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Dental Plans

Dentist speaking with a patient during a dental exam.

 

Administrator: Cigna Health and Life Insurance Company
Website:  http://www.cigna.com/
Phone: 1-800-CIGNA24
Mobile App: myCigna® Mobile App

You may elect one of the dental options offered under the Plan or choose no coverage at all. This election is independent of your medical election. 

  Self Self +1 Family
CIGNA Dental PPO (Traditional) $4.00 $8.92 $12.83
CIGNA Dental DHMO $1.61 $3.05 $4.46
CIGNA Dental Plan Comparison
CIGNA Healthy Rewards Discount Programs

IMPORTANT: Effective January 1, 2019,  the two-year waiting period has been removed. You can now join a dental plan during Open Enrollment or within sixty days of a qualifying event such as birth of a child, or marriage even if you previously waived the coverage within the past two years. 

The Traditional Dental Plan (Dental PPO) provides payment for the following covered services, subject to the plan maximums and limitations:

Class schedule: 

Class I Diagnostic and Preventive (no more than two in any calendar year). 100%  of Contract Fee or Maximum Reimbursable Charge 
Class II Basic Restorative, Endodontics, Periodontics, Maintenance of Prosthodontics and Oral Surgery 80%  of Contract Fee or Maximum Reimbursable Charge
Class III Major Restorative, Installation of Prosthodontics 60%  of Contract Fee or Maximum Reimbursable Charge
Class IV Orthodontics 60%  of Contract Fee or Maximum Reimbursable Charge

The maximum benefit, excluding Class IV Services, is $2,000 per person each year. The lifetime maximum for Class IV Services (orthodontics) is $1,000 per person. Each year, you will need to meet a deductible of $50 per person, or $150 for family. The deductible does not apply to Class I and Class IV Services. As an additional plan feature, if you use a dentist who is a member of the Preferred Provider Organization (PPO), charges for covered services will usually be discounted. This means your cost will usually be less than that associated with a dentist who is not a member of the PPO. Please remember that under the Traditional Dental Plan (Dental PPO), you may use any dentist you wish; use of the PPO feature is voluntary. Out of network claims submitted to CIGNA after 365 days from date of service will be denied. 

How to find a PPO Dentist
Frequently Ask Questions (FAQ'S)

The UCCI Dental PPO plan termed after December 31, 2018
UCCI Dental PPO Summary
Dental Claim Form (UCCI PPO)
 

The Dental HMO (DHMO) is an alternative option to the Traditional Dental Plan and operates much like a medical HMO. The key features of the plan include: No charge or modest patient charges for diagnostic/preventive and restorative procedures, as well as oral surgery,  fixed patient charges for services associated with crowns and bridges, endodontics, periodontics, prosthetics, denture relining and orthodontics (24 month maximum lifetime benefit for orthodontic services), the patient charge schedule applies only when procedures are performed by a network dentist; procedures performed by a non-network dentist are not covered,  only the procedures listed on the patient charge schedule for the Dental HMO (DHMO) will be covered; those procedures not listed will not be covered, and visits to a network specialist, such as an Endodontist, Periodontist, Orthodontist, Oral Surgeon, or Pediatric Dentist (under the age of 7) require a signed specialty referral form from the patient’s primary dentist. 

CIGNA Dental DHMO Certificate of Plan Booklet
CIGNA Dental Fee DHMO Schedule
How to find a DHMO Dentist
Frequently Ask Questions (FAQ's)

The UCCI Dental DHMO Plan termed after December 31, 2018
UCCI Dental DHMO Fee Schedule

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