Santa Maria Bonita School District Understanding How Your Benefits Work Educational Series 2008 Dental Insurance

1. Santa Maria Bonita School DistrictUnderstanding How Your Benefits WorkEducational Series 2008Dental Insurance

2. Dental Insurance • This is a self-funded plan. By self-funding the dental plan, SMB is able to reduce their plan costs by avoiding paying additional overhead/profit to the insurance company. • Previously the dental plan was administered by ASI. Effective January 1st the new administrator was Guardian. • Guardian was chosen because they are able to deliver a much higher level of service and support and are much more capable of administering dental benefits for such a large group.

3. Controlling Costs • Because the dental plan is self-funded, SMB is able to hold down the cost of offering a very rich dental benefit plan at a minimal cost to the employee. • One of the keys to controlling the costs of the plan is to encourage use of Guardian network dentists. However, the plan still provides for a very rich out of network benefit if your dentist is not currently participating in the network.

4. Guardian Dental Benefits

5. Network Dentists • Finding a dentist is easy. Locate providers at www.guardianlife.com or call their Dental Member Services Team at (800) 541-7846. • Guardian is very actively growing their network of dentists in the area. It is in their best interest to have as many dentists contracted with them as possible. • It is up to the dentist whether they want to accept Guardian’s contracted fees as payment in full. If they do not they will not accept Guardian’s coverage as a network provider but they will still accept payment from Guardian.

6. How To Nominate Your Dentist • If you would like Guardian to approach your dentist to become contracted, you can fill out a Dentist Nomination form (available today or online at www.guardianlife.com) • Dentist should only discuss their fee schedules (which are proprietary) with Guardian directly. • Fee schedules are developed by Guardian to provide for less out of pocket expenses for the employees now and in the future.

7. Information at your fingertips 24/7 Check out www.GuardianAnytime.net/webtour/member to take a tour of the many available resources and great information on the Guardian website for members. • Review benefits/ look up coverage amounts • Find a provider/ nominate a dentist not already accepting Guardian insurance • View deductible and co-insurance amounts • Track progress toward your maximum out-of-pocket costs for the year • Check claim status • Print forms and plan materials It’s Easy to Register! • Go to www.GuardianAnytime.com • Select the link for “Self-Register” • Follow the easy instructions

8. Pre-Determination Review • Guardian will gladly assist you and your dentist by determining what benefits could be payable for services and procedures over $300. • Have your dentist fax Guardian your treatment plan with a note requesting a “pre-determination review” and Guardian will let your dentist know what benefits would be payable before you have the work done. • This service is available for in and out of network claims including orthodontic treatment.

9. Unclear about what your benefits are or still have questions? • Call Guardian Dental Member Services at (800) 541-7846. • Reference your personal Group Plan Number 432972 when calling Member Services and they will be able to provide you information specific to your plan benefits.