Dental - Guardian Benefit Summary - VWG - 7.26.22

Download as pdf or txt
Download as pdf or txt
You are on page 1of 6

VWG WEALTH MANAGEMENT

ALL ELIGIBLE EMPLOYEES WORKING 30 OR MORE


HOURS PER WEEK
Group Number: 00552214

Customer Service (888) 600-1600


Monday to Friday | 8am to 8:30pm ET

Welcome to

Workplace benefits
Everyone deserves a Guardian Your coverage options 
Every day, Guardian gives 26 million Americans the
security they deserve through our insurance and Dental Taking care of teeth and
insurance overall health
wealth management products and services. 
We’ve partnered with your organization to offer Vision Looking after your eyesight
you a range of employee benefits. Inside this pack, insurance and related health issues
you’ll find the plans your employer thinks you might Long term disability Coverage for longer periods
benefit from.  insurance where you can't work

Know your benefits


Your benefits support your physical and
financial wellbeing, to help keep you and
your loved ones protected.
With Guardian, you’re in good hands.
We’ve been delivering on our promises for
over 150 years, and we’re looking forward
to doing the same for you too.

1 Read through this information.

2 Find out more about your benefits.

3 Talk to your employer if you need


help or have any questions.
© Copyright 2020 The Guardian Life Insurance Company of America
This document is a summary of the major features of the insurance
coverage that's been agreed to with your employer – it isn't your contract.
Watch our video
Learn how dental insurance can
protect your long-term health.

Dental
insurance
Taking care of your teeth is about more Staying healthy
than just covering cavities and cleanings. Joe visits his dentist for a routine
dental cleaning, to take care of his
It also means accounting for more expensive teeth as well as his overall health.
dental work, and your overall health.
With dental insurance, routine preventive care can lead to Oral health is about more than just
better overall health. And you’ll be able to save money if any teeth and gums. It’s also essential
extensive dental work is required. for a range of other health and
wellbeing reasons:
Cardiovascular disease: Some
Who is it for? research suggests that heart
Everyone should have access to great dental coverage, which is why we disease, clogged arteries, and
offer comprehensive plans that are available through employers as part of infections may be linked to
your benefit offerings. inflammation and infections
from oral bacteria.
What does it cover? Osteoporosis: Weak and brittle
bones may be linked to tooth loss.
Dental insurance helps to protect your overall oral care. That includes
services like preventive cleanings, x-rays, restorative services like fillings, Diabetes: Research shows that
and other more serious forms of oral surgery if you ever need them. people with gum disease find it
more difficult to control their
Why should I consider it? blood sugar levels.
Poor oral health isn’t just aesthetic, it’s also been linked to conditions Alzheimer’s disease: Tooth loss
including diabetes, heart disease, and strokes. So, while brushing and before the age of 35 may be a risk
flossing every day can help keep your teeth clean, nothing should replace factor for Alzheimer’s disease.
regular visits to the dentist.

All information contained here is


from the Mayo Clinic, Oral Health:
A Window to Your Overall Health,
www.mayoclinic.com. 2018.
You will receive these benefits if you meet the conditions listed in the policy.

GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America


VWG WEALTH MANAGEMENT Kit created 07/26/2022
ALL ELIGIBLE EMPLOYEES WORKING 30 OR MORE HOURS PER WEEK Group number:00552214 3
2020-104309 (07/22)
Your dental coverage
PPO plan, you can visit any dentist; but you pay less out-of-pocket when you choose a PPO dentist. Out-of-network benefits are
limited to our PPO fee schedule.
Your Dental Plan PPO

Your Network is DentalGuard Preferred


Calendar year deductible In-Network Out-of-Network
Individual $50 $50
Family limit 3 per family
Waived for Preventive Preventive
Charges covered for you (co-insurance) In-Network Out-of-Network
Preventive Care 100% 100%
Basic Care 80% 80%
Major Care 50% 50%
Orthodontia Not Covered (applies to all levels)
Annual Maximum Benefit $1000
Maximum Rollover Yes
Rollover Threshold $500
Rollover Amount $250
Rollover In-network Amount $350
Rollover Account Limit $1000
Lifetime Orthodontia Maximum Not Applicable
Dependent Age Limits 26

GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America


VWG WEALTH MANAGEMENT Kit created 07/26/2022
ALL ELIGIBLE EMPLOYEES WORKING 30 OR MORE HOURS PER WEEK Group number: 00552214 4
Your dental coverage
A Sample of Services Covered by Your Plan:

PPO
Plan pays (on average)
In-network Out-of-network

Preventive Care Cleaning (prophylaxis) 100% 100%


Frequency: Once Every 6 Months
Fluoride Treatments 100% 100%
Limits: Under Age 19
Oral Exams 100% 100%
Sealants (per tooth) 100% 100%
X-rays 100% 100%
Basic Care Anesthesia* 80% 80%
Fillings‡ 80% 80%
Repair & Maintenance of
Crowns, Bridges & Dentures 80% 80%
Major Care Bridges and Dentures 50% 50%
Dental Implants 50% 50%
Inlays, Onlays, Veneers** 50% 50%
Perio Surgery 50% 50%
Periodontal Maintenance 50% 50%
Frequency: Once Every 6 Months
Root Canal 50% 50%
Scaling & Root Planing (per quadrant) 50% 50%
Simple Extractions 50% 50%
Single Crowns 50% 50%
Surgical Extractions 50% 50%

