. Low Plan

In-Network % of Negotiated Fee 2

Out-of-Network 1 % of R&C Fee 4

Coverage Type:

Type A - Preventive

100%

Type B - Basic Restorative Type C - Major Restorative

80%

Type D – Orthodontia

Deductible 3 Individual

$50

Family

3 Individual Deductibles

Annual Maximum Benefit: Per Individual

$1500

Dependent Age: Eligible for benefits until the day that he or she turns 26. 1 . "In-Network Benefits" means benefits provided under this plan for covered dental services that are provided by a MetLife PDP dentist. "Out-of-Network Benefits" means benefits provided under this plan for covered dental services that are not provided by a MetLife PDP dentist. Utilizing an out-of-network dentist for care may cost you more than using an in-network dentist. 2 . Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.

High Plan 3. Applies to Type B and C services only. 4. Out-of-network benefits are payable for services rendered by a dentist who is not a participating provider. The Reasonable and Customary

DN-GCERT-GOLD Multioption Dental Benefit Summary

charge is based on the lowest of: •

the dentist’s actual charge (the 'Actual Charge'),

• the dentist’s usual charge for the same or similar services (the 'Usual Charge') or • the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife (the 'Customary Charge'). For your plan, the Customary Charge is based on the 90th percentile. Services must be necessary in terms of generally accepted dental standards. Low Plan 3. Applies to Type B and C services only. 4. Out-of-network benefits are payable for services rendered by a dentist who is not a participating provider. The Reasonable and Customary charge is based on the lowest of: • the dentist’s actual charge (the 'Actual Charge'), • the dentist’s usual charge for the same or similar services (the 'Usual Charge') or • the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife (the 'Customary Charge'). For your plan, the Customary Charge is based on the 90th percentile. Services must be necessary in terms of generally accepted dental standards.

DN-GCERT-GOLD Multioption Dental Benefit Summary

Understanding Your Dental Benefits Plan

The Preferred Dentist Program is designed to provide the dental coverage you need with the features you want. Like the freedom to visit the dentist of your choice – in or out of the network. .

If you receive in-network services, you will be responsible for any applicable deductibles, cost sharing, negotiated charges after benefit maximums are met, and costs for non-covered services. If you receive out-of-network services, you will be responsible for any applicable deductibles, cost sharing, charges in excess of the benefit maximum, charges in excess of the negotiated fee schedule amount or R&C Fee, and charges for non-covered services.

Once you’re enrolled you may take advantage of online self-service capabilities with MyBenefits. • Check the status of your claims • Locate a participating dentist • Access MetLife’s Oral Health Library • Elect to view your Explanation of Benefits online To register, just go to www.metlife.com/mybenefits and follow the easy registration instructions.

• Plan benefits for in-network covered services are based on a percentage of the Negotiated fee – the Fee that participating dentists have agreed to accept as payment in full for covered services, subject to any deductibles, copayments, cost sharing and benefit maximums. Negotiated fees are subject to change. • Plan benefits for out-of-network services are based on a percentage of the Reasonable and Customary (R&C) charge. If you choose a dentist who does not participate in the network, your out-of-pocket expenses may be greater.

DN-GCERT-GOLD Multioption Dental Benefit Summary

IMPORTANT ENROLLMENT INFORMATION

You may only enroll for Dental Expense Benefits within 31 days of your Personal Benefits Eligibility Date, or if you have a Qualifying Event or during the Plan's Annual Open Enrollment Period.

Qualifying Event: Request to be covered, or to change your coverage, upon a Qualifying Event If there is a Qualifying Event you may request to be covered, or to change your coverage, for Personal Dental Expense Benefits only within 31 days of a Qualifying Event. Such a request will not be a late request. Except for marriage or the birth or adoption of a child, you must give us proof of prior dental coverage under your spouse's plan if you are requesting coverage under This Plan because of a loss of the prior dental coverage. If you make a request to be covered for Personal Dental Expense Benefits or a request for change(s)in Personal Dental Expense Benefits within thirty-one days of a Qualifying Event, your Personal Dental Expense Benefits or the change(s) in Personal Dental Expense Benefits will become effective on the first day of the month following the date of your request, subject to the Active Work Requirement, and provided that the change in coverage is consistent with your new family status.

