Basic Plan
provides solid coverage for basic dental hygiene and necessary procedures
Mosaic offers dental coverage through Guardian (and Cigna, for Carlsbad, NM only), designed to help you maintain healthy teeth and gums through regular preventive care and to fix any dental problems that may arise.
provides solid coverage for basic dental hygiene and necessary procedures
provides added coverage for major dental procedures, including orthodontia
Basic Plan | Comprehensive Plan | |
---|---|---|
In-network | ||
Annual deductible | $0 | $0 |
Annual benefit maximum | $1,500 per person | $1,500 per person |
Preventive services (cleanings and X-rays) | You pay $0 | You pay $0 |
Basic restorative services (fillings, root canals, oral surgery) | You pay 20%, plan pays 80% | You pay 20%, plan pays 80% |
Major restorative services (crowns, dentures, bridges) | Not covered | You pay 50%, plan pays 50% |
Orthodontia | Not covered | You pay 50%, plan pays 50% (capped at $2,000 per person per lifetime) |
TMJ appliances | Not covered | You pay 50%, plan pays 50% (capped at $500 per person per lifetime) |
Rollover paid claims threshold* | $700 | $700 |
Rollover amount* | $500 | $500 |
Maximum Rollover Account limit* | $1,250 | $1,250 |
To see your premiums, go to My HR Portal. | ||
*Guardian only
Here’s how to make the most of your dental benefits:
Using a participating dentist in your provider's network will ensure you receive the highest benefits from your plan. To find a provider, go to the Guardian website or the Cigna website (Carlsbad, NM only). Choose a provider from the DPPO network for the best rate.
You should always submit a request for a pretreatment estimate for procedures and services your dentist believes will exceed $300 (procedures such as crowns, inlays, bridges, and periodontics). For more information, visit the Guardian website or the Cigna website (Carlsbad, NM only).
Guardian or through Cigna (Carlsbad, NM only). You can review Explanation of Benefits (EOB) statements, check if claims have been paid, and more.
Guardian will automatically roll over a portion of your unused annual maximum into your personal Maximum Rollover Account (MRA). If you reach your plan’s annual benefit maximum in future years, you can use money from your MRA. To qualify for an MRA, you must have a paid claim (not just a visit) and must not have exceeded the paid claims threshold during the benefit year. Your MRA may not exceed the MRA limit. Guardian will automatically apply your MRA balance to qualifying claims, you are not required to submit claims. You can view your annual MRA statement detailing your account and those of your dependents on the Guardian website.