Dental plan at a glance

Dental plan at a glance

Plan features DPPO (current plan) DHMO (new plan)
In-network Out-of-network In-network only
Deductible (individual/family) $0/$0 $50/$150 No deductible
Annual benefit maximum (per person) $2,000 $2,000 No maximum
Orthodontia lifetime maximum (per person) $1,500 $1,500 No maximum
Preventive and Diagnostic

  • Cleanings
  • Oral examinations
  • Fluoride
  • X-rays
  • Space maintainers for dependent children up to age 19
  • Sealants
100% of the DPPO fee 100% of the reasonable and customary (R&C) fee 100%
Basic Care

  • Fillings
  • Simple extractions
  • Crown, denture, bridge repair/recommendations
  • General anesthesia (when in connection with oral surgery, extraction or other covered services)
  • Periodontal maintenance
80% of the DPPO fee 80% of the R&C fee, after deductible The DHMO sets the cost for services based on a Patient Charge Schedule (PCS)
Major Care

  • Implants
  • Bridges and dentures
  • Crowns, inlays, onlays
  • Endodontics
  • Oral surgery
  • Periodontal surgery
60% of the DPPO fee 60% of the R&C fee, after deductible See the PCS
Orthodontia Services 60% of the DPPO fee 60% of the R&C Fee, after deductible
Dental Card No Yes
How does the Cigna DPPO plan work?

How does the Cigna DPPO plan work?

With the Cigna DPPO plan:

  • You can go to any dentist but typically spend less when you visit a Cigna in-network dentist.
  • You do not have to choose a network dentist ahead of time, you choose a dentist when you are ready to make an appointment.
  • No ID Cards needed. Your Group Number (3339080) is all your dentist will need to confirm your dental coverage and submit a claim.

DPPO in-network services are based on the fee amount the DPPO provider has agreed to charge for covered services. An in-network provder will not bill you for charges in excess of the in-network negotiated fees.

DPPO out-of-network services are based on the reasonable and customary (R&C) amount that Cigna determines using the lowest of either the dentist’s actual charge, the dentist’s usual charge, or the charge of most dentists in the same geographic area for the same/similar service. Out-of-network dentists may bill you for amounts that exceed the R&C fee limit.

How does the Cigna DHMO plan work?

How does the Cigna DHMO plan work?

With the DHMO plan:

  • There are no deductibles to meet.
  • Your share of out-of-pocket costs is listed on your Patient Charge Schedule (PCS).
  • Referrals are required for some specialty care services. Exceptions are pediatric dentists for children under 7, orthodontics and endodontics.
  • There are no dollar maximums, no matter the amount of your covered expenses.
  • There are no claim forms to file and no waiting periods for coverage.
  • You will receive a dental card

When you enroll in the Cigna DHMO plan, you’ll be assigned a dentist from the Cigna Dental Care Access Plus network who will be your source for basic care, advice and referrals to other in-network specialists, if you need them. If you want to select a different dentist from the network, you can call Cigna to make a switch.

Under the DHMO, Cigna allows your network dentist to charge a certain amount. Then you pay a fixed portion of that cost, as listed in the Patient Charge Schedule (PCS). The DHMO pays the rest.

Out-of-network benefits are not offered with the Cigna DHMO plan (except for emergencies or where required by law).

Dental plan rates for 2022

Dental plan rates for 2022

Coverage level Associate per-pay-period contribution
Dental PPO
Associate only $8.00
Associate + spouse/DP $25.25
Associate + child(ren) $15.75
Associate + family $25.25
Dental HMO
Associate only $4.50
Associate + spouse/DP $8.50
Associate + child(ren) $10.00
Associate + family $14.75

Need assistance?

Cigna

800.244.6224
Visit website
Group Number 3339080

Dental ID card

You will only receive a dental ID card if you are enrolled in the DHMO plan. If you are enrolled in the DPPO plan your group number (3339080) is all your dentist will need to confirm your dental coverage.

Can I enroll in the DHMO plan?

To see if the DMHO is available in your area, follow these steps:

  • Go to www.cigna.com
  • Click on Find a Doctor, Dentist or Facility.
  • Under How are you Covered?, select Employer or School.
  • Enter your location.
  • Click the Doctor by Type button and choose Dentist from the drop-down menu.
  • Continue as Guest.
  • Choose Cigna Dental Care Access Plus.

Or, you can all Cigna at 888.806-5042.