Page 13 - American Advisors Group Benefit Guide 2_NonCA

EMPLOYEE BENEFITS 13

DENTAL COVERAGE

In order to provide you with the level of dental coverage that best fits the needs of you and your family,
AAG offers one dental plan option; CIGNA DPPO.
To help you understand the features and coverage available to you, we have provided the following brief summary of benefits.
Please refer to plan documents for details, including important coverage exclusions and limitations.

CIGNA DPPO
COVERAGE CIGNA – HIGH OPTION
In-Network Out-of-Network

Deductible (Single/ Family) $50 / $100 $50 / $100
Calendar Year Maximum $2,000 $2,000
Texas
Preventative & Diagnostic Care No charge deductible waived No charge deductible waived
(Cleanings, Exams, X-rays, etc.) Other States
80%
Texas
Basic Care Plan pays 80% after deductible
(Fillings, extractions, Root canal, Plan pays 80% after deductible Other States
etc.)
Plan pays 60% after deductible
Texas
Major Services Plan pays 50% after deductible Plan pays 50% after deductible
(Crowns, Bridges, Dentures, etc.) Other States
Plan pays 40% after deductible
Texas
Plan pays 50% after deductible
Coverage: Implants Plan pays 50% after deductible
Other States
Plan Pays 40% after deductible
Orthodontia 50% to a Lifetime maximum benefit of $2,000 50% to a Lifetime maximum benefit of $2,000
(Adult and Children)
Reimbursements Contracted MRC 80th percentile