DN-GCERT-GOLD Multioption Dental Benefit Summary

Selected Covered Services and Frequency Limitations*

High Plan

How Many/How Often:

Type A - Preventive

Oral Examinations Full Mouth X-rays

2 in a year

1 in 36 months 1 in 12 months

Bitewing X-rays (Adult/Child)

Prophylaxis - Cleanings

2 in a year

Topical Fluoride Applications

1 in 12 months - Children to age 19

Type B - Basic Restorative

How Many/How Often:

Sealants Space Maintainers Amalgam and Composite Fillings Endodontics Root Canal Periodontal Surgery Periodontal Scaling & Root Planing Periodontal Maintenance Oral Surgery (Simple Extractions) Oral Surgery (Surgical Extractions) Other Oral Surgery Emergency Palliative Treatment General Anesthesia

1 in 36 months - Children to age 16 1 per lifetime per tooth area - Children up to age 19 1 in 24 months. 1 per tooth per lifetime

1 in 36 months per quadrant 1 in 36 months per quadrant 2 in 1 year, includes 2 cleanings

Type C - Major Restorative

How Many/How Often:

Crowns/Inlays/Onlays Prefabricated Crowns

1 per tooth in 84 months 1 per tooth in 60 months

Repairs Bridges Dentures

1 in 12 months 1 in 84 months 1 in 84 months 1 in 12 months

Consultations

Implant Services

1 service per tooth in 84 months - 1 repair per 84 months

TMJ

Major Service as part of Annual Maximum.

Type D – Orthodontia • Dependent children up to age 26. Age limitations may vary by state. Please see your Plan description for complete details. In the event of a conflict with this summary, the terms of the certificate will govern. • All dental procedures performed in connection with orthodontic treatment are payable as Orthodontia. • Benefits for the initial placement will not exceed 20% of the Lifetime Maximum Benefit Amount for Orthodontia. Periodic follow-up visits will be payable on a monthly basis during the scheduled course of the orthodontic treatment. Allowable expenses for the initial placement, periodic follow-up visits and procedures performed in connection with the orthodontic treatment, are all subject to the Orthodontia coinsurance level and Lifetime Maximum Benefit Amount as defined in the Plan Summary. • Orthodontic benefits end at cancellation of coverage *Alternate Benefits: Where two or more professionally acceptable dental treatments for a dental condition exist, reimbursement is based on the least costly treatment alternative. If you and your dentist have agreed on a treatment that is more costly than the treatment upon which the plan benefit is based, you will be responsible for any additional payment responsibility. To avoid any misunderstandings, we suggest you discuss treatment options with your dentist before services are rendered, and obtain a pretreatment estimate of benefits prior to receiving certain high cost services such as crowns, bridges or dentures. You and your dentist will each receive an Explanation of Benefits (EOB) outlining the services provided, your plan’s reimbursement for those services, and your out-of-pocket expense. Actual payments may vary from the pretreatment estimate depending upon annual maximums, plan frequency limits, deductibles and other limits applicable at time of payment. The service categories and plan limitations shown above represent an overview of your Plan of Benefits. This document presents many services within each category, but is not a complete description of the Plan. Please see your Plan description/Insurance certificate for complete details. In the event of a conflict with this summary, the terms of your insurance certificate will govern.

DN-GCERT-GOLD Multioption Dental Benefit Summary

Selected Covered Services and Frequency Limitations*

Low Plan

How Many/How Often:

Type A - Preventive

Oral Examinations Full Mouth X-rays

2 in a year

1 in 36 months 1 in 12 months

Bitewing X-rays (Adult/Child)

Prophylaxis - Cleanings

2 in a year

Topical Fluoride Applications

1 in 12 months - Children to age 19

Type B - Basic Restorative

How Many/How Often:

1 in 36 months - Children to age 16 1 per lifetime per tooth area - Children up to age 19 1 in 24 months. 1 per tooth per lifetime

1 in 36 months per quadrant 1 in 36 months per quadrant 2 in 1 year, includes 2 cleanings

Type C - Major Restorative

How Many/How Often:

TYPE C SERVICES ARE NOT COVERED WITH THIS COVERAGE TYPE.

