HMO Plan - Guardian HMO members pay no annual deductible. Preventative services are paid at 100%, all other services are set at a pre-negotiated rate (see plan for fee schedule). There is no annual maximum benefit except for orthodontics’. See the plan summary link below for more details.
HMO Plan Summary: Click Here
PPO Plan – Guardian PPO members are required to pay an annual deductible of $50.00 per member (max of three family members). Preventative services are paid at 100%, regular services are covered at 90% and major services are covered at 60% within the network. There is a maximum benefit of $2,000.00 per year in-network and $1500.00 per year out-of-network. This plan doesn’t cover orthodontic services. Maximum Rollover: With Maximum Rollover, we’ll roll over a portion of each member’s unused annual maximum, called the Maximum Rollover Amount, into his or her Maximum Rollover Account (MRA). The MRA can be used in future years, if a member reaches the plan’s Annual Maximum. Even better, if a member uses the services of Preferred Providers exclusively during the benefit year, we’ll increase the amount credited to his or her MRA to the In-network Only Maximum Rollover Amount. To qualify, a member must submit a claim and not exceed the paid claims Threshold during the benefit year. The employee and each insured dependent maintain separate MRAs based on their own claim activity. Each member’s MRA may not exceed the MRA limit.
Plan Annual Maximum- $1,500.00
Maximum Rollover Amount- $350.00
In-Network Only Maximum Rollover Amount- $500.00
Maximum Rollover Account Limit- $1,250.00
- 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.
See the plan summary link below for more details.
PPO Plan Summary: Click Here
Provider Search: If you would like to do a provider search you can do this at www.guardianlife.com. On the top right side in the grey box under Resources select "Provider Online Search", then click on Find a Dentist, and lastly you will need to select your plan type. Note: DHMO/Pre-paid is our HMO Dental Plan. You can then search within a zip code or from a specific address.
Guardian Account Information: Go to this website: www.guardiananytime.com. You will need to register to access your personal account information.
IMPORTANT NOTE: You should notify HR immediately with any status changes such as marriage, divorce, birth of a child, or loss of coverage with another provider. Contact HR with any questions.
Guardian Dental Change Form: Click Here
*Open enrollment for Guardian is in January each year.