This plan provides dental care services at a fixed cost when you go to a dentist who is a member of Cigna's DHMO network. Similar to a medical HMO, the plan requires you and each of your covered dependents to choose a primary care dentist from Cigna's network. You must receive all your non-emergency dental care from your Cigna DHMO network dentist.
This plan is a preferred provider program that gives you the option of receiving treatment from any licensed dental provider you choose. If you go to a dentist who is a member of Cigna's DPPO network, you will receive a higher level of benefits and reduce your out-of-pocket costs.
| Dental Benefits | Dental HMO (Access Plus) | Dental PPO (In & out-of-network) | |
|---|---|---|---|
| * deductible waived | |||
| Annual Deductible | No deductible | $50 per individual $150 per family |
|
| Annual Maximum | Unlimited | $1,750 per person (Out-of-network: $1,500 per person) |
|
| Diagnostic & Preventive Services |
100% covered | 100% covered* | |
| Basic Services | Copay varies | 80% | |
| Endodontic & Periodontic Services | Copay varies | 80% | |
| Major Services | Copay varies | 50% | |
| Orthodontia | $1,608 child copay $2,592 adult copay | 50% up to $1,500 lifetime maximum benefit* (adults and dependent children) |
|
| Coverage Level | HMO | PPO |
|---|---|---|
| Employee Only | $2.50 | $18.83 |
| Employee + Spouse | $7.13 | $35.50 |
| Employee + Child(ren) | $7.07 | $43.47 |
| Employee + Family | $14.52 | $64.76 |
The information contained in this website should in no way be construed as a promise or guarantee of employment. The company reserves the right to modify, amend, suspend, or terminate any plan at any time for any reason. If there is a conflict between the information in this website and the actual plan documents or policies, the documents or policies will always govern. Complete details about the benefits can be obtained by reviewing current plan descriptions, contracts, certificates, policies and plan documents available from your Human Resources Office.