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P. 8
Open Enrollment
Dental
Dental coverage is transitioning from Cigna offers two networks: a DPPO Advantage network and a
Guardian to Cigna, and utilizes the DPPO network. While the DPPO network offers deep discounts,
Cigna PPO and PPO Advantage you will ind the greatest discounts with providers who are under
networks. the DPPO Advantage network. Always note if you choose to seek
treatment from an out-of-network provider, you may be subject to
To ind a new dentist, or conirm balance billing. Be sure to search your dentist to see which network
whether your current dentist is in- tier they fall under.
network, please visit www.cigna.com,
click on “Find a Doctor/Dentist”, Cigna DPPO Cigna DPPO Out-of-Network
Advantage
choose the dentist or place you would Calendar Year Deductible
like to receive care, and search your Individual $50 $50 $50
network options. Family $150 $150 $150
Calendar year maximum $1,000 *
Employee Bi-Weekly Payroll Contributions Coinsurance (Deductible applies to Basic and Major services)
Employee $9.23 Preventive 0% 0% 0%
Employee + spouse $19.38 Basic 10% 20% 20%
Employee + child(ren) $23.08 Major 40% 50% 50%
Family $33.23 Orthodontia
Coinsurance 50%, no 50%, no 50%, no
deductible deductible deductible
Lifetime maximum $1,000
Beneit applies to Children up to age 19
* Dental plan includes Cigna Dental WellnessPlus features. When you or your family
members receive any preventive care in one plan year, the annual dollar maximum will
increase by $250 in the following plan year. This annual increase will continue until you
have reached $1,750 as your total plan maximum.
Generic ID cards for dental coverage will Note: Texas employees coinsurance 0%/20%/50% both in- and out-of-network per state
mandate (Cigna DPPO network).
be distributed by email. Personalized ID
cards are not required and will not be
mailed to your home.
8
Dental
Dental coverage is transitioning from Cigna offers two networks: a DPPO Advantage network and a
Guardian to Cigna, and utilizes the DPPO network. While the DPPO network offers deep discounts,
Cigna PPO and PPO Advantage you will ind the greatest discounts with providers who are under
networks. the DPPO Advantage network. Always note if you choose to seek
treatment from an out-of-network provider, you may be subject to
To ind a new dentist, or conirm balance billing. Be sure to search your dentist to see which network
whether your current dentist is in- tier they fall under.
network, please visit www.cigna.com,
click on “Find a Doctor/Dentist”, Cigna DPPO Cigna DPPO Out-of-Network
Advantage
choose the dentist or place you would Calendar Year Deductible
like to receive care, and search your Individual $50 $50 $50
network options. Family $150 $150 $150
Calendar year maximum $1,000 *
Employee Bi-Weekly Payroll Contributions Coinsurance (Deductible applies to Basic and Major services)
Employee $9.23 Preventive 0% 0% 0%
Employee + spouse $19.38 Basic 10% 20% 20%
Employee + child(ren) $23.08 Major 40% 50% 50%
Family $33.23 Orthodontia
Coinsurance 50%, no 50%, no 50%, no
deductible deductible deductible
Lifetime maximum $1,000
Beneit applies to Children up to age 19
* Dental plan includes Cigna Dental WellnessPlus features. When you or your family
members receive any preventive care in one plan year, the annual dollar maximum will
increase by $250 in the following plan year. This annual increase will continue until you
have reached $1,750 as your total plan maximum.
Generic ID cards for dental coverage will Note: Texas employees coinsurance 0%/20%/50% both in- and out-of-network per state
mandate (Cigna DPPO network).
be distributed by email. Personalized ID
cards are not required and will not be
mailed to your home.
8
