GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America AESOPINTERMEDIATELLC Kit created 12/05/2022 ALL ELIGIBLE EMPLOYEES Groupnumber:00554984 Your dental coverage Option 1 or 2: HIGH or LOW plan, you'll have access to one of the largest networks of dentists with two reimbursement levels that give you more control over savings. You will always save money with any dentist in Guardian's network and when they belong to a tier in the Tier 1 reimbursement level you will maximize your savings. Reimbursement for covered services received from a non-contracted dentist will be based on Guardian's fee schedule. Your Dental Plan Option 1: HIGH Tier 1 Tier 2 Option 2: LOW Tier 1 Tier 2 Your Network is DentalGuard Preferred Network Gold *, Silver * Non-Contracted Gold *, Silver * Non-Contracted Calendar year deductible Tier 1 Tier 2 Tier 1 Tier 2 Individual $50 $50 $50 $50 Family limit 3 per family (applies to all levels) 3 per family (applies to all levels) Waived for Preventive Preventive Preventive Preventive Charges covered for you (co-insurance) Tier 1 Tier 2 Tier 1 Tier 2 Preventive Care 100% 100% 100% 100% Basic Care 80% 80% 50% 50% Major Care 50% 50% 50% 50% Orthodontia 50% 50% Not Covered (applies to all levels) Annual Maximum Benefit $2000 (applies to all levels) $1000 (applies to all levels) Lifetime Orthodontia Maximum $2000 (applies to all levels) Not Applicable (applies to all levels) Dependent Age Limits 26 (applies to all levels) 26 (applies to all levels) 4