Page 8 - 2018 VER Benefit Guide
P. 8
Balance billing is the practice of non- Dental
network dentists billing the patient for
amounts which exceed the maximum Your oral health is a critical component of your overall health. VER
reimbursement under a patient’s partners with Cigna to provide comprehensive dental plan options.
dental plan. The patient is responsible
for the additional amounts charged. Cigna offers access to two networks, the Cigna Advantage network and
Cigna DPPO network. If you use an Advantage dentist you will receive
the greatest discount on services and you cannot be billed for charges
exceeding the negotiated rate. The DPPO network is another network
option but offers lower discounts on services. DPPO dentists also cannot
bill you for charges exceeding negotiated rates. You also have the option
to use a non-network dentist; however, you will pay more for covered
services, you may have to ile your own claims, and you may be subject to
balance billing.
To access a list of participating providers visit www.cigna.com.
VER pays 100% of the premiums for the core plan. Employees wishing
to enroll in either buy-up option will pay the full difference in cost. The
following charts summarize the key features of each plan offering.
Core Plan Benefits
Advantage DPPO Non-Network
Network Network Provider
Class 1 Preventive 100% 100% 100%
Class II Basic 90% 90% 80%
Class III Major 60% 60% 50%
Calendar Year Deductible $25 $25 $50
Waived for Class I Yes Yes Yes
Calendar Year Maximum $1,000 $1,000 $1,000
Per Family Member
Class IV Orthodontia N/A N/A N/A
8 2018 Benefits Enrollment
network dentists billing the patient for
amounts which exceed the maximum Your oral health is a critical component of your overall health. VER
reimbursement under a patient’s partners with Cigna to provide comprehensive dental plan options.
dental plan. The patient is responsible
for the additional amounts charged. Cigna offers access to two networks, the Cigna Advantage network and
Cigna DPPO network. If you use an Advantage dentist you will receive
the greatest discount on services and you cannot be billed for charges
exceeding the negotiated rate. The DPPO network is another network
option but offers lower discounts on services. DPPO dentists also cannot
bill you for charges exceeding negotiated rates. You also have the option
to use a non-network dentist; however, you will pay more for covered
services, you may have to ile your own claims, and you may be subject to
balance billing.
To access a list of participating providers visit www.cigna.com.
VER pays 100% of the premiums for the core plan. Employees wishing
to enroll in either buy-up option will pay the full difference in cost. The
following charts summarize the key features of each plan offering.
Core Plan Benefits
Advantage DPPO Non-Network
Network Network Provider
Class 1 Preventive 100% 100% 100%
Class II Basic 90% 90% 80%
Class III Major 60% 60% 50%
Calendar Year Deductible $25 $25 $50
Waived for Class I Yes Yes Yes
Calendar Year Maximum $1,000 $1,000 $1,000
Per Family Member
Class IV Orthodontia N/A N/A N/A
8 2018 Benefits Enrollment
