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1 Rates may only be increased if all rates in the state the policy was issued change or rates may change on a class basis. 2 Colonial Life’s dental network includes providers under direct contract and under access arrangements with other dental networks. Visit ColonialLifeDental.com for a current provider directory. INJURY • ILLNESS • DENTAL • VISION • LIFE ColonialLife.com Summary of Dental Benefits and Coverage Disclosure Matrix (SDBC) is available at ColonialLifeDental.com/California. THIS POLICY PROVIDES LIMITED BENEFITS. This coverage is a supplement to health insurance. It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law. Insureds in some states must be covered by comprehensive health insurance before applying for this insurance. This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. Applicable to policy form IDN8100 (including state abbreviations where used, for example, IDN8100-TX). For cost and complete details of coverage, call or write your Colonial Life benefits representative or the company. An insurance producer may be in contact with you. Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. Not available for use in ID, MA, MD, MN, MT, NM, NY, OR, PA, VA, WA ADDITIONAL DISCLOSURES:

How can it meet my employees’ needs?

Our individual dental coverage includes competitive features that help businesses support more employees.

Dental features at a glance

In today’s environment, businesses face challenges offering dental insurance that helps employees effectively manage the costs of dental care. Our new individual dental insurance helps employers meet that challenge.

Enhance their wellbeing with strong dental benefits

Biting into finances: Dental costs may be impacting your employees

Talk with your Colonial Life independent agent today to learn more.

Stable premium rates and choice of plans to fit their needs

Find an in-network dentist

Clay was surfing when he wiped out and broke his tooth. Watch how his parents' dental insurance helped cover his costs.

Employees can easily maximize their benefits by using a dental provider in our nationwide network. Our online provider directory makes it easy to search for care.

What benefits are provided?

Preventive, basic and major services; orthodontia and vision coverage are optional

What benefits are provided?

How can it meet my employees’ needs?

When do benefits start?

First-day coverage for cleanings and fillings, with options for major services with no waiting period

When do benefits start?

Who is eligible to enroll?

Select an FAQ to learn more

of employees ranked dental insurance as the second-most desired benefit after health insurance. Source: LIMRA & EY, 2023 Workforce Benefits Study.

Is there a participation requirement?

Only one employee is required to enroll

Is there a participation requirement?

What if an employee leaves their job?

Employee can take the policy with them; no COBRA administration is needed

What if an employee leaves their job?

Part-time, 1099s, full-time and dependents

Who is eligible to enroll?

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Young Woman Reading Label On Food Item In Supermarket

Who is eligible to enroll?

Part-time, 1099s, full-time and dependents

Who is eligible to enroll?

When do benefits start?

First-day coverage for cleanings and fillings, with options for major services with no waiting period

When do benefits start?

Is there a participation requirement?

Only one employee is required to enroll

Is there a participation requirement?

What benefits are provided?

Preventive, basic and major services; orthodontia and vision coverage are optional

What benefits are provided?

What if an employee leaves their job?

Employee can take the policy with them; no COBRA administration is needed

What if an employee leaves their job?

How can it meet my employees’ needs?

Stable premium rates and choice of plans to fit their needs

How can it meet my employees’ needs?

Search for dental providers by name or location or call 1-888-400-9304.