*Alternate Benefits: Where two or more professionally acceptable dental treatments for a dental condition exist, reimbursement is based on the least costly treatment alternative. If you and your dentist have agreed on a treatment that is more costly than the treatment upon which the plan benefit is based, you will be responsible for any additional payment responsibility. To avoid any misunderstandings, we suggest you discuss treatment options with your dentist before services are rendered, and obtain a pretreatment estimate of benefits prior to receiving certain high cost services such as crowns, bridges or dentures. You and your dentist will each receive an Explanation of Benefits (EOB) outlining the services provided, your plan’s reimbursement for those services, and your out-of-pocket expense. Actual payments may vary from the pretreatment estimate depending upon annual maximums, plan frequency limits, deductibles and other limits applicable at time of payment. The service categories and plan limitations shown above represent an overview of your Plan of Benefits. This document presents many services within each category, but is not a complete description of the Plan. Please see your Plan description/Insurance certificate for complete details. In the event of a conflict with this summary, the terms of your insurance certificate will govern.

DN-GCERT-GOLD Multioption Dental Benefit Summary

We will not pay Dental Insurance benefits for charges incurred for:

1. Services which are not Dentally Necessary, those which do not meet generally accepted standards of care for treating the particular dental condition, or which We deem experimental in nature; 2. Services for which You would not be required to pay in the absence of Dental Insurance; 3. Services or supplies received by You or Your Dependent before the Dental Insurance starts for that person; 4. Services which are primarily cosmetic (For residents of Texas, see notice page section in your certificate). 5. Services which are neither performed nor prescribed by a Dentist except for those services of a licensed dental hygienist which are supervised and billed by a Dentist and which are for: • scaling and polishing of teeth; or • fluoride treatments. For NY Sitused Groups, this exclusion does not apply.

6. Services or appliances which restore or alter occlusion or vertical dimension. 7. Restoration of tooth structure damaged by attrition, abrasion or erosion. 8. Restorations or appliances used for the purpose of periodontal splinting. 9. Counseling or instruction about oral hygiene, plaque control, nutrition and tobacco.

10. Personal supplies or devices including, but not limited to: water piks, toothbrushes, or dental floss. 11. Decoration, personalization or inscription of any tooth, device, appliance, crown or other dental work. 12. Missed appointments. 13. Services • covered under any workers’ compensation or occupational disease law; • covered under any employer liability law; • for which the employer of the person receiving such services is not required to pay; or • received at a facility maintained by the Employer, labor union, mutual benefit association, or VA hospital. For North Carolina and Virginia Sitused Groups, this exclusion does not apply. 14. Services paid under any worker’s compensation, occupational disease or employer liability law as follows: • for persons who are covered in North Carolina for the treatment of an Occupational Injury or Sickness which are paid under the North Carolina Workers’ Compensation Act only to the extent such services are the liability of the employee, employer or workers’ compensation insurance carrier according to a final adjudication under the North Carolina Workers’ Compensation Act or an order of the North Carolina Industrial Commission approving a settlement agreement under the North Carolina Workers’ compensation Act; • or for persons who are not covered in North Carolina, services paid or payable under any workers compensation or occupational disease law. This exclusion only applies for North Carolina Sitused Groups. 15. Services: • for which the employer of the person receiving such services is required to pay; or • received at a facility maintained by the Employer, labor union, mutual benefit association, or VA hospital. This exclusion only applies for North Carolina Sitused Groups. 16. Services covered under any workers' compensation, occupational disease or employer liability law for which the employee/or Dependent received benefits under that law. This exclusion only applies for Virginia Sitused Groups. 17. Services: • for which the employer of the person receiving such services is not required to pay; or • received at a facility maintained by the policyholder, labor union, mutual benefit association, or VA hospital. This exclusion only applies for Virginia Sitused Groups. 18. Services covered under other coverage provided by the Employer.

19. Temporary or provisional restorations. 20. Temporary or provisional appliances. 21. Prescription drugs. 22. Services for which the submitted documentation indicates a poor prognosis. 23. The following when charged by the Dentist on a separate basis: • claim form completion; • infection control such as gloves, masks, and sterilization of supplies; or •

local anesthesia, non-intravenous conscious sedation or analgesia such as nitrous oxide. 24. Dental services arising out of accidental injury to the teeth and supporting structures, except for injuries to the teeth due to chewing or biting of food. For NY Sitused Groups, this exclusion does not apply. 25. Caries susceptibility tests. 26. Other fixed Denture prosthetic services not described elsewhere in this certificate.

27. Precision attachments, except when the precision attachment is related to implant prosthetics. 28. Adjustment of a Denture made within 6 months after installation by the same Dentist who installed it. 29. Fixed and removable appliances for correction of harmful habits. 1

30. Appliances or treatment for bruxism (grinding teeth), including but not limited to occlusal guards and night guards. 1 31. Diagnosis and treatment of temporomandibular joint ( TMJ ) disorders. This exclusion does not apply to residents of Minnesota. 1 32. Orthodontic services or appliances. 1 33. Repair or replacement of an orthodontic device. 1 34. Duplicate prosthetic devices or appliances.

