Dental Benefits Summary SmartPremium 100 80 50 2

Dental Benefit Summary Dash Delivery Inc. Plan: SmartPremium Policy effective date: 10/01/2024 Group #: OR00704 Policy length: 12 months In-network Out-of-network Plan Coverage (PPO fee) (90th percentile UCR) Preventive & Diagnostic Diagnostic and preventive: exams, cleanings, fluoride, space 100% 100% maintainers, x-rays, and sealants Basic Emergency palliative treatment: to temporarily relieve pain Minor restorative: fillings 80% 80% Prosthetic maintenance: relines and repairs to bridges and dentures Major Endodontics: root canals Implants: endosteal in lieu of a 2 or 3 unit bridge Major restorative: crowns, inlays, and onlays Oral surgery: extractions and dental surgery 50% 50% Periodontics: to treat gum disease Prosthetics: bridges Prosthodontics: dentures Plan maxes Annual maximum applies to diagnostic & preventive, basic services, and major services. Lifetime maximum applies to orthodontic services. If at least one Covered Service is paid in a calendar (or plan) year and the total benefit paid does not exceed $1,000.00 in that calendar (or plan) year, $500.00 will be added to the next year rollover maximum. This amount will accumulate to the next period, but will not exceed $2,000.00. Annual max based on calendar year. Annual max $2,000 /yr Benefit period: calendar year Ortho Lifetime Max $0 /lifetime FIND A DENTIST QUESTIONS? CHECK CLAIMS & ELIGIBILITY dentists.beambenefits.com [email protected] providers.beambenefits.com BM-SOB-0035-202306 Valid as of 10/01/24 1 of 3

Plan deductible The deductible is waived for diagnostic & preventive services. Individual $50.00 /yr Family $150.00 /yr Claims Information Beam Insurance Administrators Electronic payer ID NEA ID Fax number Phone number Claim form accepted PO Box 75372 BEAM1 BEAM1 (844) 688-4821 (800) 648-1179 ADA form 2006 or later Cincinnati, OH 45275 Beam Dental PPO Standard coverages, as of August 1, 2019 Questions? If you have questions, call us at (800) 648-1179. We'd love to help! Or visit app.beambenefits.com and login to view more info. Please check your Certificate of Insurance for a description of coverage, limitations, and exclusions under the plan. Some services require prior authorization. FIND A DENTIST QUESTIONS? CHECK CLAIMS & ELIGIBILITY dentists.beambenefits.com [email protected] providers.beambenefits.com BM-SOB-0035-202306 Valid as of 10/01/24 2 of 3

This benefit summary is not a complete description of the insurance coverage. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern. Dental insurance product underwritten by National Guardian Life Insurance Company (NGL), Madison, WI, marketed by Beam Insurance Services LLC (Beam Benefits Insurance Services LLC, in CA). Dental policy form number NDNGRP 2020. Dental product underwritten by Nationwide Life Insurance Company, Columbus, OH in NY, DE, ID, LA, UT, OH, TX and NM. Dental coverage applicable to policy form GDTL AO L20, or state equivalent. Dental product administered by Beam Insurance Administrators LLC (Beam Dental Insurance Administrators LLC, in Texas). Not all Products Available in All States. Two life groups made up of only a husband-wife, domestic partners or same-sex couple are not eligible for coverage. National Guardian Life Insurance Company, Madison, WI, is not affiliated with The Guardian Life Insurance Company of America, a.k.a. The Guardian, or Guardian Life. Nationwide and Beam Insurance Services LLC are separate and non-affiliated companies. National Guardian Life Insurance Company, Two East Gilman, Madison, Wisconsin 53703 Nationwide Life Insurance Company, One Nationwide Plaza, Columbus, OH 43215 FIND A DENTIST QUESTIONS? CHECK CLAIMS & ELIGIBILITY dentists.beambenefits.com [email protected] app.beambenefits.com/providers BM-SOB-0035-202306 3 of 3