Guardian Dental DPO - Human Resources - Santa Clara University

Guardian Dental DPO

Dental Plan Option

Guardian Dental
800-541-7846
Group Number: 00056564

Dental benefits are another important element of your overall health. With proper care, your teeth can and should last a lifetime. Santa Clara University provides comprehensive dental care for employees and their eligible dependents.

GUARDIAN DENTAL PLAN HIGHLIGHTS	IN-NETWORK	OUT-OF-NETWORK ⁽¹⁾
GUARDIAN DENTAL PLAN HIGHLIGHTS	General Information	When you obtain dental services from network providers, you will receive higher coverage.	You may receive dental care from any dentist you wish. If you receive care from non-network dentists, your coinsurance will be higher.
Annual Deductible	Waived for Preventive Care Services
Individual	$25	$25
Family	$75	$75
Annual Maximum Benefit	$3,500	$3,500
Preventive Services
X-rays; Cleanings; Examinations	Eligible Charges Covered at 100%	Eligible Charges Covered at 100%
Routine Basic Services
Amalgam Fillings; Extractions; Root Canals	Eligible Charges Covered at 100%	Eligible Charges Covered at 80%
Major Services
Bridges; Dentures; Crowns, Implants	Eligible Charges Covered at 60%	Eligible Charges Covered at 50%
Orthodontia Services (employee, spouse/domestic partner, and dependent children to age 26 only)
	Eligible Charges Covered at 50%, up to a Lifetime Maximum of $3,000	Eligible Charges Covered at 50%, up to a Lifetime Maximum of $3,000

^{(1) Reimbursement is based on PPO contracted fees for PPO dentists.}

Plan Documents and Resources

Plan Documents

Plan Resources

Guardian - Find A Dental Provider