Dental Effective: January 1, 2027 Amounts shown below are your responsibility. This table only shows in-network benefits UNUM | Network | UNUM PPO | | Plan Year Deductible | $50 per person / $150 per family | | Preventive & Diagnostic Care | Covered in full / Deductible waived | | Basic Care | 20% | | Major & Restorative Care | 50% | | Plan Year Maximum Per | $1,500 | | Person | | Orthodontia | 50% | | (Children under 26) | | Orthodontic Lifetime | $1,500 | Maximum Members that receive at least one exam and cleaning during the plan year can Dental Carryover have a portion of the unused annual maximum carry over to the following year. Preventive care is covered at 100% on your dental plan. Studies show that oral health is closely related to your overall health. For example, gum disease has connections to diabetes, heart disease, high blood pressure and stroke. Having access to a plan that will cover your preventive visits can go a long way in maintaining your overall health. www.unumdentalcare.com / 1-866-679-3054 14

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