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11
UNDERS TAND I NG
YOUR
DENTAL
PLAN
Dental Questions? Need to Locate a Provider?
Contact Guardian
1-888-600-1600 or
www.guardiananytime.comGroup #: 00518964
Oglethorpe University’s dental benefits are insured by Guardian. Employees can enroll in either the Value
Plan or the NAP Plan. Both plans are passive PPO plans so employees are free to utilize any provider they
wish. Although you can visit any dentist you would like, in or out of network, staying in network excludes any
possibility of balance billing.
The NAP Plan pays out of network providers at a higher reimbursement level than the Value Plan. For those
employees who visit a dentist that does not participate in the Guardian PPO network, enrolling in the NAP
plan will assure that your dentist receives the highest possible reimbursement from Guardian and will help
mitigate any additional charges due to balance billing.
In-Network
Out-of-Network
*Subject to Negotiated Fee Schedule
Deductible
Single: $50
Family: $150
Single: $50
Family: $150
Annual MaximumBenefit Per Individual
$2,000
$2,000
Preventive Services
(Oral exams, cleanings, X-Rays)
100%
(deductible waived)
100%
(deductible waived)
*
Basic Services
(Fillings, periodontics, simple extractions, root canals)
100% after deductible
100% after deductible*
Major Services
(Crowns, dentures, complex extractions, inlays and veneers)
60% after deductible
60% after deductible*
Orthodontia
(children to age 26 and adults)
In-Network
Out-of-Network
*Subject to 90th Percentile of Usual and
Customary
Deductible
Single: $50
Family: $150
Single: $50
Family: $150
Annual MaximumBenefit Per Individual
$2,000
$2,000
Preventive Services
(Oral exams, cleanings, X-Rays)
100%
(deductible waived)
100%
(deductible waived)
*
Basic Services
(Fillings, periodontics, simple extractions, root canals)
80% after deductible
80% after deductible*
Major Services
(Crowns, dentures, complex extractions, inlays and veneers)
50% after deductible
50% after deductible*
Orthodontia
(children to age 26 and adults)
Annual MaximumRollover
Available with both Value and NAP plan: If members receive at least one cleaning per year
and use a total benefit of less than $800, they will be rewarded with a $400 increase in the
next year's benefit maximum, to a maximum of an additional $1,500.
Value Plan
Covered at 50%; $1,000 Lifetime Benefit Maximum
NAP Plan
Covered at 50%; $1,000 Lifetime Benefit Maximum