DN-GCERT-GOLD Multioption Dental Benefit Summary

35. Replacement of a lost or stolen appliance, Cast Restoration, or Denture. 36. Intra and extraoral photographic images.

37. Services or supplies furnished as a result of a referral prohibited by Section 1-302 of the Maryland Health Occupations Article. A prohibited referral is one in which a Health Care Practitioner refers You to a Health Care Entity in which the Health Care Practitioner or Health Care Practitioner’s immediate family or both own a Beneficial Interest or have a Compensation Agreement. For the purposes of this exclusion, the terms “Referral”, “Health Care Practitioner” , “Health Care Entity”, “Beneficial Interest” and Compensation Agreement have the same meaning as provided in Section 1-301 of the Maryland Health Occupations Article. This exclusion only applies for Maryland Sitused Groups

1 Some of these exclusions may not apply. Please see your Certificate of Insurance.

DN-GCERT-GOLD Multioption Dental Benefit Summary

Common Questions … Important Answers

Who is a participating dentist? A participating, or network, dentist is a general dentist or specialist who has agreed to accept negotiated fees as payment in full for covered services provided to plan members, subject to any deductibles, copayments, cost sharing and benefit maximums. Negotiated fees typically range from 30-45% below the average fees charged in a dentist’s community for the same or substantially similar services.* In addition to the standard MetLife network, your employer may provide you with access to a select network of dental providers that may be unique to your employer’s dental program. When visiting these providers, you may receive a better benefit, have lower out-of-pocket costs and/or have access to care at facilities at your worksite. Please sign into MyBenefits for more details.

* Based on internal analysis by MetLife. Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. Savings from enrolling in a dental benefits plan will depend on various factors, including the cost of the plan, how often members visit a dentist and the cost of services rendered. Negotiated fees are subject to change.

How do I find a participating dentist? There are thousands of general dentists and specialists to choose from nationwide --so you are sure to find one that meets your needs. You can receive a list of these participating dentists online at www.metlife.com/dental or call 1-800-275-4638 to have a list faxed or mailed to you.

What services are covered by my plan? Please see your Certificate of Insurance for a list of covered services.

May I choose a non-participating dentist? Yes. You are always free to select the dentist of your choice. However, if you choose a non-participating (out-of-network) dentist, your out-of-pocket costs may be greater than your out-of-pocket costs when visiting an in-network dentist. Can my dentist apply for participation in the network? Yes. If your current dentist does not participate in the network and you would like to encourage him or her to apply, ask your dentist to visit www.metdental.com, or call 1-866-PDP-NTWK for an application.* The website and phone number are for use by dental professionals only.

* Due to contractual requirements, MetLife is prevented from soliciting certain providers.

How are claims processed? Dentists may submit your claims for you which means you have little or no paperwork. You can track your claims online and even receive email alerts when a claim has been processed. If you need a claim form, visit www.metlife.com/dental or request one by calling 1-800-275-4638. Can I get an estimate of what my out-of-pocket expenses will be before receiving a service? Yes. You can ask for a pretreatment estimate. Your general dentist or specialist usually sends MetLife a plan for your care and requests an estimate of benefits. The estimate helps you prepare for the cost of dental services. We recommend that you request a pre-treatment estimate for services in excess of $300. Simply have your dentist submit a request online at www.metdental.com or call 1-877-MET-DDS9. You and your dentist will receive a benefit estimate for most procedures while you are still in the office. Actual payments may vary depending upon plan maximums, deductibles, frequency limits and other conditions at time of payment. Can MetLife help me find a dentist outside of the U.S. if I am traveling? Yes. Through international dental travel assistance services* you can obtain a referral to a local dentist by calling +1-312-356-5970 (collect) when outside the U.S. to receive immediate care until you can see your dentist. Coverage will be considered under your out-of-network benefits.** Please remember to hold on to all receipts to submit a dental claim. * International Dental Travel Assistance services are administered by AXA Assistance USA, Inc. (AXA Assistance). AXA Assistance provides dental referral services only. AXA Assistance is not affiliated with MetLife and any of its affiliates, and the services they provide are separate and apart from the benefits provided by MetLife. Referral services are not available in all locations. ** Refer to your Certificate of Insurance for your out-of-network dental coverage.

