Disclosures

Premier Access Insurance Company “Premier Access,” and Access Dental Plan (“Access Dental”) are wholly owned subsidiaries of  The Guardian Life Insurance Company of America  (“Guardian”). Premier Access is a California domiciled insurance company offering PPO dental products in California, .., among others. Access Dental is a California Knox Keene licensed company offering managed care dental products in California. In addition, Access Dental Plan (NV) and Access Dental Plan (UT) are also wholly owned subsidiaries of Guardian offering dental managed care products in Nevada and Utah respectively.

Guardian Managed DentalGuard products are underwritten by: First Commonwealth Insurance Company — (IL), First Commonwealth of Missouri — (MO), First Commonwealth Limited Health Services Corporation — (IN), First Commonwealth Limited Health Services Corporation of Michigan — (MI), Managed Dental Care — (CA), Managed DentalGuard, Inc. — (NJ, OH, TX), The Guardian Life Insurance Company of America — (CO, FL, NY and all PPO and Indemnity plans), Liberty Dental Plan of Nevada, Inc. — (NV). With the exception of Liberty Dental plan of NV, all referenced companies are wholly owned subsidiaries of The Guardian Life Insurance Company of America. Limitations and exclusions apply. Products are not available in all states.  Optional riders and/or features may incur additional costs.

Plan documents are the final arbiter of coverage.

Guardian Group and Individual Dental PPO insurance products are underwritten by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states.  Optional riders and/or features may incur additional costs.  Group Policy Form #GP-1-DG2000, et al. Individual Policy Form #IP-DENF-

For NY Residents only:

This policy provides DENTAL insurance only.  The expected benefit ratio for this policy is 60% percent.  This ratio is the portion of future premiums that the company expects to return as benefits, when averaged over all people with this policy.

On Exchange –Policy Form #IP-DENF-EXCH-16; Off Exchange – Policy Form #IP-DENF-

Links to external sites are provided for your convenience in locating related information and services. Guardian, its subsidiaries, agents, and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-​party sites, organizations, products, or services, and make no representation as to the completeness, suitability, or quality thereof.

Important Information about Guardian’s DentalGuard Indemnity and DentalGuard Preferred PPO Plans: This policy provides dental insurance only. Coverage is limited to those charges that are necessary to prevent, diagnose or treat dental disease, defect, or injury. Deductibles apply. Waiting periods may also apply for some services. The plan does not pay for: oral hygiene services (except as covered under preventive services), orthodontia (unless expressly provided for), cosmetic or experimental treatments, any treatment to the extent benefits are payable by any other payor or for which no charge is made, prosthetic devices unless certain conditions are met, and services ancillary to surgical treatment. The plan limits benefits for diagnostic consultations and for preventive, restorative, endodontic, periodontic and prosthodontic services. The services, exclusions, and limitations listed above do not constitute a contract and are a summary only. The Guardian plan documents are the final arbiter of coverage.

Important Information About Guardian’s Managed DentalGuard Pre-​Paid (Florida) Plan, Managed Dental Care’s DHMO (California) Plan and Managed DentalGuard, Inc.‘s Managed DentalGuard DHMO (Texas) Plan: This plan provides Pre-​Paid dental benefits through a network of participating general dentists and specialty care dentists. All covered services must be provided by the member’s Primary Care Dentist. Specialty care services are covered only when referred by the member’s Primary Care Dentist and approved in advance by Managed DentalGuard. Only those services listed in the plan are covered. Certain services are subject to annual or other periodic limitations. Where orthodontic benefits are specifically included, the plan provides for one course of comprehensive treatment per lifetime, per member. The Managed DentalGuard plan does not provide orthodontic benefits if comprehensive orthodontic treatment or retention is in progress as of the member’s effective date under the Managed DentalGuard plan. The services, exclusions and limitations listed here do not constitute a contract and are a summary only. The Managed DentalGuard plan documents are the final arbiter of coverage. GP-​1-​MDG1, et al. (Florida), GP-​1-​MDC1, et al. (California), GP-​1-​MDG-​TX1, et al. (Texas)

New York Residents: Individual HCR DHMO Policy Form Numbers: Form IP-MDG-NY-EHB-ON-15; Form IP-MDG_NY-EHB-OFF-15; Form IP-MDG-NY-FP-ON-15; Form IP-MDG-NY-FP-OFF-15

Important information about First Commonwealth Inc.‘s and their subsidiaries’ dental plans (Illinois, Missouri, Wisconsin, Michigan and Indiana): This plan provides pre-​paid benefits through a network of participating general dentists and specialty care dentists. All covered services must be provided by the member’s Primary Care Dentist. Specialty care services are covered only when referred by the member’s Primary Care Dentist and approved in advance by First Commonwealth. Only those services listed in the plan are covered. Certain services are subject to annual or other periodic limitations. Where orthodontic benefits are specifically included, the plan provides for one course of comprehensive treatment per lifetime, per member. The First Commonwealth plan does not provide orthodontic benefits if comprehensive orthodontic treatment or retention is in progress as of the member’s effective date under First Commonwealth plan. The services, exclusions and limitations listed here do not constitute a contract and are a summary only. The First Commonwealth plan documents are the final arbiter of coverage. INS GMC 11/​97.

GUARDIAN® and the GUARDIAN G® logo are registered service marks of The Guardian Life Insurance Company of America and are used with express permission.

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