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The information below explains certain terms to make it easier f or you to understand and use yourbenefits.1. Coverage Typ es. Dent alprocedures are grouped intothe following categori es:Preventive(Type A), Basic Restorative (Type B),Major Restorative (Type C), andOrthodontia (Type D). Your group’splan det ermines how eachprocedure is categorized (Type A, B,C, D). Generally, benefits f or Type Aprocedures pay at the highestbenefits lev el because they preventand diagnose dental disease.2. Co-insurance. The co-insurancepercentage helps determine whatyour o ut-of -pocket costs will be f or each coverage type. Each Type A, B, C, and D has a pre-setpercentage that represents what your plan will reimburse for the serv ices in each category. Your totalout-of-pocket responsibility is subject to any d deductibles, benefit maximums, plan provisions, ifyou receive out-of-network serv ices, and your plan’s basis f or reimbursement. Please see your DentalPlan Benefits Summary f or more information. Copay. This is the f ix ed amount that you have to pay f orcovered services. Copayment amounts are listed in the Procedure Charge Schedule that yo u receivedwit h your Dental Benefits Plan Summary. Your total out-of-pocket responsibility is subject to anydeductibles, benefit maximums, plan provisions, if you receive out-of-network services, and yourplan’s basis f or reimbursement. Please see your Dental Plan Benefits Summary and ProcedureCharge Schedule f or more information.3. Deductible. This is the amount you must p ay out-of-pocket before benefit payments will be mad e b ythe plan. For most plans, the deductible amounts f or in-network services are less than the amount f orout-of-network services. Many plans d o not require that a deductible be met f or Typ e A serv ices.4. Annual Maximum Benefit. This is the total amount the plan will p ay in the plan year. Once t hisamount is reached, no further benefits wi ll be paid.5. Orthodontia Lifetime Maximum. Not all plans cover Orthodontia Treatment. If your plan coversOrthodontia there is a Lifetime Maximum that is applicable only to Orthodontia. This does no t affectyour Annual Maximum Benefit f or Typ es A, B, and C coverage. The Lif etime Maximum is the totalamount the pl an will p ay for orthodontic services f or each covered person (subject to any plan agelimitations). Once this amount is reached, no further benefits will be paid.6

Putting it all together – maximizing the value of your dental benefits. Make the most of your benefits — visit a participating dentist to reduce your out-of-pocket costs. Keep a healthy dental regimen by getting routine exams and cleanings – the cost ofpreventive services (Type A) is usually less than the cost for fillings, root canals,extractions, etc. – and can help to prevent the need f or these higher-cost treatments. It is recommended that you request a pre-treatment estimate f or services that cost more than 300.The estimate will give you an idea of what your out-of-pocket costs will be. To receivea benefit estimate, have your dentist submit a request online at www.metdent al.c om orby calling 1-877-MET- DDS9 (phone number and website f or dental professionalsonly). Visit the dental education website at www.oralf itnesslibrary.co m f or importanttools and resources to help you become more informed about dental care.Remember, dental coverage can be an important p art of protecting your health andfinances. By using the educational tools and benefits made available to you throught h i s p l a n , you’ll be better prepared to protect your oral health and your budget.1 Negotiated fees refers to th e fees th at in -netwo rk dentists have ag reed to accep t as p ayment in fullfor covered services, subject to an y co -p aym en ts, deductibles, cost sharin g an d ben efits maxi mums.Negotiated fees are subject to ch an g e. Th e R&C fee referenced in th e table in th e Out-o