This document provides an overview of the dental insurance benefits offered by [Company Name] through their partnership with Guardian. The dental PPO plan covers preventive care like cleanings at 100% with no deductible. Basic services like fillings are covered at 80% after a $50 annual deductible is met. Major services like bridges and crowns are covered at 50% after the deductible. Orthodontia is covered at 50% with no age limits on dependents. Employees and eligible family members can use dentists in or out of the Guardian network, but out of network costs may be higher. The company pays a portion of the monthly premiums to lower employees' out of pocket costs and increase take home pay.

1. Rajshree Chauhan
July 18, 2014
[Company Name]– HealthyTeeth
Slide 1 – Intro to Dental Benefits
[Companyname] isnotjusta fun place to work,butalsooffers othercompensationperks.Insurance can
be a bigcost for employees.Withourbenefitsplans,youhave reducedoutof pocketexpensesand
highertake home pay. In additiontoyourhealthbenefits, we have partneredwithGuardianasour
dental insurance carrierto offerHealthyTeethdental benefits.Manypeoplenew todental benefits
wonderwhatiscovered,andwhatto expectfromdental insurance.
Slide 2 – Whois covered?
Dental benefitsare availabletoall Full Time employeesandeligible-enrolledfamilymembers. Eligible
familymembers include yourspouseanddependentchildrenunder26 fora discountedadditionalcost
everymonth [verifythis].
[Needadditional information:Include informationaboutpayments.Will the companypaythe full
monthlypremium?Or,will employeesseepayroll deductionsontheirpaycheckstubs?How muchisthe
premiumbeingpaidbythe companyor bythe employee?]
Slide 3 – Your PPO plan
“PPO?Howdoes it workfor dentalinsurance?” I suggesta 2nd
person’svoice,orshortanimationvideo
for the italicquestions.Asanalternative, abrief chalkwritingscripttointroduce the topic before going
to the nextslide withinformation There are differenttypesof dentalplansavailable.Our planiscalleda
PPO,or PreferredProviderOrganization.Foralowercostto you, in network PPOdentistshave agreed
to accept contractedfeesinsteadof whattheynormallywould charge.Guardianhasa national PPO
networkof more than 70,000 dentistlocations.Tofindoutif yourdentistisinthe network,youcango
to www.guardianlife.com.
Slide 4 – Out of Network
“But, whatif yourdentistis not in the Guardian network?” Isuggesta 2nd
person’svoice,orshort
animationvideoforthe italicquestions.Asanalternative,abrief chalkwritingscripttointroduce the
topicbefore goingtothe nextslide withinformation Unlike othertypesof dental plansthatwill only
coveryour visitif yourdentistisinnetwork, ourPPOplanwill alsoallow youtogo toa dentistwhois
out of network. The planwill still coveryoubythe same percentage,butthe dentistscancharge what
theylike since theyare notboundbya contract withGuardian’s network. Thiscansometimesmean
payingthe balance to the dentistafterthe insurance paymenthasbeenapplied.
Slide 5 – Example of out of network cost include some kind of animation or chart to show the amount
differencesforout ofnetwork cost
For example,aregularcleaningis100%coveredevery6 months.If yougo in network,the dentistcan
onlycharge $xx,and thiscost is 100% covered.If yougo outof network,the dentistmightcharge $yy.In
thiscase,Guardian will pay$xx,andyouwill be responsible topaythe dentistdirectly forthe difference
between$yyand$xx.
Slide 6 – Deductibles
“I havea deductiblefor my healthinsurance.Do I also havea deductiblefor my dentalinsurance?” ?” I
suggesta 2nd
person’svoice,orshortanimationvideoforthe italicquestions.Asanalternative,abrief
chalkwritingscriptto introduce the topicbefore goingtothe nextslide withinformation

