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Dental Plan

Group Number 434378

Benefit Period January 1, 2024 – December 31, 2024

Your dental coverage is through Guardian and the dental network is Dental Guard Preferred. Network dentists agree to accept Guardian’s usual, customary & reasonable (UCR) amounts as payment in full for covered services. Non-network dentists will bill you for any difference in cost between the Guardian scheduled amount and the dentist’s fee (balance billing).

To avoid balance billing you should select providers within the network. Frequency limitations apply to certain services.

Base Plan

Dental Benefit Provisions PPO Network PPO Non-Network
Calendar Year Deductible None None
Class I – Preventive Care
Oral Exams, Prophylaxis (dental cleaning), Bitewing X-rays, Full Mouth X-Rays, Sealants
100% 100% of Prevailing Fee
Class II – Basic Care
Fillings (one surface), General Anesthesia, Scaling & Root Planing (per quadrant), Simple Extractions
100% 100% of Prevailing Fee
Class III – Major Care
Dentures, Single Crowns, Implants
60% 60% of Prevailing Fee

Class IV – Orthodontic Procedure

60% 60% of Prevailing Fee

Orthodontic Lifetime Maximum

$2,500 $2,500

Annual Yearly Maximum (Per Person)

$1,500 $1,500

How to Find a Dentist:

  1. Go to www.guardiananytime.com/fpapp/FPWeb
  2. Click “Search Providers”
  3. Make sure you are on the “Find a Dentist” tab
  4. Select Plan Type “PPO”
  5. Enter your information
  6. Click on “Search”

Pre-determination Review

Guardian will gladly assist you and your dentist by determining what benefits could be payable for services and procedures over $300. Have your dentist fax your treatment plan to Guardian, note that it is a pre-determination review and we will let your dentist know what benefits would be payable.