As a PerkinElmer employee, you have the option to enroll yourself and your eligible dependents in

the Delta Dental PPO Plus Premier Plan and choose between the Low Option or the High Option.
Both you and the company pay a portion of the cost of dental coverage.

BENEFIT DESCRIPTION
With Delta Dental PPO Plus Premier, you have access to two of Delta Dental’s extensive national
networks – Delta Dental PPO and Delta Dental Premier. Three out of four dentists nationwide
participate in one or both networks. Your out-of-pocket costs are lower when you see a network
dentist because these dentists have agreed to accept negotiated fees for their services. Non-
participating dentists have no fee agreements, so you are responsible for the difference between
what Delta Dental pays and the dentist’s normal rate. NOTE: Even though you have access to
both networks the discounts are not the same between the Delta Dental PPO Network is not the
same as the Delta Dental Premier Network. By choosing a Delta Dental PPO dentist, your
coinsurance is calculated off of a lower provider fee, using less of your annual maximum and
lowering your out of pocket expense.

There are three service categories:

• Preventive care (exams, cleanings, etc.) is covered at 100%
• Basic restorative care (fillings, root canals, etc.) is covered at 80% after deductible
• Major restorative care (crowns, dentures, etc.) is covered at 50%.

Each plan option has a calendar year deductible* and maximum benefit**:
• Low Option
o Deductible - $50 per individual with a $150 family maximum
o Maximum Benefit - $1,000 per covered person
• High Option
o Deductible - $25 per individual with a $75 family maximum
o Maximum Benefit - $1,000 per covered person
*The deductible does not apply to preventive services.
**With Delta Dental’s Rollover Max feature, you may be able to roll over a portion of your unused
annual benefit dollars for use the following year and beyond.

As a Delta Dental member, you also get access to Healthy Living Discounts that can save you
money.

• Sonic ToothCare Discount: Delta Dental members get a special deal on the Z Sonic
toothbrushes and replacement heads. You’ll also save on replacement heads and a travel-
size, battery-powered toothbrush. See the Z Sonic toothbrush offer

Rev 10/2021
 • Hearing Health Discount: As a Delta Dental member you receive discounts on hearing aids
and many extras from Amplifon to better take care of your hearing.

LEARN MORE
Additional dental plan information is available under Your Benefit Plans in bswift or by contacting
Delta Dental at 800-872-0500 or www.deltadentalma.com.

This Overview highlights key features of the PerkinElmer benefits program. Complete information can be
found in the official plan documents and insurance certificates, which define and govern actual benefits. The
Company may change or terminate these benefits at any time. Plan provisions and eligibility for coverage do
not constitute a contract of employment with any individual.

Rev 10/2021