Page 10 - Quarles

Dental Benefits

You have two choices for dental benefits through Sun Life Financial, the

Freedom Basic Plan and the Freedom Preferred Plan. Both plans cover

expenses from in-network and Dental Benefits
out-of-network. However, you
save money when using in- See the Sun Life Financial summary for coverage details

network dentists. Freedom Freedom
Basic Plan Preferred Plan

Freedom Basic provides Plan Features Combined Combined
coverage for some of the most In-Network and In-Network and
common dental procedures. Annual Deductible Out-of-Network Out-of-Network
Does not apply to $50 per person $50 per person
Freedom Preferred offers Preventive and Diagnostic
valuable protection with Services $1,250 $1,250
increased benefits over the Annual Maximum Benefit
Freedom Basic plan. Maximum the plan pays
per plan year

How often should Preventive Services Plan pays 100%; Plan pays 100%;
you change your Two routine exams every no deductible no deductible
toothbrush? 12 months, includes x-rays Plan pays 80% Plan pays 80%
and cleanings after deductible
The American Dental Basic Services after deductible Plan pays 50%
Association recommends Restorative and Not Covered after deductible
changing your toothbrush replacement fillings, simple
every three to four months extractions, minor gum
or sooner if the bristles disease treatment, scaling
are frayed. and root planning,
periodontal maintenance
Major Services
Endodontics, complex oral
surgery, major gum
disease treatment, inlays,
onlays, crowns, dentures

Child Orthodontia Not Covered Plan pays 50% up to
For children up to age 19 $1,000 lifetime

maximum per person

Don’t Overpay for Dental Plan
Your Dental Care Bi-Weekly Contribution Rates
Be aware that both plans
cover out-of-network Coverage Freedom Freedom
charges up to specified amounts, but out-of-network providers Basic Plan Preferred Plan
may charge significantly more.
Associate $8.87 $13.88
To find network dentists for better coverage of your expenses,
go to the dentist network at assurantemployeebenefits.com. Spouse $8.13 $13.13

Per child $7.54 $10.60

9 2016-2017 Benefits Guide