2. Rajshree Chauhan
July 18, 2014
A deductibleisthe minimumamountyouhave topay out of pocketbefore the insurance plancoverage
takeseffect.Foryourdental insurance,youhave no deductible forpreventive care – teethcleanings,
oral examsandx-raysare covered100% every6 monthswithout adeductible.However, there isa$50
deductible forothertypesof dental visits. Forbasiccare like fillings,ormajorcare like crowns,the plan
will paythe percentage listedinthe plandetails afteryou’ve alsopaid$50 once duringthe calendaryear
for anycontracted costs. For the underlinedpart,Iwouldsuggestachart to illustrate the idea
Slide 7 - Annual Maximums
Yes,there isa maximumamountthat Guardianwill payperyear.If by chance yourdental costs during
the year exceed$2000, you will have topaythe rest out of pocket.There’s anotherbenefitif youuse
the Guardian network of dentists:if yourdentistisinnetworkandyoudon’tcome close to that
maximumamount,youalsogetto roll overthe unusedportiontothe followingyear. Maybe showa
chart – the informationisinthe commonservicesplandetails Rolloveris onlyforinnetworkthough,not
out of network.
Slide 8 – Common Services
You should have a planreference thatdetailsthe mostcommonservices.We’ll review those common
servicesandyourout of pocketexpenses next.
Slide 9 – Preventive Care Chart and Plan Pays
[Notspoken. Preventive care includes:cleaning once every6months,oral exams,sealantsandx-rays.]
Include thisinfoasa chart
Luckily,bothinnetworkandout of networkpay100% of the contractedcost for Preventive Care.But,
keepinmind thateventhoughitis covered, if youchoose togo out of network,youmayhave to pay
the difference betweenthe contractedcostandwhatthe dentistischarging. Also,because these
servicesare fullycoveredbythe plan,youwon’tbe able touse preventive care servicestowardyour
deductible evenif youhadtopay extrato yourout of networkdentist.Thatamountdoesnotapply
towardyour deductible.
Slide 10 – Basic Care Chart and Plan Pays
[Notspoken. Basiccare includes:general anesthesia, compositefillings,periosurgery,periodontal
maintenance once every6months,repairandmaintenance of crownsbridgesanddentures,rootcanals,
scalingandroot planning,simpleandsurgical extractions.] Include thisinfoasa chart
Afteryou’ve paid$50 for the year forany dental service,bothinnetworkandoutof networkdentists
are coveredat80% of the contractedcost, andyou are responsible forthe difference.
Slide 13 – Major Care Chart and PlanPays
Major care includes:bridgesanddentures. Othercare suchas inlays,onlays, veneersandcrownsare
coveredwhenneededbecause of decayorinjuryandwhenthe toothcan’tbe restoredinotherways.
Include thisinfoasa chart
Afteryou’ve paid$50 for the year forany dental service,both innetworkandoutof networkpay50% of
the contractedcost, and youare responsible forthe difference.
Slide 14 – OrthodontiaCoverage and Maximums
Who can forgetbraces?Well,incase you needadultbraces,oryou have dependent children whoneed
them,orthodontiaisacoveredbenefit.The planpays50% of all contractedcosts afteryou’ve paid$50
for the yearfor any contracteddental service. Thisisafantasticbenefitforus.Some planshave age
limitationsfordependents,butwiththisone,we’re all good.

3. Rajshree Chauhan
July 18, 2014
Slide 15 – OverviewofOut of Pocket Costs (optional slide)
So afterall this,whatare yourout of pocketcostsand how doesit factorintoyour overall compensation
package?Let’stake a lookat howmuch youare savingeveryyear Insertvisual of costcomparison [cost
comparisonchart. Monthlycost paidby company on employee’sbehalf:$[fillin]]
Thisincreasesyourtake home pay!
Slide 16 – Conclusion
We maynot like goingtothe dentist,buthopefullywe’ve takenawaysome of the mysteryandshown
youhow yourPPOworksfor you.As always,if youhave anyquestionsabout coverage,service or
eligibility,youwill wanttocheckyourcertificate of benefits,call HumanResources, orcall Guardianat
[800-xxx-xxxx]. Take care of those teeth!