Page 4 Understanding your benefits Commonly Used Terms Standard Benefit Waiting Period A dental insurance waiting period is a set period before you receive coverage for some specific dental procedures. Waiting periods vary based on your plan. Please refer to your certificate of insurance for any associated waiting periods (e.g., 6 months). In-Network Provider Dentists who have agreed to provide dental services at discounted rates for participants. You can save up to 34% on average off of provider charge by visiting an in network provider. You will not be liable for the difference between the discounted rate and the provider charge if you visit an in-network provider. Out-of-Network Provider Dentists who have not agreed to provide dental services at discounted rates for participants. You are free to visit out-of-network providers, but you may be balance billed for the difference between our allowed amount and the provider charge. Annual Individual Maximum Annual maximum for each individual covered under the plan for procedures other than orthodontia. Lifetime Orthodontia Maximum Maximum for orthodontia procedures which pays up to the maximum over a lifetime including treatment covered under other dental plans. Frequently Asked Questions When can I enroll? You can enroll when you are initially eligible for benefits and during any subsequent annual enrollment period defined by your employer or if there is a life status change, such as involuntary termination under another policy. Are my dependents eligible for coverage? Your dependent children are eligible up to end of the month they reach age 26 Who is eligible for Orthodontic Services? Covered members to age 19 How does a PPO Work? PPO stands for Preferred Provider Organization. PPOs help you save money because in- network dentists - dentists who are contracted by our leased networks - agree to charge the plan’s lower rates. How do I find an in-network provider? To find a provider near you, please visit www.equitable.com/finddentist Can I see a provider outside of the network? Yes, you can see a provider outside of the network, but your out-of-pocket cost will likely be higher as out-of-network providers have not agreed to discounted rates on their services. How do I learn more about my benefits? Go to www.equitable.com/employeebenefits and log on to EB360® to view your account details. If I have additional questions, who can I talk to? Please don’t hesitate to contact us at 1-866-274-9887. Do I need a dental ID card in order to receive benefits? ID cards are not needed in order to receive treatment from a dentist, but can help to simplify your office experience so we encourage that they are printed and brought with you to your dental visit. ID cards can be printed from www.equitable.com/employeebenefits . Is there a late entrant penalty? A late entrant waiting period of 12 months is applicable for all but Preventive services if you do not enroll within your enrollment eligibility period. Am I required to have a pre-treatment estimate submitted in order to be eligible for coverage? No, a pre-treatment estimate is not required in order to receive benefits for covered services, but it will allow you to know what your out-of-pocket expenses are prior to services being performed. We recommend that a pre-treatment estimate be submitted for all anticipated work that you consider to be expensive. A pre-treatment estimate is not a pre- authorization or guarantee of payment or eligibility; rather it is an indication of the estimated benefits available if the described procedures are performed based on eligible services and subject to benefits availability at the time that the pre-treatment is processed.