DENTAL INSURANCE
Colonial Distributing offers dental coverage through Guardian. The Dental DHMO Plan is an in-network plan only, whereas the Dental PPO Plan allows you to use in-network or out-of-network benefits. If out-of-network dentists are used, you will be responsible for paying the difference between Guardian’s allowed amount and what the dentist may charge, also known as “balance billing”. The chart below provides a brief overview of the plan.
Dental
BASE DMO Plan
PREMIUM PPO Plan
In-Network
In-Network
Out-of Network*
Calendar Year Deductible Individual
Not Applicable
$50
$50
Family
Not Applicable
$150
$150
Annual Maximum
$1,000
Not Applicable
$1,000
Diagnostic & Preventive Exams
Cleanings Fluoride X-Rays Sealants Regular Restorative Services Amalgam Fillings
Fee Schedule
Covered in full
Covered in full
Covered 90% after deductible
Fee Schedule
Covered 80% after deductible
Extractions - Single Tooth Major Services Crowns
Bridges Dentures
Fee Schedule
Covered 60% after deductible Covered 50% after deductible
Endodontics (Root Canal) Periodontics (Gum Disease)
* Subject to balance billing. Please refer to your plan document for specific details.
BASE DHMO Dental Plan
PREMIUM PPO Dental Plan
Employee Contributions (Bi-Weekly)
Employee Only
$ 1.15 $ 5.08 $ 8.82 $12.54
$ 7.70 $21.66 $29.40 $42.73
Employee/Spouse
Employee/Child(ren)
Family
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