The City of Woodstock offers two Guardian dental plans at the same cost. Under both plans, DentalGuard Preferred Network Providers are contractually obligated to accept the fee schedule as payment in full. Our dental plans cover oral exams and cleanings once every six months at 100% with no deductible for these preventive services.
Network Access Plan (NAP)
Members of the NAP can use either an in-network or out-of-network dentist for services. If you go to a non-contracted dentist, the reimbursement for services is based on usual, customary and reasonable (UCR) rates for a given area. Guardian will pay the coinsurance rate based on what 9 out of 10 dentists charge in your area and you will be billed for the balance.
The Value Plan is similar to the NAP. You have the flexibility to visit an in-network or out-of-network dentist for services. However, under the Value Plan, benefits are paid at higher reimbursement levels on basic and major services. Charges for visits to dentists outside of the DentalGuard Preferred Network fee schedule are the patients responsibility. Scheduled fees are typically lower than the UCR rate, therefore if you go out-of-network, provider reimbursement may be lower than it would be under the NAP Plan and your out-of-pocket expense may be higher.
The information contained in this website is an overview of your benefits. If you have specific questions regarding a provider or procedure, please call Guardian customer service at (800) 541-7846 or refer to the Guardian Dental SPD.
Guardian Dental Benefits
|NAP Benefits||Value Plan Benefits|
|Network||DentalGuard Preferred||DentalGuard Preferred|
|Deductible (Waived on Preventive)|
|Calendar Year Max* (Per Member)||$1,000||$1,000|
|Class 1 – Preventive Services
(Routine Oral Exams, Prophylaxis)
|Class 2 – Basic Services
(Fillings, Simple Extractions)
|80% After Deductible||100%|
|Class 3 – Major Services
(Crowns, Bridges, Dentures, Endodontics)
|50% After Deductible||60%|
|Ortho Coverage (Up to Age 19)||50% (no deductible) up to
$1,000 Lifetime Max
|50% up to
$1,000 Lifetime Max
* A portion of each DentalGuard member’s unused annual maximum can be rolled over into a Maximum Rollover Account (MRA). If a member reaches the plan’s annual maximum, they can use their MRA to pay for expenses. To qualify, a member must submit a claim and not exceed the paid claims threshold of $500 during the benefit year. To learn more, contact Guardian’s Customer Response Unit at (800) 541-7846.
Dental Payroll Deductions
|Tier of Coverage||Rates Per Pay Period (26)|
|Employee + 1||$12.30|
How do you find a Guardian Dental provider?
It’s easy! There are several ways!!
- Contact your provider and ask: “Do you participate in the Guardian DentalGuard Preferred Dental Network?”
- Contact the Guardian Customer Response Unit at (800) 541-7846
- Search online at www.guardiananytime.com