Dental Care: Academic Staff

The Dental Care plan covers you and your eligible dependents for services that maintain or restore healthy teeth and gums.

Making the Most of Your Dental Benefits

It is recommended that you discuss fees with your dentist before you receive treatment. If you do have to pay any additional charges, you will be prepared ahead of time and can choose to negotiate a better price, get a cost estimate from another dentist, or agree to pay your dentist’s extra fees.

Reimbursement of eligible expenses are based on the current year Sun Life Dental Fee Guide and is adjusted yearly for cost of living. Check with your dentist before your dental work begins to see if he or she charges according to the current dental fee guide. If your dentist charges more than the current fee guide, you will have to pay the additional amount.

The University dental coverage is provided through Sun Life. Visit the Making a Claim page to learn more.

Reimbursement of eligible expenses are based on the current year Sun Life Dental Fee Guide and is adjusted yearly for cost of living. Check with your dentist before your dental work begins to see if he/she charges according to the current dental fee guide. If your dentist charges more than the current fee guide, you will have to pay the additional amount.

Treatment Plan Pre-determination

If the proposed treatment is orthodontic or for services over $500, it is recommended that your dental office submit a treatment plan to Sun Life in order to establish what expenses will be covered by the Plan. This allows both you and your dentist to know in advance what amounts will be considered eligible under your group coverage. Generally, the Dental claim form is used for obtaining pre-determination and can be submitted electronically or by paper.

Least Cost Alternative

When two or more covered dental procedures are separately suitable for the dental care of a specific condition, and both are consistent with good dental care, the Plan will provide benefits for the least expensive service.

Co-ordination of Benefits

There are certain rules that govern the reimbursement of claims when both you and your spouse have benefit coverage with your respective employers. Visit the Co-ordination of Benefits page to learn more.

Dental Care: Academic Staff Coverage

Basic

Basic dental covers services for the basic care and maintenance of teeth including procedures to restore teeth to natural and normal function. This benefit is covered at 100% of the Sun Life Dental Fee Guide.

Eligible Services Include

Oral Exam Once every 12 months (Adult)
Twice every 12 months (Under age 16)
Cleaning & Light Scaling Once every 12 months (Adult)
Twice every 12 months (Under age 16)
Fluoride Treatment Once every 12 months (Adult)
Twice every 12 months (Under age 16)
X-Rays Once every 12 months (Adult)
Twice every 12 months (Under age 16)
Full Mouth X-Rays Once every 24 months
Emergency Palliative Treatment As required
Extractions As required
Routine Restorations As required
Minor Oral Surgery Anesthesiologist service is covered, but the facility is NOT
Root Canal Therapy As required
Periodontal Treatment Reasonable and customary as required
Space Maintainers As required
Pit and Fissure Sealant Dependents under age 16 only
Denture Repairs As required
Sleep Apnea Appliance No Coverage (see Supplementary Health Care)

Major Restorative Services

Major dental covers major restorations or replacement of missing teeth, or the reconstruction of teeth where basic restorative methods cannot be used satisfactorily. This benefit is covered at 75% of the Sun Life Dental Fee Guide.

Eligible Services Include

Fixed Bridges and Repairs
Crowns, Inlays, Metal Onlay Retainers
Crown Repairs
Periodontal Appliances
Precision Attachments
Dentures
Denture Additions

Orthodontic Services

Orthodontics corrects teeth and jaws that are positioned improperly. Orthodontic services cover expenses including ortho-exams, x-rays, casts, braces and retainers. This benefit is covered at 75% of the Sun Life Dental Fee Guide.

Eligible Services Include

Diagnostic (once only)
Interceptive Orthodontics
Comprehensive Orthodontics

If you require information on a service that is not listed above please contact Sun Life Customer Care Centre at 1-800-361-6212 or via email at askus@sunlife.com.  If you require information regarding specific coverage those details can be found by logging into your Sunlife web access and viewing coverage information.

For more information, please refer to the Academic Staff Dental Plan Policy.