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 Standard PPO
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum*
Level 1: $1,500
Level 2: $1,650
Level 3: $1,800
Level 4: $1,950
Preventive Care
$0
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Children up to age 19)
50% up to lifetime maximum benefit of $1,000
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum*
Level 1: $1,500
Level 2: $1,650
Level 3: $1,800
Level 4: $1,950
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Children up to age 19)
50% up to lifetime maximum benefit of $1,000
* This plan’s benefit maximums are determined by whether you received preventive care through the plan during the previous year. Completing preventive care increases your benefit maximum for the next plan year by one level (up to Level 4).
Per Pay Period Plan Cost
Employee Only: $2.25
Employee and Spouse/DP: $5.61
Employee and Child(ren): $6.89
Employee and Family: $10.25
Cigna Dental Premier PPO
Benefit Highlights
In-Network
Deductible (Per Individual)
$50/$150
Annual Plan Maximum
$5,000*
Preventive Care
$0
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $2,000
Out-of-Network
Deductible (Per Individual)
$50/$150
Annual Plan Maximum
$2,000*
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $2,000
* Combined In-Network and Out-of-Network maximum of $2,000 with an additional $3,000 of benefit In-Network.
Per Pay Period Plan Cost
Employee Only: $2.98
Employee and Spouse/DP: $7.41
Employee and Child(ren): $9.10
Employee and Family: $13.53