This is only a partial list of dental services. Your certificate of benefits will show exactly what is covered and excluded. **For PPO and
or Indemnity members, Crowns, Inlays, Onlays and Labial Veneers are covered only when needed because of decay or injury or other
pathology when the tooth cannot be restored with amalgam or composite filing material. When Orthodontia coverage is for
"Child(ren)" only, the orthodontic appliance must be placed prior to the age limit set by your plan; If full-time status is required by
your plan in order to remain insured after a certain age; then orthodontic maintenance may continue as long as full-time student status
is maintained. If Orthodontia coverage is for "Adults and Child(ren)" this limitation does not apply. *General Anesthesia – restrictions
apply. ‡For PPO and or Indemnity members, Fillings – restrictions may apply to composite fillings.

GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America


VWG WEALTH MANAGEMENT Kit created 07/26/22
ALL ELIGIBLE EMPLOYEES WORKING 30 OR MORE HOURS PER WEEK Group number: 00552214 5
Your dental coverage
Manage Your Benefits: Find A Dentist:
Go to www.Guardianlife.com to access secure information about Visit www.Guardianlife.com
your Guardian benefits including access to an image of your ID Click on “Find A Provider”; You will need to know your plan,
Card. Your on-line account will be set up within 30 days after your which can be found on the first page of your dental benefit
plan effective date. summary.

EXCLUSIONS AND LIMITATIONS


n Important Information about Guardian’s DentalGuard Indemnity and consultations and for preventive, restorative, endodontic, periodontic, and
DentalGuard Preferred Network PPO plans: This policy provides dental prosthodontic services. The services, exclusions and limitations listed above do
insurance only. Coverage is limited to those charges that are necessary to not constitute a contract and are a summary only. The Guardian plan
prevent, diagnose or treat dental disease, defect, or injury. Deductibles apply. documents are the final arbiter of coverage. Contract # GP-1-DG2000 et al.
The plan does not pay for: oral hygiene services (except as covered under n PPO and or Indemnity Special Limitation: Teeth lost or missing before a
preventive services), orthodontia (unless expressly provided for), cosmetic or covered person becomes insured by this plan. A covered person may have one or
experimental treatments (unless they are expressly provided for), any more congenitally missing teeth or have lost one or more teeth before he became
treatments to the extent benefits are payable by any other payor or for which insured by this plan. We won’t pay for a prosthetic device which replaces such teeth
no charge is made, prosthetic devices unless certain conditions are met, and unless the device also replaces one or more natural teeth lost or extracted after the
services ancillary to surgical treatment. The plan limits benefits for diagnostic covered person became insured by this plan. R3-DG2000

DentalGuard Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all
states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of
coverage. This policy provides DENTAL insurance only.
Policy Form # GP-1-DG2000, et al, GP-1-DEN-16

GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America


VWG WEALTH MANAGEMENT Kit created 07/26/22
ALL ELIGIBLE EMPLOYEES WORKING 30 OR MORE HOURS PER WEEK Group number: 00552214 6
Oral Health
Rewards
Program Automatic rollover
Submit a claim (without
exceeding the paid claims
Regular visits to the dentist can help prevent threshold of a benefit year),
and Guardian will roll over
and detect the early signs of serious diseases. a portion of your unused
annual dental maximum.
That’s why Guardian’s Maximum Rollover Oral Health Rewards
Program encourages and rewards members who visit the
dentist, by rolling over part of your unused annual maximum
into a Maximum Rollover Account (MRA). This can be used in
future years if your plan’s annual maximum is reached.

How maximum rollover works*


Depending on a plan’s annual maximum, if claims made for a
certain year don’t reach a specified threshold, then the set
maximum rollover amount can be rolled over.
Plan annual Threshold Maximum In-network only Maximum rollover
maximum** rollover amount rollover amount account limit
$1,000 $500 $250 $350 $1,000
Maximumclaims Claims amount that Additional dollars Additional dollars The limit that cannot
reimbursèment determines rollover added to a plan’s added if only in-network be exceeded within
eligibility annual maximum providers were used the maximum rollover
for future years during the benefit year account

* This example has been created for illustrative purposes only.


** If a plan has a different annual maximum for PPO benefits vs. non-PPO benefits, ($1500 PPO/$1000 non-PPO for example) the non-PPO maximum
determines the Maximum Rollover plan. May not be available in all states.
Guardian’s Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all
states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage.
Information provided in this communication is for informational purposes only. Dental Policy Form No. GP-1-DEN-16. GUARDIAN® is a registered service mark
of The Guardian Life Insurance Company of America ® ©Copyright 2019 The Guardian Life Insurance Company of America.

GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America


guardianlife.com
© Copyright 2020 The Guardian Life Insurance Company of America 7
2020-105050 (07/22)

You might also like