The University of Saskatchewan dental plan is designed to promote good dental health for you and your family by helping you cover the cost of many dental services.
The Dental Plan will reimburse you for the following (subject to certain limits):
- 100% of Basic Dental Services
- 50% of Major Dental Services, and
- 50% of Orthodontic Services for children under age 19 to a lifetime maximum of $2,000 per child.
There is a Basic and Major Services combined maximum of $1,500 per person per calendar year.
The Plan has no deductible.
For each dental procedure, only reasonable expenses will be covered, up to the usual charge for the most economical alternate procedure, service or treatment consistent with accepted dental practice. See exclusions and limitations below.
If your dentist recommends any dental procedure that is expected to cost over $500, you should have your dentist complete a pre-treatment plan. Submit this plan to the insurer, and you will be advised of the benefits payable for the course of treatment.
Submitting a pre-treatment plan ensures that there are no misunderstandings about what reimbursement you will receive for expensive courses of treatment.
Fee Guide: The current fee guide for general practitioners approved by the Dental Association in the employee's province of residence.
Preventive dental procedures
- complete exam once every 36 months
- recall exam once every five months, to a maximum of two exams per benefit year
- emergency or specific exams limited to two per benefit year per type of exam
- complete series of X-rays OR one panorex once every 36 months
- bitewing x-ray once every five months, to a maximum of two sets per benefit year
- radiograph to diagnose or examine progress
- required consultations with another dentist
- polishing/cleaning and topical fluoride treatment every five months, to a maximum of two per benefit year
- emergency or palliative services
- diagnostic tests and lab exams
- removal of impacted teeth and anaesthesia
- space maintainers for primary teeth
- pit and fissure sealants
- oral hygiene instruction once per benefit year
- amalgam (silver)
- composite (white) on all teeth − acrylic (replaced by composite)
- removal of teeth (except impacted teeth)
- prefab metal restorations/crowns and repairs (not custom made)
- endodontics (root canal therapy/fillings, treat disease of pulp tissue)
- periodontics (treatment of bone and gum disease)
- root planing and scaling (8 units each per year)
- occlusal adjustment
- provisional splinting
- supplies usually intended for sport use (eg. mouthguards)
- transplants and repositioning of the jaw
- surgery and related anaesthesia (except removal of impacted teeth)
- repair of bridges or dentures
- rebase or reline denture
- inlays and onlays
- bridges and dentures (prosthodontic) – construction and insertion of bridges or standard dentures (not dentures with precision attachments). Replacement after five years
For an implant related crown or prosthesis, Sun Life will pay the benefit that would have been payable under this plan for a tooth supported crown or a non-implant related prosthesis, respectively. Sun Life will take into account any limitations that would have applied if there had been no implant. All other expenses related to implants, including surgery charges, are not covered.
- interceptive, interventive or preventive services
- comprehensive treatment
General Exclusions and Limitations
Sun Life will not pay for services or supplies payable or available (regardless of any waiting list) under any government-sponsored plan or program unless explicitly listed as covered under this benefit.
Sun Life will only pay for a procedure that has a reasonably favourable prognosis in the opinion of Sun Life.
Sun Life will not pay for:
- procedures performed primarily to improve appearance.
- the replacement of dental appliances that are lost, misplaced or stolen.
- charges for appointments that a person does not keep.
- charges for completing claim forms.
- services or supplies for which no charge would have been made in the absence of this
- procedures or supplies used in full mouth reconstruction (capping all of the teeth in the mouth), vertical dimension corrections (changing the way the teeth meet) including attrition (worn down teeth), alteration or restoration of occlusion (building up and restoring the bite), or for the purpose of prosthetic splinting (capping teeth and joining teeth together to provide additional support).
- charges related to the temporomandibular joint (TMJ) treatment, except otherwise indicated in the list of covered expenses.
- experimental treatments.
Sun Life will also not pay for dental work resulting from:
- the hostile action of any armed forces, insurrection or participation in a riot or civil commotion.
- dental services required due to congenital malformation.
- participation in a criminal offence.
Coordination of Benefits
View claim procedures including coordination of benefits and submission deadlines.
Coverage and Eligibility
Learn more about:
- Eligibility and effective date of coverage for you and your dependents.
- Termination of Coverage
- Converting your benefits to an individual plan
- Proof of Coverage for Health and Dental Benefits
The information contained herein is intended only as a summary of your Dental Plan which is administered by Sun Life under policy number 150798. In the event of any misunderstanding or discrepancy, benefits will be paid according to the policy and applicable legislation.
Sun Life Customer Call Centre
Sun Life has a Customer Call Centre that provides information directly related to your benefits, claims submitted and status of your claim. Other questions or scenarios that Sun Life can assist with are:
- How do I update or change my dependents?
- My child is attending University. How do keep them on my plan as an overage dependent?
- What is the status of my claim?
- What is my maximum for a specific service? How do I know if I have reached my benefit maximum?
- What am I or my dependents covered for under a certain plan?
- I am locked out of MySunLife account. How do I reset my password?
- Why was my claim denied?
1-800-361-6212 during the work week from 8am to 8 pm EST.
Or connect online through your MySunLife account. Visit www.mysunlife.ca and enter your access ID and password.
Types of questions Connection Point can assist with:
- What date does my coverage begin?
- What type of benefit coverage am I eligibile for?
- How do I submit a claim?
Come See Us
Arts Building, Room 258
Monday to Friday, 8:00 am to 4:30 pm