Option |
Co-insurance basic services |
Co-insurance comprehensive basic service |
Co-insurance major services |
Co-insurance orthodontics |
1 - Opt Out |
Not covered |
Not covered |
Not covered |
Not covered |
2 - Spousal Top Up Option |
20% |
20%, basic services and comprehensive basic services : $250 per benefit year combined |
50%, $1,500 per benefit year |
50% (dependent children only), $2,000 per lifetime |
3 - Basic Option |
Diagnostic 100%, basic restorative 50% |
50%, basic services and comprehensive basic services : $750 per benefit year combined |
Not covered |
Not covered |
4 - Enhanced Option |
Diagnostic 80%, basic restorative 80% |
80%, basic services and comprehensive basic services : $1,000 per benefit year combined |
50%, $1,500 per benefit year |
Not covered |
5 - Extensive Option |
Diagnostic 90%, basic restorative 90% |
90%, basic services and comprehensive basic services : $1,500 per benefit year combined |
50%, $2,000 per benefit year |
50% (dependent children only), $2,500 per lifetime |