Dental Coverage
Regular dental exams can help you and your dentist detect problems in the early stages when treatment is simpler and costs are lower.
Keeping your teeth and gums clean and healthy will prevent most tooth decay and periodontal disease, and is an important part of maintaining your medical health.
Your PPO dental plan is through Sun Life and offers “in and out-of-network” benefits.
Insurance Carrier:
Sun Life Dental Insurance
Plan Type:
Basic
Enhanced
Calendar Year Deductible Calendar Year Maximum
$50 Individual / $150 Family $50 Individual / $150 Family
$1,000
$2,000
Preventive Services
100%
100%
Basic Services Major Services
80% 50%
90% 60%
Orthodontia (dependent children only) Out-of-Network Reimbursement
N / A
$1,000
90th UCR
90th UCR
Employee Bi-Weekly Deduction Employee Only
$6.76
$13.79 $26.57 $37.19
Employee + Spouse Employee + Child(ren)
$15.80 $15.54 $22.27
Family $47.02 time insured continuously under a dental plan benefits provided for only these services Less than 6 months Preventive Services At least 6 months but less than 12 months Preventive Services and fillings under Basic Services At least 12 months Preventive, Basic, Major and Ortho Services
9 Acom Integrated Solutions 2022 Enrollment Guide
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