GUARDIAN® is a registered service mark of The Guardian Life Insurance Company of America®. ©Copyright 2022 The Guardian Life Insurance Company of America.
2022-139974 (07/24)
11/06/23
Santa Clara University
Larry Daniels
2
* Guardian internal reporting, 2022
Behind every bright future
is a Guardian
TM
As one of the largest mutual
insurance companies, we
know what matters most:
putting the needs of our
customers first.
years of experience
protecting
families with
insurance solutions
Serving 29 million
customers*
Fortune 250 company with a strong
foundation
29
160+
250
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Your well-being is our focus
Doing well means being your best.
Mind
Body
Wallet
Keeping a healthy sense of
connection, self-confidence,
and support
Maintaining health levels of
physical activity, diet, sleep and
nutrition
Satisfaction with current financial
needs
Helping you reach your goals is our goal.
The past few years have been challenging, and now
more than ever taking care of your emotional,
physical, and financial health matters.
Because when you feel well you think well, when you
think well you perform well, and when you perform
well everyone does better.
Dental Insurance
Savings and choice through our powerful network
DentalGuard Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. If there is a
discrepancy between this document and the Certificate/Group Policy issued by The Guardian Life Insurance Company of America, the Group Policy will govern. This policy provides dental insurance only. It does NOT provide basic hospital, basic medical or major medical
insurance. Generic Policy Form #GP-1-DG2000, et al; GP-1-DEN-16; DG7-P. The state approved form is the governing document.
GUARDIAN® is a registered service mark of The Guardian Life Insurance Company of America® ©Copyright 2023 The Guardian Life Insurance Company of America. 2023-152668 03/25
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Dental Insurance from Guardian
can help protect
your health
Quality Care, Choice, and Cost Savings
Provides access to one of the nation’s largest dental
networks
Can save you money if you use a Guardian
in-network dentist
Helps protect your health with quality preventive
care
Helps pay for more extensive and often unexpected
expenses such as fillings, crowns, and root canals
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Your Guardian PPO Dental Plan
DentalGuard
Preferred In-Network Out-of-Network
Plan Year Deductible:
Individual
Family Limit
Waived for
$25
3 per family
Preventive
$25
3 per family
Preventive
Charges covered for you (co
-insurance):
Preventive Care (e.g. cleanings)
Basic Care (e.g. fillings)
Major Care (e.g. crowns, dentures)
Orthodontia
100%
100%
60%
50%
100%
80%
50%
50%
Annual Maximum Benefit
$3,500 $3,500
Maximum Rollover
Rollover Threshold
Rollover Amount
Rollover In
-network Amount
Rollover Account Limit
Yes
$1,000
$500
$750
$1,500
Yes
$1,000
$500
$750
$1,500
Lifetime Orthodontia Maximum
$3,000 $3,000
Dependent Age
(Non-student/student) To age 26 To age 26
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1 For illustrative purposed only. Covered benefits and benefit amounts may vary by employer-sponsored plan. See your plan for specific coverage amounts. 2 If a plan has a different annual maximum for PPO benefits vs non-PPO benefits, ($1500 PPO/$1,000 non-PPO for
example) the non-PPO maximum determines the Maximum Rollover plan.
Get the ‘Maximum’ from Your Dental Benefits
Here is an example of how the Maximum Rollover feature works
1
Guardian rolls over a portion of your unused annual maximum into your Maximum Rollover Account (MRA)
To qualify you must have one visit with a paid claim and must not have exceeded the paid claims threshold
Your MRA may not exceed the MRA limit.
Plan Annual
Maximum
2
Threshold
Maximum
Rollover Amount
In
-Network Only
Rollover Amount
Maximum Rollover
Account Limit
$3,500
$1,000
$500
$750
$1,500
Maximum Claims
Reimbursements
Claims amount
that determines
rollover eligibility
Additional dollars added
to Plan Annual Maximum
for future years
Additional dollars added to Plan
Annual Maximum for future years
if only In-Network providers were
used during the benefit year
Plan Annual Maximum plus
Maximum Rollover cannot
exceed $5,000 in total
Year 1
Year 2
Year 3
Year 4
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Dental Treatment in Progress
What happens if I’m in the middle of a dental treatment and my plan is
switched to a Guardian dental plan?
If Guardian takes over a plan and an employee or dependent is in the middle of
treatment (such as a root canal, crown, bridge or denture), this is how we will handle
the claim:
Guardian goes by the Prep-date, which is the date the tooth is opened to start
treatment. If the prep-date occurs while insured under the Guardian plan, then the
claim would be ours. If the prep-date is prior to being insured on the Guardian plan,
then the claim belongs to the prior carrier.
Some insurance carriers use the Seat-date, which is the day the work is finished. If
the prior carrier uses the seat-date, and the Guardian uses the prep-date, then the
Guardian would pay the claim. However, we would need the denial from the prior
carrier before we would consider and pay the claim.
