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DENTAL
Dental benefits are provided through Guardian. You have two different dental plan options to choose from. Please
review the summary of coverages below. In addition, detailed information from Guardian has been posted on the
enrollment site.
ITEMS TO NOTE:
97.6 % of employees have
access to an In-Network
Provider within a 10 mile radius.
Maximum Rollover Reward
Employees & covered
dependents can earn
$350 annually up to $1000
maximum. To qualify, you
must have at least one paid
claim and must not exceed
the paid claims threshold of
$500 during the benefit year.
You can check your balance
at
guardiananytime.com.In Network Preventive
Advantage
Preventive care will not be
deducted from the annual
maximum.
PPO Network in Mexico
Access listing via
www.guardiananytime.com-
Find a Provider
International Assist
Provides referral assistance for
emergency dental care while
traveling abroad.
Member Discounts through
Guardian Anytime
Epic Hearing
Dell Computers
Office Max
others
Description of Coverage
Guardian
Value
NAP
In-Network
Out-of-Network
In-Network
Out-of-Network
Network
DentalGuard
Preferred
n/a
DentalGuard
Preferred
n/a
Benefit Payment Percentile
n/a
Fee Schedule
n/a
R & C 90%
Annual Maximum
$1,000
$1,000
$1,000
$1,000
Deductible
(Individual
♦
Family)
$50 / $150
$50 / $150
$50 / $150
$50 / $150
Waived for Preventive
Yes
Yes
Yes
Yes
Preventive Services
100%
100%
100%
100%
Additional Cleanings Covered
yes w/medical condition
yes w/medical condition
Basic Services
100%
100%
80%
80%
Major Services
60%
60%
50%
50%
Endodontics
Basic
Basic
Periodontics
Basic
Basic
Implants
Major
Major
Orthodontia
Included
Included
Dependent Age Limit
Less than age 19
Less than age 19
Lifetime Maximum Benefit
$1,000
$1,000
Annual Maximum Rollover
Benefit
Included
Included
Employee Monthly Premium
Value
NAP
Employee Only
$33.38
$33.38
Employee Plus Spouse
$66.58
$66.58
Employee Plus Child(ren)
$74.30
$74.30
Employee Plus Family
$121.66
$121.66