| SERVICE | Cigna High Plan | Cigna Low Plan |
|---|---|---|
| Deductible (Deductible waived for preventive services) | $50/$150 | $50/$150 |
| Annual Out-of-Pocket Max per member | $3,000 | $1,500 |
| Preventive (cleanings) | 100% | 100% |
| Basic (fillings) | 90% | 80% |
| Major (crowns, dentures) | 60% | 50% |
| Orthodontia (child and adult) | 50% | Not covered |
| Orthodontics Lifetime Maximum | $2,000 | N/A |
Pay less with in-network providers
Both Cigna plans allow you to choose any provider you wish and receive benefits. The covered benefits listed above apply to both in-network and out-of-network dental care for each plan. However, you generally pay less when you go to a network dentist because dentists in the network have agreed to charge discounted fees.
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Semi-monthly Rates
| Benefit plan options | Employee | Employee + Spouse/DP |
Employee + Child(ren) |
Family |
|---|---|---|---|---|
| Dental High Plan | $10.32 | $29.62 | $35.46 | $55.20 |
| Dental Low Plan | $0.90 | $8.98 | $10.77 | $17.06 |