f-Networkcolumn refers to th e Reason able an d Custo mary charge, which is based o n th e lo west o f 1) th ed en tist’s actual ch arg e, 2) th e d en tist’s usual ch arg e fo r th e same o r similar services o r 3) th e usualch arg e o f mo st d en tists in th e same g eo g rap hic area fo r th e same o r similar services as d eterminedby MetLife.2 Savin g s from en ro llin g in a MetLife d en tal p lan featuring th e Preferred Den tist Pro g ram will d ep en d o n variousfacto rs, i nclud i ng th e cost o f th e p lan , h o w o ften p articip ants visit th e dentist an d th e cost o f servi ces rendered .3 Certain p ro viders may p articip ate with MetLife th ro ugh an ag reem en t th at MetLife h as with aven do r. Pro viders available th ro ugh a ven dor are subject to th e ven d o r’s cred en tialing p rocess an dreq uirements, n o t MetLife's. If yo u sho uld h ave an y q uestio ns, contact MetLife Custo mer Servi ce.4 With th e excep tio n of scheduled o r unsched uled systems main tenance o r interruption s, th eMyBen efits website is typ ically available 24 h o urs a d ay, 7 d ays a week.5 To use th e MetLife mo bile ap p , emp l o yees can ch oo se to reg ister at metlife.co m/mybenefits fro m aco mp uter o r d irectly th roug h th e ap p . Certain features o f MetLife US Mo bile Ap p are n o t available forso me MetLife Dental Plan s.Like mo st g ro up ben efits p rograms, ben efit programs o ffered by MetLife an d its affiliates co ntaincertain exclusions, excep tio ns, reductio ns, limitations, waiting p erio ds an d terms fo r keep i n g th em info rce. Please con tact MetLife o r yo ur p lan ad ministrator fo r co sts and comp lete d etail s.Metro p o litan Life In surance Com pany 200 Park Aven ue New Yo rk, NY 101661705 859144L0819517607[exp 0820][All States][DC,GU,MP,PR,VI ] 2019 MetLife Services an d So l utio ns, LLC7

PLAN SUMMARYDental InsuranceCoverage that helps makes it easier to visit a dentist and helps lower yourdental costs.Network: PDP PlusPlan option 1Gold PlanPlan option 2Silver PlanIn -Netwo rk % o fNegoti a ted Fee*Ou t-of-Netwo rk% o f Sch ed uledAmo un t**% o f R&CFee***In -Netwo rk % o fNegoti a ted Fee*Ou t-of-Netwo rk% o f Sch ed uledAmo un t**% o f 40%NANAIn d i vid ual 50 50 75 75Famil y 150 150 225 225 1,300 1,000 1,000 500 1,000 1,000NANACovera ge TypeType A: Prevent iv e(cl ean i n g s, exams, X-rays)Type B: Bas ic Res to rat iv e(fillin gs, extractio ns)Type C: Major Res torat iv e(bri d g es, d en tures)Type D: Orthodon ti aDeducti bl e †Annual Maximum Benefi tPer Perso nOrthodontiaLifetime M aximumPer Perso nChild (ren )’s eli gibility fo r dental coverag e is from birth up to ag e 26.*Negotiated Fee refers to the fees that participating dentists have ag reed to accept as payment in full for covered services, subject to any copayments, deductibles, cost sharing and benefitsmaximums. Negotiated fees are subject to change.**R ei m b u r s e m e n t for out- of - n et w o r k services is based on the lesser of the dentist’s actual fee or the Maximum Allowable Charg e (MAC). The out-of-network Maximum Allowable Charg e is ascheduled amount determined by MetLife.***R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist’s actual charge, (2) the dentist’s usual charge for the same or similarservices, or (3) the charge of most dentists in the same g eographic area for the same or similar services as determined by MetLife.†Applies to Type A, B and C Servi c e s. A p p li e s only to Type B & C Services.List of Primary Covered Service s & LimitationsTh e service catego ries an d plan limitations shown rep resent an overview o f your Plan Benefits. Th isdocument presen ts the majority of services with in each category, but is n o t a complete descrip tion o f th e Plan .Plan Option 1: Gold PlanHow Many/How OftenPlan Option 2: Silver PlanHow Many/How OftenPro p h ylaxis (cleanings)Two per calend ar yearTwo p er calendar yearOral Examin ationsTwo exams per calendar yearTwo exams per calendar yearPlan TypeType A — Preventive8

