Dental
Dental coverage helps you maintain a healthy smile with preventive care, basic services, and major procedures. You can visit any licensed dentist, but you’ll save the most when you use an in-network provider who has agreed to discounted rates. Out-of-network dentists may charge more than the plan’s allowed amount, and you may be responsible for the difference. Most plans cover preventive services—such as exams, cleanings, and X-rays—at 100% when you stay in-network, making regular checkups an easy way to protect your oral health and avoid costly issues.
Guardian PPO Base
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$2,000
Preventive Care
$0
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
Not covered
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$2,000
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Adults and Children)
Not covered
Per-Pay-Period Plan Cost
Employee Only: $0.00
Employee and Spouse/DP: $1.50
Employee and Child(ren): $2.50
Employee and Family: $4.00
Guardian PPO Buy-Up w/ Orthodontia
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$5,000
Preventive Care
$0
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50%; $2,000 lifetime plan maximum
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$5,000
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Adults and Children)
50%; $2,000 lifetime plan maximum
Per-Pay-Period Plan Cost
Employee Only: $13.00
Employee and Spouse/DP: $25.00
Employee and Child(ren): $26.50
Employee and Family: $39.50