Guardian Dental Guard Plan
Guardian Dental Group
P.O. Box 2459
Spokane, WA 99210-2459
(800) 541-7846
Plan Year
January 1 through December 31 (calendar year)
Per Calendar Year Maximum
$1,000
Deductible
$50 per calendar year - per person
Preventative Services
100% - Not subject to deductible
- Emergency Treatment
- Oral Examinations
- X-Rays
- Teeth Cleaning
- Fluoride Treatments for children under age 14
- Space maintainers for children under age 16
- Topical Sealants for children under age 16
Basic Services
80% - Subject to deductible
- Laboratory Tests
- Fillings: Amalgam, Silicate, Acrylic
- Anesthesia
- Extractions/oral surgery
- Periodontic Services
- Root canals (endodontics)
Major Services
50% - Subject to deductible
- Gold/porcelain fillings/crowns
- Stainless steel/acrylic crowns
- Installation of bridgework and dentures
- Repair and maintenance of bridgework and dentures
Orthodontics
50% - Subject to deductible
- $1500 lifetime maximum on each covered dependent child
- Applies only to dependent children under 19 years of age
Premiums
- Employee Only (paid by AB Tech)
- Employee & Spouse 28.00
- Employee & Child(ren) 36.00
- Employee & Family 64.00
Dental Forms
follow link to "common forms" and then to "dental claim form"
- Change Form - contact the Human Resources Office
- Additional Cards - contact the Human Resources Office
AB Tech Human Resources phone number 828.254.1921 ext 114
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