Search Now

FOR RESIDENTS OF ARIZONA

FOR RESIDENTS OF KentucKy

No benefits are payable under this policy for the procedures and services listed below unless such procedure or service is listed as covered in the Schedule of Covered Procedures. In addition, the procedures listed below will not be recognized toward satisfaction of any deductible. EXCLUSIONS We will not pay benefits for any loss that is caused by, contributed to by, or occurs as a result of any of the following: • federal, state or local taxes are not included as part of a covered dental expense; • any procedure or service not shown on the Schedule of Covered Procedures; • benefits in excess of the policy year maximum benefit amount; • any procedure we determine which is not necessary, does not offer a favorable prognosis, or which is experimental in nature based on dental standard of care; • services considered inclusive of other procedures billed; the most comprehensive service may be payable; • services performed in conjunction with, as part of, or related to an applicable associated service (including prior history); • any injury or illness when covered under workers’ compensation or similar law, or which is work related; • any procedure or appliance installed before an insured’s policy effective date, including started but not completed services; • any procedure begun after an insured’s insurance under this policy terminates, or for any prosthetic dental appliance finally installed or delivered after an insured’s insurance under this policy terminates; • charges for dental services performed by anyone other than a licensed dentist, dental hygienist, dental therapist, or denturist; • services that are not recommended by a dentist or that are not required for the preservation or restoration of oral health; • any adjustment, reline, rebase, or repair (including adding or replacing missing or broken teeth) to prosthetic dental work within six months of the initial; • retreatment of previous root canal therapy within six months of the initial; • replacement of full or partial dentures unless the prior prosthetic appliance is older than the age allowed in the Schedule of Covered Procedures and cannot be made serviceable; • replacement of implants, crowns, inlays or onlays unless the prior restoration is older than the age allowed in the Schedule of Covered Procedures and cannot be made serviceable; • any treatment which is elective or primarily cosmetic in nature and not recognized as a generally accepted dental practice by the American Dental Association, as well as any replacement of prior cosmetic restorations;•the correction of congenital malformations, with the exception of newborns, adopted children and children placed for adoption; • the replacement of lost or discarded or stolen appliances;•replacement of bridges unless the prior bridge is older than the age allowed in the Schedule of Covered Procedures and cannot be made serviceable;ting brand of Colonial Life & Accident Insurance Company. • appliances, services or procedures relating to: (a) the change or maintenance of vertical dimension; (b) restoration of occlusion (unless otherwise noted in the Schedule of Covered Procedures-only for occlusal guards); (c) splinting; (d) correction of attrition, abrasion, erosion or abfraction; (e) bite registration; (f) bite analysis or (g) bruxism;

• services provided for any type of temporomandibular joint (TMJ) dysfunctions, muscular, skeletal deficiencies involving TMJ or related structures, myofascial pain; • orthognathic surgery; • prescribed medications, premedication or analgesia; • any instruction for diet, plaque control and oral hygiene; • charges for: implants of any type (except those implants specified in the Schedule of Covered Procedures), and all related procedures, removal of implants, precision or semi-precision attachments, denture duplication, overdentures and any associated surgery, or other customized services or attachments; • cast restorations, inlays, onlays and crowns for teeth that are not broken down by extensive decay or accidental injury or for teeth that can be restored by other means (such as an amalgam or composite filling); • for treatment of malignancies, cysts and neoplasms; • for orthodontic treatment except those services or treatments provided in the Schedule of Covered Procedures; • charges for failure to keep a scheduled visit or for the completion of any claim forms; • expenses provided or paid for by any governmental program or law, except Medicaid, and except as to charges which the person is legally obligated to pay or as addressed later under the payment of benefits provision; • procedures started but not completed; • any duplicate device or appliance; • general anesthesia and intravenous sedation except in conjunction with covered complex oral surgery procedures as defined by us, plus the services of anesthetists or anesthesiologists; • the replacement of 3rd molars; • crowns, inlays and onlays used to restore teeth with micro fractures or fracture lines, undermined cusps, or existing large restorations without overt pathology. LIMITATIONS See the Schedule of Covered Procedures for all specific procedure limitations. ALTERNATE BENEFIT Many dental problems can be resolved in more than one way. If: • we determine that a less expensive alternate benefit could be provided for the resolution of a dental problem; and • that benefit would produce the same resolution of the diagnosed problem within professionally acceptable limits, we may use the less expensive alternate benefit to determine the amount payable under this policy. If an alternate benefit is applied, the insured may be responsible for any remaining allowable amount after benefits are paid by the plan.