Dental InsuranceTopical Fluo ride ApplicationsOn e fluoride treatment p er calendaryear for d ep en d en t child ren up toh is/her 19th birth d ayOn e fluoride treatment per cal end aryear fo r dependent child ren up toh is/her 19th birth d ayBrush BiopsiesNo more than once in any 24 monthperiodNo more than once in any 24 monthperiodX-rays (Bitewing s)Bitewing X-rays; o n e set per calendaryearBitewing X-rays; o n e set per calendaryearSp ace Main tain ersSpace main tain ers fo r dependent child renup to h is/her 14th birth d aySpace maintainers fo r dependent child renup to h is/her 14th birth d ayFilli n gsUnlimited , but subject to the AnnualMaxi mumUnlimited , but subject to the AnnualMaxi mumSi mp le Extractio n sUnlimited , but subject to the AnnualMaxi mumUnlimited , but subject to the AnnualMaxi mumCro wn , Den ture an d Bri d g e Rep air/Recemen tatio n sUn limited , but subject to the AnnualMaxi mumUnlimited , but subject to the AnnualMaxi mumX-Rays (Full Mouth)Full Mouth X-Rays limited to o n e per 60month .Full Mouth X-Rays limited to o n e per 60month s. Peri o d o n tal scaling an d roo t planing Periodon tal scaling an d ro ot planing Total n umber o f periodontalType B — Bas ic Res to rat iv ePeriodo n ticsSealantsonce per quad ran t, every 24 monthsTotal n umber o f periodontalmai ntenance treatments an dprophylaxis cannot exceed fo urtreatments in a calendar year (4 p eriomai ntenance an d 0 clean in g , o r 3 p eriomai ntenance an d 1 clean in g o r 2 p eriomai ntenance an d 2 clean in g s, o r 1perio mai ntenance an d 3 clean in g s)once p er quadran t, every 24 monthsmai ntenance treatments andprophylaxis cannot exceed fo urtreatments in a calend ar year (4 p eriomaintenance an d 0 clean in g , o r 3 p eriomaintenance an d 1 clean in g o r 2 p eriomaintenance an d 2 clean in g s, o r 1perio maintenance an d 3 clean in g s)On e app lication o f sealant material o n cep er to o th p er lifetime o f a d ep en d en t ch ildup to h is/h er 19th birth d ayOn e ap p lication o f sealant material o n cep er to o th p er lifetime o f a d ep en d en t ch ildup to h is/h er 19th birth d ayRep lacement o n ce p er to o th every 10yearsRep lacement o n ce p er to o th every 10years Dentures limited to o n ce p er to o th p er Dentures limited to o n ce p er to o th p er10 years for p erso n s 13 years o f ag ean d o ld er10 years for perso n s 13 years o f ag ean d o ld er Brid g es limited to o n ce p er tooth p er 10 Brid g es limited to o n ce p er to o th p er 10years fo r perso n s 16 years o f ag e an dolderyears fo r perso n s 16 years o f ag e an dolderType C — Major Res to rati v eImp l antsBrid g es an d Den turesCro wn s, In lays an d On l aysLimited to o n ce per tooth p er 10 years fo rperso n s 13 years o f ag e an d o ld erLimited to o n ce per tooth p er 10 years forp erso n s 13 years o f ag e an d o ld erEn d o d o nticsRo o t can al treatment limited to o n ce p erto o th p er 24 mon th sRo o t canal treatment limited to once perto oth per 24 monthsGen eral An esth esi aWh en d entally necessary in connectionwith oral surg ery, extraction s o r othercovered dental servi cesWh en d entally necessary in connectionwith oral surg ery, extraction s o r othercovered dental servi cesM etropo li t a n Life Ins u ranc e Co mp a n y 200 Park Aven ue New Yo rk, NY 10166L0520003788[exp0521][xNM] 2020 MetLife Services and Solutions, LLCDN-ANY-PPO-DUAL9