DN-GCERT-GOLD Multioption Dental Benefit Summary

How does MetLife coordinate benefits with other insurance plans? Coordination of benefits provisions in dental benefits plans are a set of rules that are followed when a patient is covered by more than one dental benefits plan. These rules determine the order in which the plans will pay benefits. If the MetLife dental benefit plan is primary, MetLife will pay the full amount of benefits that would normally be available under the plan. If the MetLife dental benefit plan is secondary, most coordination of benefits provisions require MetLife to determine benefits after benefits have been determined under the primary plan. The amount of benefits payable by MetLife may be reduced due to the benefits paid under the primary plan. Do I need an ID card? No, You do not need to present an ID card to confirm that you are eligible. You should notify your dentist that you are enrolled in a MetLife Dental Plan. Your dentist can easily verify information about your coverage through a toll-free automated Computer Voice Response system.

Do my dependents have to visit the same dentist that I select? No. You and your dependents each have the freedom to choose any dentist.

DN-GCERT-GOLD Multioption Dental Benefit Summary

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Dental Insurance

Find a Dental Provider With MetLife Dental insurance, you can choose from thousands of general dentists and specialists nationwide. You can find the names, addresses, languages spoken and phone numbers of participating dentists by searching our online Find a Dentist directory.

Step 1: Go to metlife.com

Step 2: Select “Find a Dentist” next to "What would you like to do today ?"

Step 3: Select "PDP/ PDP Plus" next to "Choose your network." Enter your Zip, City or State and select the “Find a Dentist” button.

Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact MetLife or your plan administrator for complete details.

Dental Insurance

Discover dental coverage that keeps you smiling bright

Why Dental Insurance Makes Sense

Please see your Plan Summary for more information. Enroll in Dental Insurance during annual enrollment.

Dental problems can be unpredictable and expensive. For example, did you know that a crown can cost up to $1,454? 1 With MetLife Dental Insurance, you can reduce your out-of-pocket expenses and maintain your smile with preventive care. Dental insurance not only helps you pay for your dental care, it can also help prevent costly problems in the future. When your preventive care is covered, you’re more likely to go for cleanings and checkups — this can help you avoid problems before they become too costly or complicated.

How it works:

How it works: While eating dinner, Kathy bit down and broke her crown. A crown in Kathy’s area is about $1,454 . 1 Since Kathy’s participating dentist agreed to charge $895 for covered MetLife enrollees, and her plan covers 50% for this procedure, Kathy’s out-of-pocket costs are only $447.50 . That’s a savings of $1,006 ! By using a participating dentist, Kathy maximized her benefits and paid less than a quarter of the typical cost. 2

Why should I enroll?

Competitive group rates

•

Easy payroll deduction

•

Value-added services at no additional cost to you Choose from 490,000+ in-network dentist locations nationwide 3

•

$1,454

Dentists’ usual fee 1

•

$895

Charge by MetLife participating dentist

$447.50 Kathy out-of-pocket costs

ADF#D3061.23

Why MetLife Dental Insurance is the right fit for you.

Visits to the dentist can be expensive. From preventive care to major services, Dental Insurance is a smart way to protect your smile and wallet.

Extensive provider network The MetLife dental network includes over 150,000 licensed dentists in more than 490,000 locations nationwide. 3

Know what your plan covers:

Flexibility to see any dentist Our plans give you the flexibility to visit providers in or out-of-network.

Preventive care* Cleanings and exams

Basic care X-rays and fillings

Cost savings As a MetLife member, take advantage of savings up to 35-50% on dentist list prices. 5

Major care Crowns and root canals

*Subject to frequency limits.

Savings 6 to sink your teeth into.

Although costs vary based on a variety of factors, the right coverage can help you manage dental expenses for your whole family. Please see your Plan Summary for more information .

Offset the gaps in your healthcare coverage with MetLife Dental Insurance.

Dental Insurance offers coverage that helps with dental expenses that may not be covered under your medical plan. It can protect your health, smile and family budget.

Product overview

Helps pay for routine cleanings and exams and reduces costs for X-rays and fillings. Plus, it helps lower your out-of-pocket costs for unexpected dental care such as crowns and root canals.

Why needed

Choose which plan best suits you and your family.

