Benefit summary

Benefit summary of the ExxonMobil Dental Plan

This chart provides only a brief summary of benefits under this Plan. It is not intended to include all ExxonMobil Dental Plan provisions. Non-network benefits are subject to reasonable and customary limits.

Covered services

Payment for the following oral surgery procedures is coordinated with the EMMP POS II option and the RMP POS II option but not for the EMMP Aetna Select HMO option, the RMP Aetna Select HMO option, or the EMMSP:

For more information, please contact: Aetna Member Services: (800) 255-2386 or visit www.aetna.com