Dental Care Benefits are designed to help you pay for your family’s dental expenses, both for routine (basic and preventive) care and for expensive and unforeseen treatments (major restorative services).
To be considered as a “covered expense”, the charge for a particular service must be reasonable and customary for the service provided in the area where the expense is incurred, and will be limited to the maximum fee level of the 2016 suggested fee guide for dental services provided by General Practitioners of the Ontario Dental Association (increasing to the 2017 fee guide on January 1, 2018 and the 2017 fee guide on January 1, 2018). Fee schedule adjustments are at the discretion of the Board of Trustees. Any amounts charged by the dentist which are in excess of the fee guide approved by the Trustees, must be borne by the member.
The Plan covers necessary dental treatment by a dentist, denturist, qualified dental hygienist, or any other qualified personnel under the direct supervision of a dentist. If you are going to use the services of a denturist, check with the Denturist Society to ensure that the denturist is licensed and that he is practicing within the scope of his license. Coverage will be on the 2016 suggested fee guide provided by the Denturist Society of Ontario or The Ontario Association of Denture Therapists (increasing to the 2017 fee guide on January 1, 2018 and the 2017 fee guide on January 1, 2018).
This benefit is provided to you and your eligible dependents. Eligible dependents are defined as:
- your legal or common-law spouse, and
- your unmarried children under 21 years of age, and
- your unmarried children aged 21 and over who were continuously covered under the Plan and who are full time students and under the age of 26 years or who are unable to support themselves because of mental or physical handicap,
- but excluding any children who are not financially dependent on you or a handicapped or unmarried child not covered under the Plan up to his/her 21st birthday. Your common-law spouse and dependents are eligible 6 months after notice of cohabitation is received by the Benefits Office.