Who is covered

Different plans pay different percentages for these services: 7 • Cleanings, x-rays and exams • Fillings and extractions • Bridges, crowns and dentures

Covered services

Please see your Plan Summary for details.

• Choose from over 150,000 licensed dentists in more than 490,000 locations nationwide 3 online at metlife.com. • Select any general dentist or specialist. However, you usually save more with a participating dentist. He/she has agreed to accept negotiated fees as payment in full for covered services. • Your dentist can request a pre-treatment estimate for any service that is more than $300 to help you manage your costs and care. 8 Check your personalized rates based on your zip code using our Dental Cost Estimator 9 • In-network discounts apply even after you reach your plan’s annual maximum, reducing your out-of-pocket expense. • You can also save on vision care with MetLife VisionAccess . 10 This discount plan offers you savings on eye care for the whole family.

Additional value

Discover the benefits of MetLife Dental

Did you know MetLife Dental benefits come with extras designed to help you get even more value out of your employer-sponsored benefits? Brush up on the added benefits listed below that are included when you enroll in MetLife Dental.

Digital servicing capabilities make dental care easy

MetLife’s mobile app 11 puts your ID card, plan details, and claim information at your fingertips. For added convenience, it also includes features like:

• A Find a Dentist tool with easy access to provider ratings • Online appointment scheduling for select dentists • Convenient claim status notifications via text messaging

Our digital tools available on MyBenefits also include:

• Access to a Dental Cost Estimator 9 so you can view personalized, plan-specific, and ZIP code- based cost estimates for most common procedures – as well as the deductibles, plan maximums, and frequency limitations that apply. • A digital virtual assistant that’s available 24/7 to help you with common tasks like accessing coverage information, getting personalized estimates, or viewing claims.

Dental benefits go with you as you travel

Our International Dental Travel Assistance program provides international assistance tied to your out-of-network benefits, including: • 24/7 help in multiple languages • Access to dental providers (based on strict credentialing criteria) in approximately 200 countries • Toll-free calling within the U.S. or collect calling outside the U.S.

SmileDirectClub discounts make you smile

MetLife Dental benefits include valuable discounts on SmileDirectClub’s customized clear aligners, whether your plan includes orthodontia coverage or not. Plus, all SmileDirectClub dentists are part of MetLife’s Dental provider network.

Multi-language health history forms enhance communications

Our health history forms, which are available in nearly 40 languages, are designed to help dentists better communicate with non-English speaking patients.

Teledentistry options offer added convenience

MetLife Dental provides teledentistry options, so you’re able to connect with your dentist from home via smartphone, tablet, or computer for problem-focused exams and reevaluations.

An Oral Health Library provides the information you need

MetLife’s Oral Health Library – oralfitnesslibrary.com – offers unlimited online access to articles and videos on a wide range of helpful dental-related topics.

Frequently Asked Questions

What types of services does the plan cover? A. A number of dental procedures, including: 7

Your benefit in action Take advantage of how simple and easy it is to use Dental Insurance: Premiums will be conveniently paid through payroll deduction, so you don’t have to worry about writing a check or missing a payment.

• Exams and cleanings • X-rays • Fillings • Root canals • And much more How does the plan save me money?

A. Premiums will be conveniently paid through payroll deductions, so you don’t have to worry about writing a check or missing a payment. Who can enroll in the plan? A. You and your eligible family members. For example, your spouse and dependents. How are claims processed? A. Dentists may submit claims for you, which means you have little or no paperwork. You can track your claims online and even receive email alerts when a claim has been processed. If you need a claim form, visit metlife.com/mybenefits or call 1-800-GET-MET8. How can I access my account? A. Go to metlife.com/mybenefits or download the MetLife Mobile App 11 on the App Store and Google Play. You can find a dentist, view your claims, access your ID card, and more.

Dentists may submit claims for you, which means you have little or no paperwork. Track claims online and even receive email alerts once claim has been processed. Find claim forms at metlife.com/mybenefits or call 1-800-GET-MET8.

Do I need an ID card to schedule an appointment?

A. No, you do not need an ID card to schedule an appointment, but you will need your SSN or EE ID.*

*There are two states that require ID cards per legislation, Georgia & New Hampshire.

MetLife’s Mobile App 11 is available on the App Store and Google Play. Scan the QR code to access the Mobile App or visit metlife.com/dental. Enter your ZIP code and select the PDP Plus network.

Enroll in Dental Insurance during annual enrollment .

Please see your Plan Summary for more information.

