9 DENTAL Good oral care enhances overall physical health, appearance and mental well-being. Keep your teeth healthy and your smile bright with our dental benefit plan. Hover over the insurance terms below to learn what they mean. ANNUAL DEDUCTIBLE None Individual: $50 Family: $150 Individual: $50 Family: $150 ANNUAL PLAN MAXIMUM Unlimited $2,000 $2,000 PREVENTIVE SERVICES No Charge 100% 100% BASIC SERVICES Various Copays Apply 90% 80% MAJOR SERVICES Various Copays Apply 60% 50% ORTHO SERVICES $725- $1,450 (additional $250 for retention) 50% 50% ORTHO LIFETIME MAXIMUM Unlimited $2,000 $2,000 FIRM MONTHLY PREMIUM Employee: $10.04 Employee + Spouse: $17.36 Employee + Children: $19.06 Family: $26.55 Employee: $42.48 Employee + Spouse: $81.24 Employee + Children: $85.74 Family: $132.73 EMPLOYEE MONTHLY PREMIUM Employee: $7.00 Employee + Spouse: $15.00 Employee + Children: $15.00 Family: $22.00 Employee: $26.00 Employee + Spouse: $56.00 Employee + Children: $54.00 Family: $89.00 MetLife Dental HMO MetLife Dental PPO The benefits and rates in this guide are for illustrative purposes only. To the extent the rates or the benefit plan information summarized herein differs from the underlying plan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlying insurance documents will govern in all cases. HMO PPO Review Plan Summaries In-Network In-Network Only Out-of-Network (No Out-of-Network Benefits)