Waiting Period 3 monthsDeductible $25 Individual, $50 Family, per calendar year(s)Deductible Carry-Forward/Covered expenses used to satisfy the deductible in the last 3 months of the calendar year may also be used to satisfy the deductible in the following calendar year.$1,000 per calendar yearLevel I - Basic ServicesIncludes items such as: complete oral exam, one per 2 calendar years full-mouth x-rays, one per 2 calendar years one unit of light scaling and one unit of polishing twice per calendar year, when the service is performed outside Quebec, or prophylaxis twice per calendar year, when the service is performed in Quebec bitewing x-rays, two films, twice per calendar year recall exams, and fluoride treatments, twice per calendar year (fluoride treatments are a covered expense for dependant children under 19 years of age) routine diagnostic and laboratory procedures fillings, retentive pins and pit and fissure sealantsReplacement fillings are covered provided:- the existing filling is at least 12 months old and must be replaced either due to significant breakdown of the existing filling or recurrent decay, or- the existing filling is amalgam and there is medical evidence indicating that the patient is allergic to amalgam pre-fabricated full coverage restorations (metal and plastic) space maintainers (appliances placed for orthodontic purposes are not covered) minor surgical procedures and post surgical care extractions (including impacted and residual roots) consultations, anaesthesia, and conscious sedation denture repairs, relines and rebases, only if the expense is incurred later than 3 months after the date of the initial placement of the denture injection of antibiotic drugs when administered by a Dentist in conjunction with dental surgery 80% to a combined maximum of $1,000 per calendar year Level II - Supplementary ServicesIncludes items such as: surgical procedures not included in Level I (excluding implant surgery) periodontal services for treatment of diseases of the gums and other supporting tissue of the teeth, including:- scaling not covered under Level I, and root planing, up to a combined maximum of 8 units per calendar year(s) ;- provisional splinting; and- occlusal equilibration, up to a maximum of 8 units per calendar year(s) endodontic services which include root canals and therapy, root amputation, apexifications and periapical services root canals and therapy are limited to one initial treatment plus one re-treatment per tooth per lifetime re-treatment is covered only if the expense is incurred more than 12 months after the initial treatment 80% to a combined maximum of $1,000 per calendar year.

Our plan sponsor has chosen to offer the following benefits to form the coverage in this program: Accidental Death and Dismemberment Insurance Dental Counselling Services [Workplace Advisor] Extended Health Care Benefit Health Service Navigator® Life Insurance Long-Term Disability Survivor Benefit Health for Life® - Resources to help you and your family maintain overall good health and wellnes