Dental
Dental coverage helps you maintain a healthy smile with preventive care, basic services, and major procedures. You can visit any licensed dentist, but you’ll save the most when you use an in-network provider who has agreed to discounted rates. Out-of-network dentists may charge more than the plan’s allowed amount, and you may be responsible for the difference. Most plans cover preventive services—such as exams, cleanings, and X-rays—at 100% when you stay in-network, making regular checkups an easy way to protect your oral health and avoid costly issues.
Cigna Dental PPO
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$2,000
Preventive Care
$0
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Children less than 19 years of age)
50% up to a lifetime maximum benefit of $1,000 per individual
Out-of-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$2,000
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Children less than 19 years of age)
50% up to a lifetime maximum benefit of $1,000 per individual
Monthly Plan Cost
Earnings Under $75,000
Employee Only: $5.94
Employee and Spouse/DP: $72.69
Employee and Child(ren): $77.85
Employee and Family: $162.58
Earnings Between $75,000 – $119,999.99
Employee Only: $11.86
Employee and Spouse/DP: $78.61
Employee and Child(ren): $83.77
Employee and Family: $168.50
Earnings Between $120,000 – $179,999.99
Employee Only: $17.81
Employee and Spouse/DP: $84.56
Employee and Child(ren): $89.72
Employee and Family: $174.45
Earnings Greater than or Equal to $180,000
Employee Only: $24.12
Employee and Spouse/DP: $90.87
Employee and Child(ren): $96.04
Employee and Family: $180.76
