Dental Benefits

This voluntary plan is available to all executive employees.

Dental insurance offers coverage for preventive care like routine exams, cleanings, and X-rays, as well as basic and major services like fillings, extractions, root canals, and crowns.

Keep in mind that your costs will generally be lower if you choose an in-network dentist. To find an in-network dentist, please visit www.guardianlife.com.

• This is a brief outline of your benefits, showing in-network benefits only.
• Dependents are covered until the end of the calendar year at age 26.

	In-Network
Preventive & Diagnostic Services	100% covered
Basic Services	90% covered
Major Services	60% covered
Deductible (Individual/Family)	$50/$150
Annual Plan Maximum Per Person	$1,500
Annual Maximum Rollover	$1,250

	Rates Per Pay Period
Employee	$0
Employee + Spouse	$14.08
Employee + Child(ren)	$14.87
Family	$35.08

Maximum Rollovers
Guardian will roll over a portion of your unused annual maximum into a personal Maximum Rollover Account, which can be used in future years if your dental expenses exceed the plan’s annual maximum. As an added advantage, more money is rolled over if in-network dentists are used exclusively during the benefit year.

Plan Annua	Threshold	Maximum Rollover Amount	In-Network Only Rollover Amount	Maximum Rollover Account Limit
$1,500	$700	$350	$500	$1,250
Maximum Claims Reimbursement	Claims amount that determines rollover eligibility	Additional dollars added to Plan Annual Maximum for future years	Additional dollars added to Plan Annual Maximum for future years if only in-network providers were used during the benefit year	Cannot exceed $1,250

Downloads

Summary of Benefits

Group Number

00529559

Provided By

Guardian

Provider Website

www.guardianlife.com

Customer Service

888.600.1600

Resources

Frequently Asked Questions