Compunnel offers comprehensive dental insurance covering services such as diagnostic exams, periodic oral evaluations, restorations, oral surgery, periodontics, and emergency treatments. You and your family members can enroll in the CIGNA Dental Insurance Plan and enjoy the flexibility to choose a dentist of your choice.
https://hcpdirectory.cigna.com/web/public/consumer/directory/search
The employee premium cost per month for Dental insurance are mentioned below
Single: $30.00
Employee & Spouse: $80.00
Employee & Child: $80.00
Family: $80.00
The Total Cigna DPPO plan allows you to see any licensed dentist, but using an in-network
dentist may minimize your out-of-pocket expenses.
| Plan Option Name: DENTAL PPO | ||
|---|---|---|
| Network Options | Total Cigna DPPO | Non-Network |
| Annual Deductible | No Deductible | No Deductible |
| Annual Maximum Individual Includes: Implants |
$1500 | $1500 |
| Reimbursement Level | Based on Contracted Fees | 90th percentile of Maximum Reimbursable Charge |
| Summary of Benefits For a complete listing of your benefits, please see your Certificate or Plan Document | ||
| Diagnostic services Annual Maximum Applies Unless Noted | ||
| Oral Evaluations: Limited to 2 per Year | 100% | 100% |
| Radiographs (X-Rays): Limited to 1 per Year | 100% | 100% |
| Non-Standard Radiographs (X-Rays): Limited to 1 per 36 Consecutive Months | 100% | 100% |
| Preventive Annual Maximum Applies Unless Noted | ||
| Prophylaxis (Cleaning): Limited to 2 per Year | 100% | 100% |
| Fluoride: Limited to 1 per Year, age 0 – 18 | 100% | 100% |
| Sealants: Limited to 1 per 36 Consecutive Months, age 0 – 18 | 100% | 100% |
| Space Maintainers: Age 0 – 18 | 100% | 100% |
| Basic Restoration Annual Maximum Applies Unless Noted | ||
| Amalgam/Silver Restoration (Filling): Limited to 1 per 12 Consecutive Months | 100% | 100% |
| Composite/White Restoration (Filling): Limited to 1 per 12 Consecutive Months | 100% | 100% |
| Crown Repair | 50% | 50% |
| Bridge Repair | 50% | 50% |
| Denture Adjustment: Limited to 1 per 12 Consecutive Months | 50% | 50% |
| Denture Repair: Limited to 1 per 12 Consecutive Months | 50% | 50% |
| Denture Reline: Limited to 1 per 12 Consecutive Months | 50% | 50% |
| Major Restoration Annual Maximum Applies Unless Noted | ||
| Inlay/Onlay: Limited to 1 per 96 Consecutive Months | 50% | 50% |
| Crown: Limited to 1 per 96 Consecutive Months | 50% | 50% |
| Bridge/Pontic: Limited to 1 per 96 Consecutive Months | 50% | 50% |
| Removable and Fixed Prosthetic: Limited to 1 per 96 Consecutive Months | 50% | 50% |
| Prosthetic Over Implant: Limited to 1 per 96 Consecutive Months | 50% | 50% |
| Endodontics Annual Maximum Applies Unless Noted | ||
| Root Canal: Limited to 1 per Lifetime | 100% | 100% |
| Periodontics Annual Maximum Applies Unless Noted | ||
| Periodontal Scaling and Root Planing: Limited to 1 per 24 Consecutive Months | 100% | 100% |
| Major/Surgical Periodontics: Limited to 1 per 36 Consecutive Months | 100% | 100% |
| Oral Surgery Annual Maximum Applies Unless Noted | ||
| Simple/Non-Surgical Extraction | 100% | 100% |
| Surgical Extraction | 100% | 100% |
| Other Oral Surgery | 100% | 100% |
| Adjunctive Annual Maximum Applies Unless Noted | ||
| Anesthesia | 100% | 100% |
| Emergency Care | 100% | 100% |
| Implants Annual Maximum Applies Unless Noted | ||
| Implants: Limited to 1 per 96 Consecutive Months | 50% | 50% |
| Benefit Plan Provisions | ||
| Implants: Limited to 1 per 96 Consecutive Months | 50% | 50% |
| Benefit Plan Provisions | ||
| Cross Accumulation | All deductibles, plan maximums, and service specific maximums cross accumulate between in and out of network. Benefit frequency limitations are based on the date of service and cross accumulate between in and out of network. | |
| Benefits Maximum | The plan will only pay for covered charges up to the yearly Benefits Maximum, when applicable. Benefit specific maximums may also apply. | |
| Alternate Benefit Provision | When more than one covered Dental Service could provide suitable treatment based on common dental standards, Cigna HealthCare will determine the covered Dental Service on which payment will be based and the expenses that will be included as Covered Expenses. | |
| Oral Health Integration Program | The Cigna Dental Oral Health Integration Program offers
enhanced dental coverage for customers with certain medical
conditions. There is no additional charge to participate for in
the program. Those who qualify can receive reimbursement of
their coinsurance for eligible dental services. Eligible customers
can also receive guidance on behavioral issues related to oral
health. Reimbursements under this program are not subject to
the annual deductible but will be applied to the plan annual
maximum. For more information and a complete list of terms and eligible conditions, go to www.mycigna.com or call customer service 24/7 at 1-800-Cigna24 |
|
| Reimbursement Level | For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse according to a Fee Schedule or Discount Schedule. Cigna Dental will reimburse based on the Maximum Reimbursable Charge. For this plan, the MRC is calculated at the 90th percentile of all provider allowed amounts in the geographic area. The dentist may balance bill up to their usual fees. | |
| Timely Filing | Claims submitted to Cigna after a specified number of months from date of service could be denied. Please see your Certificate or Plan Document for detail. | |
| Pretreatment Review | Pretreatment review is available on a voluntary basis when dental work in excess of $200 is proposed by the provider. | |
| Missing Tooth Limitation Provision | For teeth missing prior to coverage with Cigna, the amount payable is 50% of the amount otherwise payable until covered for 12 months. | |
Your plan provides for most dentally necessary services. The complete list of exclusions is provided in your Certificate or Plan Document. To the extent there may be differences, the terms of the Certificate or Plan Document will prevail. Examples of things your plan does not cover, unless required by law, include but are not limited to: