Who are eligible dependents? Those qualified to be covered under your dental plan include your spouse and children less than age 26. See your certificate or group insurance policy for additional eligibility details.
Dental plan provisions, limitations and exclusions Benefit Adjustments
Benefits will be coordinated with any other dental coverage. Under the Alternative Treatment provision, benefits will be payable for the most economical services or supplies meeting broadly accepted standards of dental care. If the charge for any dental treatment is expected to exceed $300, it is recommended that a dental treatment plan be submitted to Sun Life Financial for review before treatment begins. Late Entrant If you apply for dental insurance more than 31 days after a covered person first becomes eligible, the person is a late entrant. The benefits for the first 24 months of coverage for late entrants will be limited as follows: Time Insured Continuously Under the Policy Benefits Provided for Only These Services Less than 6 months Preventive Dental Services At least 6 months but less than 12 months Preventive and Basic Restorative Dental Services At least 12 months but less than 24 months Preventive and all Basic Dental Services At least 24 months Preventive, Basic and Major Dental Services We will not pay for any treatment that is started or completed during the late entrant limitation period. For additional limitations and exclusions, as well as other details about your coverage, please see the Other Important Plan Provisions section. This dental plan does not provide coverage for pediatric oral health services that satisfies the requirements for “minimum essential coverage” as defined by the Patient Protection and Affordable Care Act. (“PPACA”).
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