Page 12 - 2019 Murphy Benefits Enrollment
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Find an In-Network DENTAL
Provider Murphy Company partners with Cigna to offer you the choice between
Remember to visit in-network two dental plan options: a PPO and DHMO plan.
dentists to receive the deepest level
of discount on your services. The PPO plan offers two network options—the Cigna DPPO Advantage
To ind a participating in-network Network and the Cigna DPPO Network. Beneits by network are outlined
dentist in your area go to below.
www.cigna.com and click on “Find a
Doctor, Dentist, or Facility”. In-Network In-Network
Dental PPO Cigna DPPO Cigna DPPO Out-of-Network
Covered Services Advantage
Preventive—exams, cleanings, Calendar Year Deductible
luoride, x-rays, and sealants Individual $50 per person $50 per person $50 per person
Basic—illings, extractions, Family $150 per family $150 per family $150 per family
periodontics, repairs, and oral Calendar Year Maximum
surgery $1,000 $750 $750
Major—crowns, inlays,
dentures, and dental implants Coinsurance (Plan pays)
Preventive 100% no 80% no 80% no
deductible deductible deductible
Basic 80% after 60% after 60% after
deductible deductible deductible
Major 50% after 40% after 40% after
deductible deductible deductible
Orthodontia Not Covered Not Covered Not Covered
Beneits in the DHMO plan are based on a schedule of beneits and vary
by service. Please refer to the beneit summary for more information.
Monthly Contributions
DPPO DHMO
Employee $7 .39 $4 .37
Employee and Spouse $39 .44 $23 .83
Employee and Child(ren) $40 .28 $29 .94
Employee and Family $72 .32 $49 .18
This is a high level summary of your beneit coverage. Full coverage details are available in your
summary plan description (SPD). In the event there is a discrepancy between what is relected in
this guide and what is communicated in your SPD, the terms of your SPD will prevail.
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Provider Murphy Company partners with Cigna to offer you the choice between
Remember to visit in-network two dental plan options: a PPO and DHMO plan.
dentists to receive the deepest level
of discount on your services. The PPO plan offers two network options—the Cigna DPPO Advantage
To ind a participating in-network Network and the Cigna DPPO Network. Beneits by network are outlined
dentist in your area go to below.
www.cigna.com and click on “Find a
Doctor, Dentist, or Facility”. In-Network In-Network
Dental PPO Cigna DPPO Cigna DPPO Out-of-Network
Covered Services Advantage
Preventive—exams, cleanings, Calendar Year Deductible
luoride, x-rays, and sealants Individual $50 per person $50 per person $50 per person
Basic—illings, extractions, Family $150 per family $150 per family $150 per family
periodontics, repairs, and oral Calendar Year Maximum
surgery $1,000 $750 $750
Major—crowns, inlays,
dentures, and dental implants Coinsurance (Plan pays)
Preventive 100% no 80% no 80% no
deductible deductible deductible
Basic 80% after 60% after 60% after
deductible deductible deductible
Major 50% after 40% after 40% after
deductible deductible deductible
Orthodontia Not Covered Not Covered Not Covered
Beneits in the DHMO plan are based on a schedule of beneits and vary
by service. Please refer to the beneit summary for more information.
Monthly Contributions
DPPO DHMO
Employee $7 .39 $4 .37
Employee and Spouse $39 .44 $23 .83
Employee and Child(ren) $40 .28 $29 .94
Employee and Family $72 .32 $49 .18
This is a high level summary of your beneit coverage. Full coverage details are available in your
summary plan description (SPD). In the event there is a discrepancy between what is relected in
this guide and what is communicated in your SPD, the terms of your SPD will prevail.
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