ARIZONA Individual Dental Insurance Exclusions and limitations

• replacement of implants, crowns, inlays or onlays unless the prior restoration is older than the age allowed in the Schedule of Covered Procedures and cannot be made serviceable; • any treatment which is elective or primarily cosmetic in nature and not recognized as a generally accepted dental practice by the American Dental Association, as well as any replacement of prior cosmetic restorations; • the correction of congenital malformations; • the replacement of lost or discarded or stolen appliances; • replacement of bridges unless the prior bridge is older than the age allowed in the Schedule of Covered Procedures and cannot be made serviceable; • appliances, services or procedures relating to: (a) the change or maintenance of vertical dimension; (b) restoration of occlusion (unless otherwise noted in the Schedule of Covered Procedures-only for occlusal guards); (c) splinting; (d) correction of attrition, abrasion, erosion or abfraction; (e) bite registration; (f) bite analysis or (g) bruxism;•services provided for any type of temporomandibular joint (TMJ) dysfunctions, muscular, skeletal deficiencies involving TMJ or related structures, myofascial pain; • orthognathic surgery; • prescribed medications, premedication or analgesia; • any instruction for diet, plaque control and oral hygiene; • charges for: implants of any type (except those implants specified in the Schedule of Covered Procedures), and all related procedures, removal of implants, precision or semi-precision attachments, denture duplication, overdentures and any associated surgery, or other customized services or attachments; • cast restorations, inlays, onlays and crowns for teeth that are not broken down by extensive decay or accidental injury or for teeth that can be restored by other means (such as an amalgam or composite filling); • for treatment of malignancies, cysts and neoplasms; • for orthodontic treatment except those services or treatments provided in the Schedule of Covered Procedures; • charges for failure to keep a scheduled visit or for the completion of any claim forms; • expenses provided or paid for by any governmental program or law, except Medicaid, and except as to charges which the person is legally obligated to pay or as addressed later under the payment of benefits provision; • procedures started but not completed; • any duplicate device or appliance; • general anesthesia and intravenous sedation except in conjunction with covered complex oral surgery procedures as defined by us, plus the services of anesthetists or anesthesiologists; • the replacement of 3rd molars; • crowns, inlays and onlays used to restore teeth with micro fractures or fracture lines, undermined cusps, or existing large restorations without overt pathology. LIMITATIONS See the Schedule of Covered Procedures for all specific procedure limitations. ALTERNATE BENEFIT Many dental problems can be resolved in more than one way. If: • we determine that a less expensive alternate benefit could be provided for the resolution of a dental problem; and • that benefit would produce the same resolution of the diagnosed problem within professionally acceptable limits, we may use the less expensive alternate benefit to determine the amount payable under this policy. If an alternate benefit is applied, the insured may be responsible for any remaining allowable amount after benefits are paid by the plan.

PREMIUM Premium will vary based on the coverage selected. We have the right to change the premium we charge. However, we cannot single anyone out for a rate change. If we make a change, it will be made on all policies in your rating group in the state where this policy was issued. If we plan to make a change, we will send a notice at least 40 days before we make it. We will not change premiums more than once in a 12 month period. RENEWABILITY Guaranteed Renewable to Age 80. This policy is guaranteed renewable to the policy anniversary date on or next following the policyholder’s 80th birthday as long as you pay the premiums when they are due or within the grace period. We may discontinue or terminate this policy if you have performed an act or practice that constitutes fraud or have made an intentional misrepresentation of material fact relating in any way to this policy, including claims for benefits. CANCELABILITY If you are not satisfied with the coverage for any reason, you may return this policy to us within 30 days of the date it is delivered. The coverage will be cancelled as of your coverage effective date and any claims that were submitted during the 30 day period will be denied. Any premium paid will be refunded to you. TERMINATION OF COVERAGE Your coverage under this policy will end on the earliest of: • the date of your death; • the date this policy lapses for nonpayment of premium per the grace period provision in the premiums section of the policy; • the date we receive a request in writing to cancel this policy; or • the policy anniversary date on or next following the policyholder’s 80th birthday. EXCLUSIONS No benefits are payable under this policy for the procedures and services listed below unless such procedure or service is listed as covered in the Schedule of Covered Procedures. In addition, the procedures listed below will not be recognized toward satisfaction of any deductible.We will not pay benefits for any loss that is caused by, contributed to by, or occurs as a result of any of the following: • federal, state or local taxes are not included as part of a covered dental expense;•any procedure or service not shown on the Schedule of Covered Procedures; • benefits in excess of the policy year maximum benefit amount; • any procedure we determine which is not necessary, does not offer a favorable prognosis, or which is experimental in nature based on dental standard of care; • services considered inclusive of other procedures billed; the most comprehensive service may be payable; • services performed in conjunction with, as part of, or related to an applicable associated service (including prior history); • any injury or illness when covered under workers’ compensation or similar law, or which is work related; • any procedure or appliance installed before an insured’s policy effective date, including started but not completed services; • any procedure begun after an insured’s insurance under this policy terminates, or for any prosthetic dental appliance finally installed or delivered after an insured’s insurance under this policy terminates; • charges for dental services performed by anyone other than a licensed dentist, dental hygienist, dental therapist, or denturist; • services that are not recommended by a dentist or that are not required for the preservation or restoration of oral health; • any adjustment, reline, rebase, or repair (including adding or replacing missing or broken teeth) to prosthetic dental work within six months of the initial; • retreatment of previous root canal therapy within six months of the initial; • replacement of full or partial dentures unless the prior prosthetic appliance is older than the age allowed in the Schedule of Covered Procedures and cannot be made serviceable;

KENTUCKY Individual Dental Insurance Disclosures, exclusions and limitations

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