Common use of Dental Care Benefit Clause in Contracts

Dental Care Benefit. Dental care benefits are provided for you and your eligible dependents subject to the limitations and exclusions described below. Eligible services are all reasonable and customary dental services which are recommended as necessary and performed by a qualified dentist or physician and for which a Treatment Plan has been submitted to and approved by the insurer before the services are rendered. The filing of a Treatment Plan is not required if the total cost of the proposed work is less than $500 or if treatment is rendered in emergency conditions. Eligible dental services are classified under three major categories: a. Basic Services - examinations and cleaning of teeth (once in any six-month period), fillings, fluoride treatment for dependants under 18 years old or if medically required and other necessary treatment for the relief of dental pain. b. Restorative Services - crowns and inlays, bridge work, dentures, root canal therapy (endodontics), and the treatment of tissues and bones supporting the teeth (periodontics). c. Orthodontia – extractions, proper fitting of natural teeth and prevention or correction of irregularities of the teeth. In addition, extractions shall be treated as an orthodontic procedure for purposes of reimbursement. You will be reimbursed for 90% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 in a calendar year. After January 1, 2012 you will also be reimbursed for 50% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $7,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. After January 1, 2020, you will be reimbursed for 80% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 in a calendar year. You will also be reimbursed for 50% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $5,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. Benefits will be paid on the basis of the lesser of the actual fee charged or the amount stated in the Current Fee Schedule in the province in which you reside. If optional procedures are possible, benefits will be payable in accordance with the procedure involving the smallest fee. Expenses incurred for the replacement of dentures are eligible for benefits, except that if the replacement is for a denture for which benefits were payable under this plan, benefits for the replacement will be payable only if at least 3 years have elapsed since the placement or replacement for which benefits were paid. In addition, benefits are payable for rebasing, relining or repairing of dentures. Benefits will not be paid for the replacement of dentures which have been lost, misplaced or stolen. Dental care benefits are not payable for any service eligible for payment from another source such as provincial health insurance plans, WSIB or government plans, expenses incurred principally for cosmetic purposes, expenses resulting from an act of war, or any service for which an employee or dependent does not have to pay. Your dental care insurance will be cancelled as of the date you retire or terminate service and claims will not be accepted for any service performed after the date on which your insurance is cancelled.

Dental Care Benefit. Dental care benefits are provided for you and your eligible dependents subject to the limitations and exclusions described below. Eligible services are all reasonable and customary dental services which are recommended as necessary and performed by a qualified dentist or physician and for which a Treatment Plan has been submitted to and approved by the insurer before the services are rendered. The filing of a Treatment Plan is not required if the total cost of the proposed work is less than $500 or if treatment is rendered in emergency conditions. Eligible dental services are classified under three major categories: a. : Basic Services - examinations and cleaning of teeth (once in any six-month period), fillings, fluoride treatment for dependants under 18 years old or if medically required and other necessary treatment for the relief of dental pain. b. . Restorative Services - crowns and inlays, bridge work, dentures, root canal therapy (endodontics), and the treatment of tissues and bones supporting the teeth (periodontics). c. . Orthodontia – extractions, proper fitting of natural teeth and prevention or correction of irregularities of the teeth. In addition, extractions shall be treated as an orthodontic procedure for purposes of reimbursement. You will be reimbursed for 90% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 in a calendar year. After January 112, 2012 you will also be reimbursed for 50% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $7,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. After January 1, 2020, you will be reimbursed for 80% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 in a calendar year. You will also be reimbursed for 50% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $5,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. Benefits will be paid on the basis of the lesser of the actual fee charged or the amount stated in the Current Fee Schedule in the province in which you reside. If optional procedures are possible, benefits will be payable in accordance with the procedure involving the smallest fee. Expenses incurred for the replacement of dentures are eligible for benefits, except that if the replacement is for a denture for which benefits were payable under this plan, benefits for the replacement will be payable only if at least 3 years have elapsed since the placement or replacement for which benefits were paid. In addition, benefits are payable for rebasing, relining or repairing of dentures. Benefits will not be paid for the replacement of dentures which have been lost, misplaced or stolen. Dental care benefits are not payable for any service eligible for payment from another source such as provincial health insurance plans, WSIB or government plans, expenses incurred principally for cosmetic purposes, expenses resulting from an act of war, or any service for which an employee or dependent does not have to pay. Your dental care insurance will be cancelled as of the date you retire or terminate service and claims will not be accepted for any service performed after the date on which your insurance is cancelled.

Dental Care Benefit. Dental care benefits Care Benefits are provided for you and your eligible dependents subject to the limitations and exclusions described below. Eligible services are all reasonable and customary dental services which are recommended as necessary and performed by a qualified dentist or physician and for which a Treatment Plan has been submitted to and approved by the insurer before the services are rendered. The filing of a Treatment Plan is not required if the total cost of the proposed work is less than $500 or if treatment is rendered in emergency conditions. Eligible dental services are classified under three major categories: a. (a) Basic Services - examinations and cleaning of teeth (once in any sixnine-month period), fillings, topical fluoride treatment for dependants under 18 years old or if medically required required, extractions, fillings and other necessary treatment for the relief of dental pain. b. (b) Restorative Services - crowns and inlays, bridge work, dentures, root canal therapy (endodontics), and the treatment of tissues and bones supporting the teeth (periodontics). c. (c) Orthodontia – extractions, proper fitting of natural teeth and prevention or correction of irregularities of the teeth. In addition, extractions shall be treated as an orthodontic procedure for purposes of reimbursement. You will be reimbursed for 90100% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 1,000 in a calendar year. After January 1, 2012 you You will also be reimbursed for 5075% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $7,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. After January 1, 2020, you will be reimbursed for 80% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 in a calendar year. You will also be reimbursed for 50% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $5,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. Benefits will be paid on the basis of the lesser of the actual fee charged or the amount stated in the Current Fee current Dental Association Schedule of Fees in the province in which you reside. If optional procedures are possible, benefits will be payable in accordance with the procedure involving the smallest fee. Expenses incurred for the replacement of dentures are eligible for benefits, except that if the replacement is for a denture for which benefits were payable under this plan, benefits for the replacement will be payable only if at least 3 three (3) years have elapsed since the placement or replacement for which benefits were paid. In addition, benefits are payable for rebasing, relining or repairing of dentures. Benefits will not be paid for the replacement of dentures which have been lost, misplaced or stolen. Dental care benefits are not payable for any service eligible for payment from another source such as provincial health insurance plans, WSIB Worker's Compensation or government plans, expenses incurred principally for cosmetic purposes, expenses resulting from an act of war, or any service for which an employee or dependent does not have to pay. Your dental care insurance will be cancelled as of the date you retire or terminate service and claims will not be accepted for any service performed after the date on which your insurance is cancelled.

Dental Care Benefit. Dental care benefits Care Benefits are provided for you and your eligible dependents subject to the limitations and exclusions described below. Eligible services are all reasonable and customary dental services which are recommended as necessary and performed by a qualified dentist or physician and for which a Treatment Plan has been submitted to and approved by the insurer before the services are rendered. The filing of a Treatment Plan is not required if the total cost of the proposed work is less than $500 or if treatment is rendered in emergency conditions. Eligible dental services are classified under three major categories: a. (a) Basic Services - examinations and cleaning of teeth (once in any six-six month period), fillings, topical fluoride treatment for dependants under 18 years old or if medically required required, extractions, fillings and other necessary treatment for the relief of dental pain. Effective January 1, 2009 recall exams go to a 9 month period. b. (b) Restorative Services - crowns and inlays, bridge work, dentures, root canal therapy (endodontics), and the treatment of tissues and bones supporting the teeth (periodontics). c. (c) Orthodontia – extractions, proper fitting of natural teeth and prevention or correction of irregularities of the teeth. In addition, extractions shall be treated as an orthodontic procedure for purposes of reimbursement. You will be reimbursed for 90100% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 1,000 in a calendar year. After January 1, 2012 you You will also be reimbursed for 5075% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $7,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. After January 1, 2020, you will be reimbursed for 80% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 in a calendar year. You will also be reimbursed for 50% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $5,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. Benefits will be paid on the basis of the lesser of the actual fee charged or the amount stated in the Current Fee current Dental Association Schedule of Fees in the province in which you reside. If optional procedures are possible, benefits will be payable in accordance with the procedure involving the smallest fee. Expenses incurred for the replacement of dentures are eligible for benefits, except that if the replacement is for a denture for which benefits were payable under this plan, benefits for the replacement will be payable only if at least 3 three (3) years have elapsed since the placement or replacement for which benefits were paid. In addition, benefits are payable for rebasing, relining or repairing of dentures. Benefits will not be paid for the replacement of dentures which have been lost, misplaced or stolen. Dental care benefits are not payable for any service eligible for payment from another source such as provincial health insurance plans, WSIB Worker’s Compensation or government plans, expenses incurred principally for cosmetic purposes, expenses resulting from an act of war, or any service for which an employee or dependent does not have to pay. Your dental care insurance will be cancelled as of the date you retire or terminate service and claims will not be accepted for any service performed after the date on which your insurance is cancelled.