Dental
Segal offers dental coverage through the Guardian Dental Preferred Provider Organization (PPO) dental plan. The plan is designed to help you maintain good oral health through preventive care, while also providing coverage for more complex dental needs.
How the plan works
- You can use in-network or out-of-network providers, but in‑network dentists have agreed to discounted fees, which generally results in lower out‑of‑pocket costs. When you use out‑of‑network providers, services are subject to higher deductibles and coinsurance and lower benefit maximums.
- The plan covers a range of dental services, including diagnostic and preventive care, basic restorative care, major restorative care and orthodontia (children under age 19 only).
- If you waive dental coverage and later elect coverage in a subsequent year, you’ll automatically be enrolled in the Transition Dental Plan, which works like the PPO but covers only diagnostic and preventive care and basic restorative services. Major restorative services and child orthodontia are not covered. During annual enrollment for the following year, your coverage will be automatically transferred to the full coverage Dental PPO.
- Deductibles, coinsurance, benefit maximums and frequency limits are outlined in the applicable Schedule of Benefits and Certificate of Coverage.
Coverage overview
Your costs for eligible dental care depend on the type of service you receive and whether you use a network dentist. Here’s what you’ll pay:
Individual deductible
(maximum 3 per family; waived for preventive care)
(maximum 3 per family; waived for preventive care)
Preventive care
Basic care
Major care
Orthodontia
Annual maximum benefit
(combined in-network and out-of-network)
(combined in-network and out-of-network)
Lifetime orthodontia maximum
In-Network
$50
Covered at 100%
Covered at 100%
40%
50%
$5,000
$2,000
Out-of-Network
$100
20%
20%
50%
50%
$2,500
$1,500
Coverage overview: NY collectively bargained employees
Your costs for eligible dental care depend on the type of service you receive and whether you use a network dentist. Here’s what you’ll pay:
Individual deductible
(maximum 3 per family)
(maximum 3 per family)
Preventive care
Basic care
Major care
Orthodontia
Annual maximum benefit
(combined in-network and out-of-network)
(combined in-network and out-of-network)
Lifetime orthodontia maximum
In-Network
$0
Covered at 100%
Covered at 100%
40%
50%
$2,000
$1,500
Out-of-Network
$50
20%
20%
50%
50%
$2,000
$1,000
Contacts
Guardian
Plan Group Number: 00387408
guardiananytime.com
800-541-7846