Your Health
Dental
Our dental plan, administered by Cigna, offers you one of the largest provider networks in the country. You can choose to visit any provider, but you’ll pay less when you stay in-network because those providers have agreed to charge discounted fees for services.
Cigna
- (800) 244-6224
- www.cigna.com
If you use an out-of-network provider, the plan will pay the same amount but the provider has not agreed to the reduced fees. You will be responsible for any remaining balance billed by the provider. If you need to submit your own claim, complete the dental claim form.
There are no ID cards for this benefit; just use your Social Security number. If you want to have an ID card, you can access and print one on mycigna.com.
Dental Benefit Summary Direct Link
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Dental PPO
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Calendar Year Maximum
In-Network:
$2,000
Out-of-Network:
$2,000
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Calendar Year Deductible
In-Network:
$50 per individual
$150 per family
Out-of-Network:
$50 per individual
$150 per family
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Class I Expenses
Preventive & Diagnostic Care
In-Network:
100%, no deductible
Out-of-Network:
100%, no deductible
Emergency Services are paid at in-network levels
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Class II Expenses
Basic Restorative Care
In-Network:
80% after deductible
Out-of-Network:
80% after deductible
-
Class III Expenses
Major Restorative Care
In-Network:
50% after deductible
Out-of-Network:
50% after deductible
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Class IV Expenses
Orthodontia (adults and children)
In-Network:
50% after deductible
Out-of-Network:
50% after deductible
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Orthodontia Lifetime Maximum
In-Network:
$2,000
Out-of-Network:
$2,000
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Pre-Treatment Review
Available on a voluntary basis when extensive dental work in excess of $200 is proposed.
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2024 Dental Cost per Paycheck Direct Link
| Coverage Level | DPPO |
|---|---|
| Employee Only | $3 |
| Employee and Spouse / Domestic Partner | $11 |
| Employee and Child(ren) | $8 |
| Family | $21 |