1. Based on 2023 MetLife data for a crown (D2740) in ZIP code 06340. This cost reflects the 80th percentile Reasonable and Customary (R&C) fee. R&C fees are calculated based on the lowest of 1) the dentist’s actual charge, 2) the dentist’s usual charge for the same or similar services or 3) the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife. This example is used for informational purposes only. Fees in your area may be different. 2. This is an example and is for illustrative purposes only. 3. Based on MetLife internal contracting system analysis as of January 2023. 4. Preventive services are subject to frequency limitations. Please see your certificate for more details. 5. Based on MetLife Data. Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services rendered by them, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. 6. Savings from enrolling in a dental benefits plan will depend on various factors, including plan design and premiums, how often participants visit the dentist and the cost of services rendered. 7. Those services defined under your dental benefits summary are covered. Please review your plan benefits summary for a more detailed list of covered services. 8. MetLife strongly recommends that you have your dentist submit a pretreatment estimate to MetLife if the cost is expected to exceed $300. When your dentist suggests treatment, have him or her send a claim form, along with the proposed treatment plans and supporting documentation to MetLife. An explanation of benefits (EOB) will be sent to you and the dentist detailing an estimate of what services MetLife will cover and at what payment level. Actual payments may vary from the pretreatment estimate depending upon annual maximums, deductibles, plan frequency limits and other plan provisions at time of payment. 9. This tool does not provide the payment information used by MetLife when processing your claims. Prior to receiving services, pretreatment estimates through your dentist will provide the most accurate fee and payment information. 10. MetLife VisionAccess is a discount program and not an insured benefit. It is provided through Vision Service Plan (VSP), Rancho Cordova, CA. VSP is not affiliated with Metropolitan Life Insurance Company or its affiliates. Availability of MetLife VisionAccess is not contingent upon the purchase of dental insurance. 11. To use the MetLife mobile app, employees can choose to register at metlife.com/mybenefits from a computer or directly through the app. Certain features of MetLife Mobile App are not available for MetLife Dental Plans. Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact MetLife or your plan administrator for complete details.

ADF#D3061.23

Dental Insurance

Understanding Your Oral Health

Your smile is worth a thousand words and keeping it healthy is worth even more.

Why is preventive dental care important? • Brushing, flossing, eating a healthy diet, and seeing your dentist regularly helps to avoid dental disease. • Routine exams and cleanings can prevent the additional cost associated with fillings, root canals, extractions, etc. Best practices for routine dental care from the American Dental Association 1 • Brush your teeth twice a day with an ADA accepted fluoride toothpaste. • Replace your toothbrush every three or four months. • Clean between teeth daily with floss or an interdental cleaner. • Eat a balanced diet, and limit soft drinks and between-meal snacks.

Did you know? • Tobacco use causes an increased level of calculus (hardened plaque) to form on teeth, which can lead to tooth decay and gum disease. 2 • Studies suggest that a diet low in fruits and vegetables may be linked to an increased risk of cancers of the oral cavity. 3 • Pregnancy can increase the risk of oral health problems like cavities and gum disease. Seeing your dentist during pregnancy for a routine checkup is important for your dental health. 4

For more information and tools, visit MetLife's Oral Health Library at oralfitnesslibrary.com

Enroll in MetLife Dental Insurance during annual enrollment.

1. American Dental Association. “Brushing Your Teeth”, http://www.mouthhealthy.org/en/az-topics/b/brushing-your-teeth. 2. Gum disease risk factors. American Academy of Periodontology website. http://www.perio.org/consumer/risk-factors. 3. American Cancer Society, “Risk Factors for Oral Cavity and Oropharyngeal Cancers”, https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/causes-risks- prevention/risk-factors.htm. 4. Centers for Disease Control and Prevention, “Pregnancy and Oral Health”, https://www.cdc.gov/oralhealth/publications/features/pregnancy-and-oral-health.html. Accessed May 2022. Like most group benefit programs, group benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, limitations, waiting periods, reductions and terms keeping them in force. Ask your MetLife group representative for details. This information is intended for your general knowledge only and is not a substitute for obtaining medical or dental advice for specific medical or dental conditions or other advice from your dentists or doctors. By making this information available to you, Metropolitan Life Insurance Company and its affiliates (collectively, “MetLife”) is not engaged in rendering any such advice. Insofar as the information provided is from third parties, it has no association whatsoever with MetLife, unless expressly stated.

