Employees' coverage will begin on the first of the month following their date of hire. Canisius offers two dental plan options - Option A and Option B. The difference between the plans are listed below.
Option A considers charges for out-of-network dentists on the same fee schedule for in-network dentists. For example, an out-of-network dentist charges $135 for a cleaning, but Guardian's fee schedule for in-network dentists allow $65 for a cleaning. Guardian would consider $65 and cleanings are paid at 100%, so the dentist would be paid $65, and the patient would be responsible for the difference of the $135 charged and the $65 paid.
Option B considers the charges for out-of-network dentists on a usual and customary amount. Using the same information listed above, Guardian would look at data for cleanings and what the usual and customary amounts are for those charges. If the usual and customary charges are $125, then Guardian would consider $125 as allowable charges and then pay the claim at 100%, and the patient would be responsible for the additional $10.
There is a $1,000 annual maximum for each member of the family, and children are covered until the end of the month in which they turn 26. The benefit year (deductible, annual limits, etc.) is January to December. For more information on coverage, please refer to the Dental Summary.pdf.
Insurance Cards must be printed from Guardian's website. Please refer to Accessing Benefits Online.pdf
Guardian has a nationwide network that can be utilized, and providers can be located on Guardian's website at www.guardiananytime.com.
Employees may enroll in a separate vision insurance plan through VSP, and the premium is completely paid by the employee. Please review the summary for more information. Both medical plans provide a routine eye exam and discounts on glasses and contacts. The coverage through Guardian is an insurance plan.