Page 12 - iFly Employee Benefit Guide 2019

Benefits

Dental Insurance
Guardian | PPO Dental Plans
With the Guardian Preferred Provider Organiza on (PPO) dental plan, you may visit a PPO den st and benefit from the nego ated
rate or visit a non‐network den st. When you u lize a PPO den st, your out‐of‐pocket expenses will be less. You may also obtain
services using a non‐network den st; however, you will be responsible for the difference between the covered amount and the
actual charges and you may be responsible for filing claims.

Guardian Guardian
Plan Name Value Plan NAP Plan
Network Name DentalGuard Non‐Network DentalGuard Non‐Network
Preferred Texas Fee Schedule Preferred NAP Texas 90th Percen le UCR
Dental Benefits
Calendar Year Maximum $1,500 $1,500 $1,500
Deduc ble (Annual)
‐ Individual $50 $50 $50
‐ Family $150 $150 $150

Preven ve No Charge No Charge No Charge No Charge
Basic Services Deduc ble, 0% Deduc ble, 0% Deduc ble, 20% Deduc ble, 20%
Major Services Deduc ble, 40% Deduc ble, 40% Deduc ble, 50% Deduc ble, 50%
Orthodon a
‐ Covered Members Children Only Children Only Children Only
‐ Coinsurance 50% 50% 50%
‐ Life me Benefit Maximum $1,000 $1,000 $1,000

Important-Find a Dental Provider Before you Select a Plan
Go to www.guardianany me.com or call (888) 600‐1600. Value Plan par cipants should refer to the
“DentalGuard Preferred Texas” network and NAP plan par cipants should refer to the “DentalGuard
Preferred NAP Texas” network when prompted. If your den st is in the DentalGuard Preferred Network,
you will receive a higher level of benefits on the Value plan. If your den st is out of network, you will
receive a higher out of network reimbursement level on the NAP plan.

Tips For Using Your Dental Benefits

Use contracted network providers when possible.
Under the PPO plan, contracted network providers have rate agreements with insurance companies for services rendered. If
you use a non‐network provider, your out‐of‐pocket expenses will be higher and you may be subject to balance billing.

Ask for a predetermination of benefits.

We strongly recommend you ask your den st for a predetermina on if total charges are expected to exceed $300.
Predetermina on enables you and your den st to know in advance what the payment will be for any service that may be in
ques on.


Have dental checkups regularly.
Rou ne dental visits not only preserve your smile, but they can provide an opportunity for the early detec on of serious
diseases such as diabetes.
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