Page 10 - TVS New Hire Guide
P. 10
VOLUNTARY DENTAL
Voluntary Dental
Dental insurance is provided through Cigna. Please see below for a high
level description of the plan.
More detailed beneit summaries are available through Human Resources.
Cigna
In-Network Out-of-Network
Calendar Year Deductible*
Individual $50 $50
Family $150 $150
Oice Visit Copay None None
Calendar Year Maximum** $1,000 $1,000
Usual and Customary N/A 90th
Percentage
Coinsurance
Preventive Covered at 100% Covered at 100%
no deductible no deductible
Basic 10% after deductible 20% after deductible
Major 40% after deductible 50% after deductible
Orthodontia
Coinsurance 50% 50%
Lifetime Maximum $1,000 $1,000
Beneit Applies To Children to age 19
* Deductibles do not apply to preventive services .
** Calendar year maximum increases $250 each year if you receive preventive services to a
maximum of $1,750 .
Dental Provider Search
1. Go to www.mycigna.com
2. Click on “Find a Doctor” or “Help” at the top of the page
3. Enter your search word or words and click “Search”, OR
4. Click on “Dentist” under the “Find a Person” heading and double-
click a specialty dentist by grouping
To view your weekly dental contribution rates,
please visit the enrollment website .
10
Voluntary Dental
Dental insurance is provided through Cigna. Please see below for a high
level description of the plan.
More detailed beneit summaries are available through Human Resources.
Cigna
In-Network Out-of-Network
Calendar Year Deductible*
Individual $50 $50
Family $150 $150
Oice Visit Copay None None
Calendar Year Maximum** $1,000 $1,000
Usual and Customary N/A 90th
Percentage
Coinsurance
Preventive Covered at 100% Covered at 100%
no deductible no deductible
Basic 10% after deductible 20% after deductible
Major 40% after deductible 50% after deductible
Orthodontia
Coinsurance 50% 50%
Lifetime Maximum $1,000 $1,000
Beneit Applies To Children to age 19
* Deductibles do not apply to preventive services .
** Calendar year maximum increases $250 each year if you receive preventive services to a
maximum of $1,750 .
Dental Provider Search
1. Go to www.mycigna.com
2. Click on “Find a Doctor” or “Help” at the top of the page
3. Enter your search word or words and click “Search”, OR
4. Click on “Dentist” under the “Find a Person” heading and double-
click a specialty dentist by grouping
To view your weekly dental contribution rates,
please visit the enrollment website .
10
