Optional Dental Care Insurance

Dental care insurance is available to all active and retired employees and their eligible dependents (see Summary of Your Benefit Program) on an optional and employee-pay-all basis. In order to be insured for this benefit, you must also be insured under the basic group insurance program.

Coverage will be based on the 2008 Newfoundland and Labrador Dental Association Fee Guide for general practitioners and specialists in accordance with the following:

Basic Benefits
Eligible expenses will be reimbursed at 80%; there is no annual or overall maximum applicable.

Diagnostic Services

• Clinical oral examinations (one recall examination every calendar year for adults; every five months for a dependent child age 17 or less)
• X-ray examinations - full mouth or panoramic films (one set of each in a calendar year) single films (up to ten), occlusal, posterior bitewing or extraoral films (four of each type in five months); and
• Tests, laboratory examinations and treatment planning.

Preventative Services
Cleaning and polishing, fluoride treatments (once a calendar year for adults; every five months for a dependent child age 17 or less) nutritional counseling, oral hygiene instruction, pit and fissure sealants, space maintainers and protective athletic appliances (one in 12 months).

Restorative Services
Fillings, recementing inlays and crowns, removal of inlays and crowns and cement restorations.

Endodontic Services
Diagnosis and treatment of the pulp (nerve) and tissue which supports the end of the root, root canal therapy and emergency procedures.

Periodontic Services
Diagnosis and treatment of disease which affects the supporting tissue of the teeth, such as the gums and bones surrounding the teeth.

Prosthodontic Services - Removable
Denture repairs, denture rebasing and relining (once in 24 months) and tissue conditioning.

Surgical Services
Extraction of teeth

Adjunctive General Services
Emergency treatment of pain, local anaesthetic or conscious sedation and consultation with another dentist.

Major Restorative Benefits
Eligible expenses will be reimbursed at 70% to a maximum of $1,250.00 per insured person per calendar year.

Extensive Restoratives
Major repairs and restorations, including inlays, onlays and crowns

Prosthodontic Services
Complete dentures, partial dentures, denture adjustments and repairs, pontics, retainers, abutments, crowns and fixed bridges.

This program excludes:

• replacement of the denture, unless it is at least five years old and cannot be made serviceable; and
• the replacement of dentures that have been lost, mislaid or stolen.

Major Surgical Procedures
Surgical exposure of the tooth, surgical repositioning or transplantation, cutting of bone to aid in removal of teeth or to permit insertion of a denture, surgical shaping of gum or tissue in order to support teeth and treatment of tumors and cysts.

Note
If you do not apply for optional dental coverage within 31 days of being eligible, you will be considered a late applicant.

Late applicants, provided they are not eligible for coverage under their spouse's dental program, will be limited to an eligible expense of $100.00 per individual during the first 12 months of coverage.

Termination of Coverage
Your dental insurance coverage terminates on the termination of employment. Coverage may be continued during early retirement provided you are in receipt of a pension from either the Public Service Pension Plan, the Uniformed Services Pension Plan or the Members of the House of Assembly.
 
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