DENTAL INSURANCE
Creative Sign Designs offers dental coverage through Guardian. 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.
DHMO
PPO
Calendar Year Deductible
In-Network
Out-of-Network
Individual
$0
$50
$75
Family
$0
$150
$225
Annual Maximum
Unlimited
$1,500
Diagnostic & Preventative
Exams & X-rays
Fee Schedule
100%
80%
Cleanings
Fee Schedule
Regular Restorative Services
Amalgam Fillings
Fee Schedule
Extractions – Single Tooth
Fee Schedule
80% after deductible
80% after deductible
Endodontics (Root Canal)
Fee Schedule
Peridontics (Gum Disease)
Fee Schedule
Major Services Crowns
Fee Schedule
Bridges
Fee Schedule
50% after deductible
50% after deductible
Dentures
Fee Schedule
Orthodontia
Child
$1,895
50%
Adult
$2,195
Not Covered
Lifetime Max
N/A
$1,000
Age Limit
N/A
18
1 Subject to balance billing. Please refer to your plan document for specific details.
Employee Contributions (Bi-Weekly)
DHMO
PPO
Employee Only
$ 5.30
$10.75
Employee + Spouse
$ 9.77
$22.17
Employee + Child(ren)
$11.92
$30.88
Family
$18.30
$42.29
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