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DENTAL BENEFITS FOR:Ron Hoover RV & Marine CentersEFFECTIVE DATE: January 01, 2024NOTE: This is not a policy and the descriptions of the policy(ies) are in summary form. If a discrepancy exists, the policy(ies) will control in all instances. For a complete description of benefits, exclusions, limitations, reduction of benefits, and/or terms under which the policy(ies) may be continued in force or discontinued, please refer to the policy(ies). DENTAL BENEFIT HIGHLIGHTSDENTAL PPO LOW(VOLUNTARY) PAYSDental PPO Low (Voluntary)IN-NETWORKOUT-OF-NETWORKDiagnostic & Preventive ServicesDiagnostic and Preventive Services — includes exams, cleanings, fluoride, and space maintainersBrush Biopsy — to detect oral cancerBitewing Radiographs — bitewing X-raysSealants — to prevent decay of permanent teeth100% 100%Basic ServicesEmergency Palliative Treatment — to temporarily relieve painAll Other Radiographs — other X-raysMinor Restorative Services — fillingsSimple Extractions — non complicated extractions80% 80%Major Services (12 months Waiting Period Applies)Other Basic Services — misc. servicesPeriodontic Services — to treat gum diseaseEndodontic Services — root canalsAll Other Oral Surgery Services — complex extractions and dental surgeryMajor Restorative Services — crowns and veneersRelines and Repairs — to bridges and denturesProsthodontic Services — bridges, implants, and dentures50% 50%OrthodonticsOrthodontic Services — braces0% 0%ADDITIONAL PLAN INFORMATIONAllowed Amounts — in-network and out-of-network providers PPO Fee PPO FeeCalendar Year Maximum — per person per Calendar Year Maximum. Applies to all services exceptorthodontic services. Includes maximum rollover.$1,000 $1,000Orthodontic Lifetime Maximum $0.00Calendar Year Deductible — per person/per family. Does not apply to any Diagnostic & Preventive Services $50/$150FIND AN IN-NETWORK DENTIST AT:MYRENPROVIDERS.COM

DENTAL BENEFITS FOR:Ron Hoover RV & Marine CentersEFFECTIVE DATE: January 01, 2024NOTE: This is not a policy and the descriptions of the policy(ies) are in summary form. If a discrepancy exists, the policy(ies) will control in all instances. For a complete description of benefits, exclusions, limitations, reduction of benefits, and/or terms under which the policy(ies) may be continued in force or discontinued, please refer to the policy(ies). ADDITIONAL DENTAL INFORMATIONWaiting Period: The following waiting period(s) apply to any person who was not covered under this employers immediately preceding group dental plan that had comparable benefits and any future enrollees. Major Services will not be covered until after a person is enrolled in the dental plan for 12 months.Maximum Payment: Per person total per Calendar Year on Diagnostic & Preventive, Basic and Major Services. Plan payment will not exceed the higheramount shown in any benefit period or lifetime.Maximum Rollover: If at least one covered service is paid in a Calendar Year and the total benefit paid does not exceed $500 in that calendar year, $250 willbe added to the next Calendar Year carryover maximum. This amount will accumulate from one Calendar Year to the next, but will not exceed $1,000.Deductible: Per person total per Calendar Year limited to a maximum family deductible per Calendar Year. Does not apply to any Diagnostic & PreventiveServicesThe Plan Specifications Are Subject To The Following Exclusions And Limitations: Payment will not be made for procedures to replace a missing tooth or teeththat were lost prior to becoming a Certificate Holder or Eligible Dependent under this Policy. Oral Exams are payable twice any Benefit Year. Prophylaxes arepayable twice any Benefit Year. Fluoride treatments are payable once any Benefit Year up to age 16. People with specific at-risk health conditions may be eligible foradditional prophylaxes (cleanings) or fluoride treatment. The patient should talk with his or her dentist about treatment. Bitewing Radiographs are payable onceany Benefit Year and Full Mouth Radiographs are payable once any 2 year period. Sealants are payable only for the occlusal surface of first and second permanentmolars once any 3 year period up to age 16. The surface must be free from decay and restorations. Space Maintainers are payable once any 3 year period up to age 16.Crowns, Inlays, Veneers, Bridgework, Dentures and Implants are payable once any 10 year period.