If an employee terminates and they are in the middle of treatment, they would have 31
days to finish the work and the Guardian would pay for it.
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Orthodontia Treatment in Progress
What if I’ve started orthodontic treatment and my dental plan is switched to
a Guardian dental plan?
When an orthodontic appliance is inserted prior to a member’s effective date, Guardian
will cover a portion of the treatment, utilizing the no loss no gain provision.
Based on the original treatment plan, we determine the portion of charges incurred by
the member prior to being covered by the Guardian dental plan and deduct them from
the total charges.
What we pay is based on the remaining charges.
We limit what we consider of the proposed treatment plan to the shorter of the
proposed length of treatment, or two years from the date the orthodontic treatment
started.
Also, we enforce the plan’s orthodontic benefit maximum by reducing the total benefit
that Guardian would pay by the amount paid by the prior carrier, if applicable.
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What are my dental costs
going to be?
Find out with a pre-treatment review
Follow the simple steps below:
1. Ask your dentist to submit the proposed dental
treatment plan to Guardian or fax the treatment plan
to 509-465-3404.
2. We will review the treatment plan and create an
estimate.
3. Estimate will be sent to you and your dentist.
A pre-treatment review is optional, however it’s
recommended if you are needing non-routine services.
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It’s easy to use your
Guardian dental benefits
No ID cards needed
Simply provide your Group ID number at your first
office visit: 056564
Or, access your ID card online:
Mobile App: Download Guardian’s Provider and ID
Card app to your mobile phone or tablet
Online: Go to guardianlife.com and select Register &
Login, then access your ID card in the Forms and
Materials section
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How to Find a Dental
Provider
Smile. Finding a dentist in the
Guardian network is easy.
1. Go to guardianlife.com and click
“Find a dentist”
2. Under “Dental benefits from your
workplace” click “Find a dentist”
3. Search for a dentist in your area
Select the Plan Type
Enter your search parameters
4. Customize your search by distance,
specialty, and language spoken
Away from your computer? No problem.
Download the Guardian Provider app to your phone or tablet and find a dentist on
the go. Visit guardianlife.com to download the app.
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1
2
3
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Summary of Plan Limitations and Exclusions
This policy provides dental insurance only. Coverage is limited to those charges that are necessary to prevent, diagnose or treat dental disease, defect, or injury. Deductibles apply. Limitations apply to specific dental services. The plan doesn’t pay for any service that
doesn’t meet professionally recognized standards of dental practice. This information doesn’t constitute a contract and is a summary only. The Guardian plan documents are the final arbiter of coverage.
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GUARDIAN® is a registered service mark of The Guardian Life Insurance Company of America®. ©Copyright 2022 The Guardian Life Insurance Company of America, New York, NY.
2022-139920 (Exp 06/24)
How to Enroll in
Guardian Benefits
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It’s easy to enroll
Get started
Visit the Santa Clara University enrollment portal to enroll
Questions?
Get answers to your Guardian benefits questions during this enrollment
period.
Employee Benefits Hotline
(888) 600-1600
M-F, 8 am – 8:30 pm ET
Refer to your Group ID number: 056564
Your enrollment period is from: 11/7/23 – 11/27/23
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The Guardian Life Insurance Company of America, New York, NY. GUARDIAN® is a registered service mark of The Guardian Life Insurance Company of America®. ©Copyright 2022 The Guardian Life Insurance Company of America.
2022-139972 (07/24)
How to Register and Enroll on Guardian
Anytime
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How to register for and access your benefits
on Guardian Anytime
1. Go to guardianlife.com and click on “Log in”
2. Choose “Register now” and select “Guardian Anytime”
3. Select “employee” for yourself or “child, spouse or partner” for your
dependents
4. Complete the self registration process, click Submit, and you’re done.
Services available to you on
Guardian Anytime
Find a provider and estimate costs
Check claim status and receive emails
when claims are paid
View, download and print materials:
Benefit summaries
Forms
Certificate booklets
Member ID cards
Provider directories
For assistance, contact
Guardian’s Customer Response
Unit
Helpline (800) 627-4200
Monday - Friday, 8:00am – 8:00 pm EST
Refer to your plan number: 056564
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The Guardian Life Insurance Company of America, New York, NY. GUARDIAN® is a registered service mark of The Guardian Life Insurance Company of America®. ©Copyright 2020 The Guardian Life Insurance Company of America.
2022-139973 (06/24)
How to File a Claim
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How to File a Claim
1. Go to guardianlife.com and select
“Forms & Claims”
2. Select “Benefits through an
employer”
3. "Select a plan type to learn more"
4. Choose “Submit a claim”
5. Select “I have my Group ID
number” and enter your Group ID
056564
6. Follow instructions to submit the
claim to Guardian
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3
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Thank you
