_private/qwestly-private-docs/HR/Benefits/dental-benefits.md
Table of Contents
QWESTLY DENTAL BENEFITS
Effective Date: November 1, 2026 Plan Year: November 1, 2026 – October 31, 2027 Provider: Guardian (administered via Gusto) Version: 1.0
Overview
Qwestly offers dental insurance through Guardian, administered via Gusto. The plan provides coverage for preventive, basic, and major services, plus child orthodontia.
Eligibility & Waiting Period
Eligibility
All full-time W-2 employees are eligible for dental benefits.
Waiting Period
Benefits begin on the 1st of the month on or following 1 month after hire (same as medical).
Dependents
Eligible dependents include:
- Legal spouse
- Children under age 26
Plan Details
| Plan Name | Guardian Diamond PPO with Child Ortho |
| Type | PPO (Preferred Provider Organization) |
Coverage
| Deductible | $25 (individual) |
| Annual Maximum Benefit | $2,500 per person |
| Preventive Care | $0 (no deductible, plan pays 100%) |
| Basic Services | 10% coinsurance (after deductible) |
| Major Services | 40% coinsurance (after deductible) |
| Child Orthodontia | Included (lifetime maximum applies — see plan document) |
What's Covered
| Category | Examples | You Pay |
|---|---|---|
| Preventive | Cleanings, exams, x-rays, sealants | $0 |
| Basic | Fillings, simple extractions, root canals | 10% after $25 deductible |
| Major | Crowns, bridges, dentures, implants | 40% after $25 deductible |
| Orthodontia | Braces for children | See plan document |
Note: 10% and 40% coinsurance reflects your share — the plan pays 90% and 60% respectively after the deductible is met. All coverages are subject to the terms, conditions, and exclusions of the actual policy.
Company Contribution
Qwestly contributes separately to employees' and dependents' premiums:
| Coverage | Company Contribution |
|---|---|
| Employee | 75% of the premium |
| Dependents | 50% of the premium |
Example: If your employee-only premium is $66/month, you pay $16.50 and Qwestly pays $49.50.
Monthly Premiums — 2026–2027 Plan Year
| Employee | Employee Premium | Dependent Premium | Total Premium | Employee Pays | Company Pays |
|---|---|---|---|---|---|
| Dominick Pham | $197.00 | $194.00 | $392.00 | $146.25 | $245.75 |
| Adam Boender | $66.00 | $0.00 | $66.00 | $16.50 | $49.50 |
| Yuan Gao | $66.00 | $0.00 | $66.00 | $16.50 | $49.50 |
| Mikelle Masciantonio | $66.00 | $0.00 | $66.00 | $16.50 | $49.50 |
| David Hsu | $66.00 | $0.00 | $66.00 | $16.50 | $49.50 |
| Total | $461.00 | $194.00 | $656.00 | $212.25 | $443.75 |
Note: Premiums are deducted pre-tax through payroll on a monthly basis. Dominick Pham's higher employee premium reflects age-banded rating by Guardian; both employee and dependent premiums may vary by age and location.
Enrollment
New Hires
You'll receive a Gusto enrollment invitation after your hire date. You have 30 days from your benefits effective date to enroll.
Open Enrollment
Open enrollment is held annually before the plan renewal date (November 1). You'll receive communication via Gusto with instructions.
Mid-Year Changes
You may change your election outside of open enrollment only with a qualifying life event (marriage, divorce, birth/adoption, loss of other coverage, etc.). You have 30 days from the event to make changes in Gusto.
How to Access Your Benefits
- ID Card: Guardian will provide a dental insurance card. You can also access a digital card via the Guardian member portal or mobile app.
- Find a Dentist: Visit guardianlife.com to search for in-network PPO dentists. Staying in-network keeps your costs lowest.
- Claims & Coverage: Log in to your Guardian member account to view claims, remaining annual maximum, and benefits usage.
Key Contacts
| Benefits Administration | Gusto (enrollment, premiums, life events) |
| Insurance Provider | Guardian (claims, coverage, ID cards, provider search) |
| HR Questions | hr@qwestly.com |
Full Plan Documents
This document is a summary of benefits and is not a substitute for the official plan documents. In the event of any discrepancy, the official plan documents govern.