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SERVICE AREA SafeGuard's service area is the geographic region In the state of California where SafeGuard is authorized by the California Department of Managed Health Care to provide Covered Services to Members and in which SafeGuard has a panel of Selected General Dentists and Specialty Care Dentists who have agreed to provide care to SafeGuard members, To enroll in the SafeGuard plan, You and Your dependents must reside, live, or work in the Service Area. DEPENDENT COVERAGE Your Organization Is responsible for determining dependent eligibility. In the absence of such a determination, SafeGuard defines eligible dependents as: • Your lawful Spouse or domestic partner; • Your children or grandchildren up to age 26 for whom You provide care, including adopted children, step-ohildren, or other children for whom You are required to provide dental care pursuant to a court or administrative order; • Your children who are incapable of self-sustaining employment and support due to a developmental disability or physical handicap; and • Other dependents if Your Organization provides benefits for these dependents, Please checkwith Your Organization If you have questions regarding your eligibility requirements WHEN COVERAGE BEGINS Coverage for You and Your enrolled dependents will begin on the date determined by Your Organization. Newborn children are covered the day of birth as long as You are enrolled; legally adopted children, foster children and stepchildren are covered the first day of the month following placement as long as SafeGuard is notified within ninety (90) days. Your coverage will begin on the date determined by Your Organization. Waiting periods for eligibility, if applicable, are determined by Your Organization. Adopted child are covered from the earlier of the moment the child is placed in Your residence, and the child's birth, if You have entered into a written agreement to adopt the child prior to its birth. Newborn children are covered the first day of the month following the date of birth, and foster children and stepchildren are covered the first day of the month following placement as long as Your Organization is notified within 90 days and any Prepayment Fee is paid within that period. Check with Your Organization if You have any questions about when Your coverage begins. Choice of Dentists PLEASE READ THE FOLLOWING INFORMATION SO YOU WILL KNOW FROM WHOM OR WHAT GROUP OF PROVIDERS DENTAL CARE MAY BE OBTAINED. When enrolling for dental benefits, You and Your dependents must choose a Selected General Dental Office from Our network. You and Your dependents each may select a different Selected General Dental Office. if You do not select a Selected General Dental Office or the one you chose is not available, SafeGuard may do so for You. Please refer to the Directory of Participating Providers for a complete listing of Selected General Dental Offices. You may obtain a Directory of Participating Providers from Our website www.metlife.00mk mybenerits or by calling (800) 880-1800. Facilities You may obtain a list of SafeGuard's Selected General Dental Offices and their hours of availability by calling SafeGuard at (800) 880-1800. A list of SafeGuard's participating General Dental Offices can be found it is Directory of Participating Providers or online at www.metlife,comlmybenefits. GCERT2011-DHMO-IEOC 26C-21