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Dental Plan                                                                                                9






            MetLife Dental PPO Plan

            ABC Company provides dental care coverage through MetLife. The plan allows you to access dental care
            from any dentist you wish. You will receive the greatest level of coverage when you access care from
            PPO network dentists. PPO dentists agree to discount their charges and benefit payments are based on
            discounted fees.

            When you obtain services from non-PPO network dentists, eligible expenses are based on Reasonable &
            Customary fees, determined by MetLife for your geographical location. Since expenses are not discounted
            with non-PPO dentists, your out-of-pocket costs may be greater.


             Plan Features                                          MetLife Dental PPO Plan

                                                           In-Network                    Out-of-Network 1
              Providers                              When you obtain dental care services from a MetLife PPO provider,
                                                                 you receive a higher level of benefits

              Annual Deductible                                   $50 per individual/$150 per family
              Annual Maximum Benefits                                        $2,000
             Diagnostic/Preventive Services
              (X-Rays, Cleanings, Examinations)  Covered at 100%; deductible waived  Covered at 100%; deductible waived
             Routine/Basic Services
              (Fillings, Extractions)                Covered at 80%; subject to      Covered at 80% of R&C fees;
                                                           deductible                   subject to deductible
             Major Services
              (Bridges, Dentures, Crowns)            Covered at 50%; subject to      Covered at 50% of R&C fees;
                                                           deductible                   subject to deductible
             Orthodontia Services
              (Child Only)                           Covered at 50%; subject to      Covered at 50% of R&C fees;
                                                           deductible                   subject to deductible

              Lifetime Maximum                                               $2,000
             1   If accessing care from a non-MetLife dentist, you may be subject to balance billing for services.
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