Individual Dental With Vision Rider Option

Plan Options EVERY BUDGET & BENEFIT NEED 8 fully insured dental plan options Optional vision rider* Value added benefits at no additional cost to Members No maximum issue age No additional fees for consumer *Not available with all plans

Plan Options Fee Schedule plans Value Standard Preferred PPO plans Ultimate Max Plan Increasing Max Plan Preventive Basic Plan Cleaning plus Vision Qualified Dental Plan All-Star Dental

Plan Options – Fee Schedule & PPO *Deductible does not apply toward preventive services

Covered Procedures Preventive ServicesOther Services Routine ExamsBasic: Prophylaxis Fillings X-rays Simple Extractions Children Services:Major: Fluoride Treatment Emergency Treatment Sealants Crowns, Dentures, Bridges Space Maintainers Endodontics and Periodontics Oral Cancer Screening (40+) Endosteal Implants (PPO Plans Only) Inlays and Onlays Oral Surgery

Plan Options – Qualified Dental Plan Available off-exchange - Qualified Dental plans with Pediatric Essential Health Benefits (EHB) designed for families with children 18 and under. 3 Coverage Tiers Available: Child Only Individual + Children Individual + Family

Vision Rider Option Fully insured vision plan Available for Fee Schedule and PPO Plans Services every 12 months May use different providers for exams and material purchases

Dental Network 270,000+ Access Points Out of Network Benefits Fee Schedule Plans – Choose any dentist PPO & QDP Plans - Out-of-network benefits paid at in-network provider discounted rate

Vision Network Proprietary Network Over 28,000 access points Independent & 39 of top 50 large regional/national retail providers including but not limited to: Walmart Sears Optical JcPenney Optical Sam’s Club Eye Care Centers of America Texas State Optical Target America’s Best Costco

Value Added Benefits No additional cost to Members Optical Discounts (if vision is elected) Hearing Savings Plan Prescription discount card *Not an insured benefit and subject to change.

State Approval Fee Schedule Plans QDP Plans PPO Plans

What makes these plans different? No additional fees No maximum age More plan options with fully insured vision rider More preventive services No waiting periods for basic services No network restrictions Value-added services available at no additional cost to members

What makes this carrier different? Technology Consumer friendly website with full back-end automation Instant policy issuance Designed for agents providing custom agent links that may be co- branded on the site Customer Service Live representative available Monday – Saturday with expanded hours Overall 97% customer satisfaction (2015 survey) One point of contact for both dental & vision benefits 24/7 member services portal with robust mobile app functionality