DN-GCERT-GOLD GCERT Voluntary Dental Benefit Summary 200 Park Ave., New York, NY 10166 © 2024 MetLife Services and Solutions, LLC L0623032885[exp0625][xNM] 35. Services or supplies furnished as a result of a referral prohibited by Section 1-302 of the Maryland Health Occupations Article. A prohibited referral is one in which a Health Care Practitioner refers You to a Health Care Entity in which the Health Care Practitioner or Health Care Practitioner’s immediate family or both own a Beneficial Interest or have a Compensation Agreement. For the purposes of this exclusion, the terms “Referral”, “Health Care Practitioner” , “Health Care Entity”, “Beneficial Interest” and Compensation Agreement have the same meaning as provided in Section 1-301 of the Maryland Health Occupations Article. This exclusion only applies for Maryland Sitused Groups 1Some of these exclusions may not apply. Please see your Certificate of Insurance.

Dental Plan  - Page 6 Dental Plan Page 5 Page 7