Dental Benefits
One Cigna Dental PPO plan provides comprehensive dental coverage.
Dental (PPO)
Your DPPO plan allows you to see any licensed dentist, but using an in-network dentist may minimize your out-of-pocket expenses.
Your Premiums
Semi-Monthly payroll deductions
| Coverage Tier | < 3 years of Tenure | > 3 years of Tenure |
|---|---|---|
| Employee Only | $0.00 | $0.00 |
| Employee + Spouse/Domestic Partner | $16.86 | $16.86 |
| Employee + Child/Children | $25.48 | $0.00 |
| Employee + Family | $42.35 | $16.94 |
Employee Only
- < 3 years of Tenure
- $0.00
- > 3 years of Tenure
- $0.00
Employee + Spouse/Domestic Partner
- < 3 years of Tenure
- $16.86
- > 3 years of Tenure
- $16.86
Employee + Child/Children
- < 3 years of Tenure
- $25.48
- > 3 years of Tenure
- $0.00
Employee + Family
- < 3 years of Tenure
- $42.35
- > 3 years of Tenure
- $16.94
Coverage Details
| Benefit | Dental (PPO) |
|---|---|
| Calendar Year - Deductible (Individual) | $50 |
| Calendar Year - Deductible (Family) | $150 |
| Calendar Year Maximum | $2,500 |
| Preventative Services Coinsurance | 100% |
| Basic Services (includes endodontics & periodontics) | 80% AD |
| Major Services (includes crowns, bridges, implants) | 50% AD |
| Orthodontic Services (children under 19 years of age) | 50% AD |
| Orthodontic Lifetime Maximum | 80% AD |
Calendar Year - Deductible (Individual)
- Dental (PPO)
- $50
Calendar Year - Deductible (Family)
- Dental (PPO)
- $150
Calendar Year Maximum
- Dental (PPO)
- $2,500
Preventative Services Coinsurance
- Dental (PPO)
- 100%
Basic Services (includes endodontics & periodontics)
- Dental (PPO)
- 80% AD
Major Services (includes crowns, bridges, implants)
- Dental (PPO)
- 50% AD
Orthodontic Services (children under 19 years of age)
- Dental (PPO)
- 50% AD
Orthodontic Lifetime Maximum
- Dental (PPO)
- 80% AD
Plan Notes
- Basic Services: includes endodontics & periodontics
- Major Services: includes crowns, bridges, implants
- Find a provider: www.cigna.com; click on “Find a Dentist” and select the “Open Access Plus” network.