Dental InsurancePerio d o n ticsPeriodon tal surgery once per quad ran t,every 36 monthsPeriodon tal surgery once per quad ran t,every 36 monthsOral Surg ery (Surg ical Extractio n s)Unlimited, but subject to the AnnualMaxi mumUnlimited, but subject to the AnnualMaxi mumType D — Orthodon ti a Yo ur ch ild ren , up to ag e 26, areco vered wh ile Dental insuran ce is ineffect. All dental proced ures performed inconnection with orthodontic treatmentare payable as Orthodontia Payments are o n a quaraterly basis Orth o do n tic benefits end at cancellati ono f coverage NAThe service categ ories and plan limitations shown above represent an overview of your plan benefits. This document presents the majority of serviceswithin each categ ory, but is not a complete description of the plan.Exclusio nsThis plan does not cover the following s services , treatments and supplies : Services wh ich are n o t Den tally Necessary, th o se wh ich d o n ot meet g enerrally accep ted sta n d ards o f care fo r treating th ep articular d en tal co n dition, o r wh ich we d eem exp erimen tal in n ature; Services fo r wh ich yo u wo uld n ot be req uired to p ay in th e absen ce o f Den tal In suran ce; Services o r sup p lies received by yo u o r yo ur Dep en d en t befo re th e Den tal In suran ce starts fo r th at p erso n ; Services wh ich are p rimarily co smetic (fo r Texas resid en ts, see n o tice p ag e secti o n in Certifi cate); Services wh ich are n eith er p erfo rmed n o r p rescribed by a Den tist excep t fo r th o se services o f a licen sed d en tal h y gi eni stwh ich are sup ervised an d billed by a Den tist an d wh ich are fo r:oScali n g an d p o lishi ng o f teeth ; o roFluo rid e treatments; Services o r ap p lian ces wh i ch resto re o r alter o cclusion o r vertical d imen si on ; Resto rati o n o f to o th structure d amag ed by attritio n , abrasio n o r ero sio n; Resto rati o n s o r ap p liances used fo r th e p urp o se o f p eri o dontal sp linting; Co un seli n g o r instruction abo ut o ral h yg ien e, p laq ue co ntrol, n utritio n an d to bacco; Person al sup p lies o r d evices includ in g, but n o t limited to : water p icks, to oth es, o r d en tal flo ss; Deco ratio n , p erso nalizatio n o r in scrip tio n o f an y to o th, d evice, ap p liance, cro wn o r o th er d en tal wo rk; Missed ap p o in tments; Servi ces:oCo vered un d er an y wo rkers’ co mp en sation o r o ccup ational disease law;ooCo vered un d er an y emp lo yer liability law;Fo r wh i ch th e emp lo yer o f th e p erso n receiv in g such services is n o t req uired to p ay; o roReceived at a facility mai n tain ed by th e Emp l o yer, labo r un io n , mutual benefit asso ci atio n , o r VA h o spital; Services co vered un d er o th er co verag e p ro vided by th e Emp lo yer; Temp o rary o r p ro vision al resto rati o ns; Temp o rary o r p ro vision al ap pl ian ces; Prescrip tio n d rugs; Services fo r wh ich th e submitted d o cumen tatio n in dicates a po o r p ro gn osis;M etropo li t a n Life Ins u ranc e Co mp a n y 200 Park Aven ue New Yo rk, NY 10166L0520003788[exp0521][xNM] 2020 MetLife Services and Solutions, LLCDN-ANY-PPO-DUAL10

Dental Insurance Th e fo llo wing wh en ch arg ed by th e Den tist o n a sep arate bas is:oooClaim fo rm co mp l etio n;In fectio n co ntro l such as g l o ves, masks, an d sterilizati o n o f sup plies; o rLocal anesth esia, n o n -intraven ous co nscious sed ation o r an algesia such as n itro us o xi de. Dental services arisi n g o ut o f accid ental in jury to th e teeth an d sup p o rtin g structures, excep t fo r in juries to th e teeth d ue toch ewi n g o r bitin g o f fo o d; Caries suscep tibility tests; Other fixed Denture p ro sth etic services n o t d escribed elsewhere in th e certificate; Precision attach men ts, excep t wh en th e p recision attach men t is related to imp lant p ro stheti cs; Adjustme t o f a Den ture mad e with in 6 mo n th s after in stallation by th e same Dentist wh o in stalled it; Fixed an d remo vable ap p li an ces fo r co rrection o f h armful h abits; Appliances o r treatment fo r bruxism (g ri n d ing teeth ), including but n o t limited to o cclusal g uard s an d n i g ht g uard s; Repair or replacement o f an o rth od ontic d evice; Duplicate pro sth etic d evices o r ap p liances; Replacement o f a lo st o r sto len ap p liance, Cast Resto rati o n , o r Den ture ; Intra an d extrao ral p h o to grap hic imag esLim ita tionsAlternate Benefit s : W h ere two o r mo re p ro fessio nally acceptable d en tal treatmen ts fo r a d en tal co n d ition exist, reimbursement isbased o n th e least co stly treatmen t altern ative. If yo u an d yo ur d en tist h ave ag reed o n a treatm en t th at is mo re co stly th an th etreatmen t up o n wh ich th e p lan ben efit is based , yo u will be resp o n sible fo r an y ad d itional p ayment resp o nsibility. To avo id an ymisun derstand ings, we sug g est yo u d iscuss treatme t options with yo ur d en tist befo re services a re rend ered , an d o btain a p retreatmen t estimate o f ben efits p rio r to receivin g certain h igh co st services such as cro wn s, brid g es o r d en tures. Yo u an d yo urd en tist will each receive an Exp lan ati o n o f Ben efits (EOB) o utlin in g th e services p rovided, yo ur p lan ’s reimbursemen t fo r th o seservices, an d yo ur o ut-o f-p o cket exp en se. Proced ure ch arg e sch ed ules are subject to ch an g e each p lan year. Yo u can o btain anup d ated p ro ced ure ch arg e sch edule fo r yo ur area via fax by callin g 1-800-942-0854 an d usin g th e MetLife Den tal Auto mated In formatio n Service. Actual p aymen ts may vary fro m th e p retreatmen t estimate d ep end i n g up o n an n ual m aximums, p lanfreq uen cy limits, d ed uctibles an d o th er limits ap p licable at time o f p aymen t.Cancellat ion / Ter m ina tion of Benefits : Co verag e is p ro vid ed un der a g ro up insuran ce p o licy (Po licy fo rm GPNP99 / G.2130-S)issued by Metro p o litan Life In suran ce Co mp an y (MetLife). Co verag e termin ates wh en yo ur membersh ip ceases, wh en yo urd en tal co n tributio ns cease o r up o n termin at ion o f th e g ro up p o licy by th e Po licyh older o r MetLife. Th e g ro up p o licy termin atesfo r n o n -p aymen t o f p remium an d may termin ate if p articip ation req uiremen ts are n o t met o r if th e Po li cyh o ld er fails to p erfo rman y o bli g atio ns un d er th e p o licy. Th e fo llowin g services th at are in p ro g ress wh ile co verage is in effect will be p aid after th eco verag e en d s, if th e ap p licable in stallmen t o r th e treatmen t is fin ish ed with in 31 d ays after in d ividual termin atio n o f co verage:Co mp leti o n o f a p ro sth etic d evice, cro wn or ro ot can al th erap y.Like mo st g ro up ben efit p ro g rams, ben efit p ro g rams o ffered by MetLife an d its affiliates co n tain certain exclusions, excep tio ns,red ucti o n s, limitation s, waiti n g p eriods an d terms fo r keep in g th em in fo rce. Fo r co mp lete d etails o f co verag e an d avail abil ity,p lease refer to th e certificate of insuran ce o r co n tact MetLife.M etropo li t a n Life Ins u ranc e Co mp a n y 200 Park Aven ue New Yo rk, NY 10166L0520003788[exp0521][xNM] 2020 MetLife Services and Solutions, LLCDN-ANY-PPO-DUAL11

Dental InsuranceQuest io n s & AnswersQ.Who is a particip at in g dentis t?A.A p articipating d entist is a g en eral den tist o r sp ecialist wh o h as ag reed to accept n eg otiated fees as p ayment in full fo rco vered services p ro vided to p lan members. Neg o tiated fees typ ically ran ge fro m 30% – 45% belo w th e aver a g e f e e sch arg ed in a d en tist’s co mmun ity fo r th e same o r substan tially similar servi ces.†Q.How do I find a participa t in g dentis t?A.Th ere are th o usan d s o f g en eral d en tists an d sp ecialists to ch oose fro m n atio n wid e --so you are sure to fin d o n e th at meetsyo ur n eed s. Yo u can receive a list o f th ese p articip atin g d en tists o

Dental Plan MetLife dental plans featuring the Preferred Dentist Program are designed to help you get t h e dental care you need and help lower your costs. You g e tbenefits for a wide range of covered services — both in and out of the network. The goal is to deliver affordable protectionf or a healthier smile and a healthier you.