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DENTAL





            With the Cigna Preferred Provider Organization (PPO) dental plan, you may visit a PPO dentist and benefit from the negotiated
            rate or visit a non-network dentist. When you utilize a PPO dentist, your out-of-pocket expenses will be less. You may also
            obtain services using a non-network dentist; however, you will be responsible for the difference between the covered amount
            and the actual charges and you may be responsible for filing claims.


                                                                                CIGNA
                                                                              PPO PLAN
             NETWORK                                          Network                         Non-Network

             DENTAL BENEFITS
             Calendar Year Maximum Benefit                                     $2,250
             Annual Deductible
             •   Individual                                    None                               $50
             •   Family                                        None                              $150
             Preventive Services (Plan Pays)                   100%                              100%
             •   Deductible Waived
             Basic Services (Plan Pays)                        100%                            Ded, 80%
             Major Services (Plan Pays)                         60%                            Ded, 50%
             Orthodontia
             •   Covered Family Members                                    Adult & Children
             •   Lifetime Benefit Maximum                                      $2,000
             •   Coinsurance                                                     50%



                           FINDING A DENTAL PROVIDER:
                           You can locate a dentist through Cigna’s online directory. Go to www.cigna.com and click Find a Doctor.
                           On the right side of the page, under “Not a Cigna Customer Yet?” select “Plans through your employer
                           or school” and then the Dentist tab. When prompted to select a plan, please choose “Cigna Dental
                           PPO or EPO”.
































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