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 Base
Benefit Highlights
In-Network
Deductible (Per Individual)
$50/$150
Plan Maximum
Year 1: $1,500
Year 2: $1,650
Year 3: $1,800
Year 4: $1,950
Preventive Care
No charge
Basic Services
10% coinsurance after deductible
Major Procedures
40% coinsurance after deductible
Orthodontia (Adults and Children)
Not covered
Out-of-Network
Deductible (Per Individual)
$50/$150
Plan Maximum
Year 1: $1,500
Year 2: $1,650
Year 3: $1,800
Year 4: $1,950
Preventive Care
No charge
Basic Services
10% coinsurance after deductible
Major Procedures
40% coinsurance after deductible
Orthodontia (Adults and Children)
Not covered
Plan Cost
Employee Only: $8.00
Employee and Spouse/DP: $23.00
Employee and Child(ren): $26.00
Employee and Family: $37.00
Cigna Dental PPO Buy-Up
Benefit Highlights
In-Network
Deductible (Per Individual)
$50/$150
Plan Maximum
Year 1: $2,000
Year 2: $2,150
Year 3: $2,300
Year 4: $2,450
Preventive Care
No charge
Basic Services
No charge after deductible
Major Procedures
40% coinsurance after deductible
Orthodontia (Adults and Children)
50% coinsurance up to a lifetime maximum benefit of $2,000
Out-of-Network
Deductible (Per Individual)
$50/$150
Plan Maximum
Year 1: $2,000
Year 2: $2,150
Year 3: $2,300
Year 4: $2,450
Preventive Care
No charge
Basic Services
No charge after deductible*
Major Procedures
40% coinsurance after deductible
Orthodontia (Adults and Children)
50% coinsurance up to a lifetime maximum benefit of $2,000
*Reimbursed at 90% of UCR
Plan Cost
Employee Only: $27.00
Employee and Spouse/DP: $71.00
Employee and Child(ren): $80.00
Employee and Family: $114.00