Sunlife ca pdsp 2026

The document is a claim form for the Pensioners' Dental Services Plan (PDSP) administered by Sun Life Assurance Company of Canada. It outlines the process for submitting dental claims, including coordination with the Public Service Health Care Plan (PSHCP) for members covered under both plans. The form requires information from both the dentist and the member, detailing patient and treatment specifics, and includes sections for major restorative claims, orthodontics, and coverage under other benefit plans. Members must certify the accuracy of their claims and authorize information release to facilitate processing.

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Click ‘Get Form’ to open the sunlife ca pdsp in the editor.
Begin with Part 1, which is to be completed by your dentist. Fill in the unique number, dentist's name, address, and patient’s office account number. Ensure that the dentist signs where indicated.
Proceed to Part 2 for member information. Enter your contract number, certificate number, date of birth, and contact details clearly.
In the 'Details of Claim' section, provide information regarding any major restorative claims and indicate if they are due to an accident. Be sure to include dates and reasons as required.
Complete the 'Coverage Under Other Benefit Plans' section if applicable. Indicate any other insurance coverage and attach necessary documents like Explanation of Benefits (EoB).
Finally, review all entries for accuracy before signing the member certification & authorization section at the bottom of the form.

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