PRODUCT OVERVIEW

Dental Insurance

Why is having a good dental plan so important?

Because a healthier smile can be important to maintaining overall health.

Enroll today!

Maintaining good oral health matters. When your preventive care is covered, you’re more likely to go for cleanings and checkups — this can help you avoid problems before they become too costly or complicated. Plus, going to the dentist regularly can help prevent problems that have been linked to diabetes or heart disease. 1 That’s where a good dental plan comes in. The right coverage makes it easier to visit the dentist and helps lower your costs. You get support to keep up with dental cleanings and other preventive care that helps you avoid costly problems and live healthier. Now that’s something to smile about.

[For questions, please call MetLife at [1 800 GET-MET8] [1 800 438-6388]

Why should I enroll now?

You’re more likely to visit the dentist when you have dental coverage.

• Help protect your

smile and your wallet. You and your family can get the dental care you need in the

While costs will vary based on where you live, with a dental plan, you get protection against costs for unexpected dental care with low to no costs for preventive care.

coming year, and save money too. 3

See how much you could save in a single year when visiting a participating dentist 3 .

Keep in mind this is only an illustration. Your costs and savings 3 could vary based on your plan design, where you live, and whether your plan requires a copayment or coinsurance. Please see your Plan Summary for details about your specific coverage.

ADF# D1545.17

Dental Insurance

Service

Dentist’s usual fee

Negotiated fee

Percent covered

MetLife pays

Your cost

You save 2, 3

Exam

$104.02

$55

100% $55

$104.02

X-rays

$142.76

$74

100% $74

$142.76

Filling

$175.52

$82

80% $65.60

$16.40

$159.12

Root Canal

$850.69

$401

80% $320.80 $80.20

$770.49

Crown

$1,364.52 $694

50% $347

$347

$1,017.52

How can having MetLife Dental Insurance benefit you?

By making it easier to get the care you need and lower your out-of-pocket costs.

For added convenience, MetLife’s Mobile App 7 is now available on the iTunes ® App Store and Google Play.

Freedom of choice MetLife’s Preferred Dentist Program is a dental PPO plan. You can visit any licensed dentist, in or out of the network, and receive benefits. • If you go to a participating dentist, you can count on the PDP Plus network. All participating dentists must meet rigorous selection standards. 4

After downloading this app, 7 you can:

• Find a participating dentist today at www.metlife.com

• Find a dentist and view their ratings where available

Lower costs • Take advantage of negotiated fees that are typically 30 – 45% less than the average charges in the same area. 5 • Participating dentists accept these fees as payment in full for covered services. Less worry, less paperwork and more service • Easy access to pre-treatment estimates, 6 real-time claims processing and 24-hour customer service by phone, fax or online.

• Access your plan

summary, with quick links to important information on deductibles, plan maximums, and covered services

• Educational tools and resources help you and your dentist make more informed decisions

• Access the Dental Cost Estimator

1. Dentists: Doctors of Oral Health , American Dental Association, Chicago, IL. http://www.ada.org/en/about-the-ada/dentists- doctors-of-oral-health. Accessed February 1, 2021. 2. These hypothetical in-network savings examples are based on average charges in the Philadelphia area (three-digit ZIP 191), for procedure codes D1110, D0210, D2391, D3310 and D2740. 3. Savings from enrolling in a dental benefits plan will depend on various factors, including plan design and premiums, how often participants visit the dentist and the cost of services rendered. 4. Certain providers may participate with MetLife through an agreement that MetLife has with a vendor. Providers available through a vendor are subject to the vendor’s credentialing process and requirements, not MetLife’s. 5. Based on internal analysis by MetLife. Negotiated fees refers to the fees that in-network dentists have agreed to accept as payment in full for covered services, subject to any co-payments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. 6. A pre-treatment estimate is only an estimate. The actual amount that MetLife will pay is determined when a claim is submitted, and is subject to any co-payments, deductibles, cost sharing and benefits maximums.

• View your claims

• View, download, and save your ID card

• Online appointment booking

7. The features of the MetLife Dental Mobile App are not available for all MetLife dental plans.

Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, limitations, reductions, waiting periods and terms for keeping them in force. Please contact MetLife or your plan administrator for costs and complete details. 8. To use the MetLife mobile app, employees can choose to register at metlife.com/mybenefits from a computer or directly through the app.

Group dental insurance policies featuring the Preferred Dentist Program are underwritten by Metropolitan Life Insurance Company, New York, NY 10166.

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