When you are selecting your Sun Life Dental coverage in your Total Rewards enrollment process, you'll notice that there are Annual Maximum provisions for each Dental plan. These are your maximum annual amounts for eligible dental expenses for the benefit year (Dec 1 -Nov 30) covered at the percentage specified. More specifically, let's define the Annual Maximums shown in the enrollment process:
- Annual Maximum (100% Coverage): Your plan covers 100% of eligible dental expenses, up until the Annual Maximum amount specified.
- Annual Maximum (60% Coverage): After the above amount is spent, your plan covers 60% of eligible dental expenses, up until the Annual Maximum amount specified. Once this amount is reached, you have zero coverage remaining for the year.
This kind of plan means that if your annual eligible dental expenses are low, they will likely be covered at 100%. Once you exceed your Annual Maximum (100% Coverage), however, you'll only be reimbursed for 60% of your additional eligible dental expenses, up to your Annual Maximum (60% Coverage). Once that amount is exceeded, you're out of Sun Life Dental coverage for the year.
Example: In your enrollment process, you select the Sun Life Dental "Basic" plan shown in the image below. During your policy year, you visit the dentist for a $300 cleaning (covered as a "Preventative Care" expense). This is within your Annual Maximum (100%), so Sun Life pays for the full $300, leaving $100 until you reach your Annual Maximum (100%). A month later, you visit the dentist for another $300 eligible cleaning. For this visit, Sun Life pays $100 at 100% coverage, and $200 at 60% coverage. Therefore, Sun Life pays for $220 ($100 + $120) in total. After this visit, you've exhausted your Annual Maximum (100%) and have used $520 of your $1000 Annual Maximum (60%). For the rest of this policy year, all eligible dental expenses will be covered at 60%, until Sun Life has paid out your remaining Annual Maximum (60%) total of $480.
After your enrollment period has concluded on November 15th, you'll be able to review your selected Sun Life Dental coverage (including your detailed policy booklet) in your League Wallet. Click here for a step-by-step walkthrough.