Common use of Required Number of Hours Clause in Contracts

Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Deductibles Single Family ▪ nil ▪ nil Coinsurance ▪ Part I Preventive ▪ Minor Restorative ▪ Part II Major Restorative ▪ Part III Orthodontic ▪ 100% ▪ 100% ▪ 50% ▪ 50% (Eligible Dependent Children only) Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited ▪ Part II - $1,500/year ▪ Part III - $2,500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months ▪ full mouth – once every 24 months

Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Deductibles Single Family ▪ nil ▪ nil Coinsurance ▪ Part I Preventive ▪ Minor Restorative ▪ Part II Major Restorative ▪ Part III Orthodontic ▪ 100% ▪ 100% ▪ 50% ▪ Part III Orthodontic ▪ 50% (Eligible Dependent Children only) Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited ▪ Part II - $1,500/year ▪ Part III - $2,500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months ▪ full mouth – once every 24 months

Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Deductibles Single ▪ nil‌ Family ▪ nil ▪ nil Coinsurance ▪ Part I Preventive ▪ 100%‌ ▪ Minor Restorative ▪ 100% ▪ Part II Major Restorative ▪ 50% ▪ Part III Orthodontic ▪ 100% ▪ 100% ▪ 50% ▪ 50% (Eligible Dependent Children only) only)‌ Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited unlimited‌ ▪ Part II - $1,500/year ▪ Part III - $2,500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months months‌ ▪ full mouth – once every 24 months

Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Deductibles Single Family ▪ nil ▪ nil Coinsurance ▪ Part I Preventive ▪ Minor Restorative ▪ Part II Major Restorative ▪ Part III Orthodontic ▪ 100% ▪ 100% ▪ 50% ▪ 50% (Eligible Dependent Children only) Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited ▪ Part II - – $1,500/year ▪ Part III - – $2,500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months ▪ full mouth – once every 24 months

Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Deductibles Single Family ▪ nil ▪ nil Coinsurance ▪ Part I Preventive ▪ Minor Restorative ▪ Part II Major Restorative ▪ Part III Orthodontic ▪ 100% ▪ 100% ▪ 50% ▪ 50% (Eligible Dependent Children only) Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited ▪ Part II - $1,500/year ▪ Part III - $2,500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months ▪ full mouth – once every 24 months

Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Deductibles Single Family ▪ nil ▪ nil Coinsurance ▪ Part I Preventive ▪ 100% ▪ Minor Restorative ▪ 100% ▪ Part II Major Restorative ▪ 50% ▪ Part III Orthodontic ▪ 100% ▪ 100% ▪ 50% ▪ 50% (Eligible Dependent Children only) Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited ▪ Part II - $1,500/year ▪ Part III - $2,500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months ▪ full mouth – once every 24 months

Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Deductibles Single Family ▪ nil ▪ nil Coinsurance ▪ Part I Preventive ▪ Minor Restorative ▪ Part II Major Restorative ▪ Part III Orthodontic ▪ 100% ▪ 100% ▪ 50% ▪ 50% (Eligible Dependent Children only) Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited ▪ Part II - $1,500/year ▪ Part III - $2,500 2500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months ▪ full mouth – once every 24 months

Required Number of Hours. ▪ same as Major Medical Dental Fee Guide ▪ current in province of residence Deductibles Single ▪ nil Family ▪ nil ▪ nil Coinsurance ▪ Part I Preventive ▪ 100% ▪ Minor Restorative ▪ 100% ▪ Part II Major Restorative ▪ 50% ▪ Part III Orthodontic ▪ 100% ▪ 100% ▪ 50% ▪ 50% (Eligible Dependent Children only) Orthodontic Dependent Children Age Basis ▪ under 19 years old Benefit Maximum ▪ Part I – unlimited ▪ Part II - $1,500/year ▪ Part III - $2,500 lifetime Recall Exam ▪ 6 months X-Rays ▪ bitewing – once every 6 months ▪ full mouth – once every 24 months