Dental

Our dental plans offer coverage for preventive, basic and major care as well as orthodontia and other services for you and your covered dependents.

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Dental HMO - Basic

An in-network dentist coordinates your care

With this plan, you must use Cigna Dental's DHMO network of dentists for your care. You also coordinate your care through one primary care dentist (PCD). If you receive care outside of the network, your care isn’t covered except in the case of an emergency.

  • When you sign up for this plan, Cigna assigns you a primary care dentist (PCD) close to your home who coordinates your care.

  • You can change your PCD at any time through Cigna. The change becomes effective the first of the following month. If you make the change prior to the 15th of a month, Cigna lets your PCD know. If you make the change after the 15th and have an appointment scheduled for the following month, the PCD may need to contact Cigna to verify change. The PCD's name is not printed on the card, but if you change your election, you can request a new card or a letter confirming change.

  • Your plan fully covers most preventive care, such as routine checkups and cleanings. You and your covered dependents can receive up to two cleanings each 12-month period, free of charge.

  • There are no deductibles to pay or claim forms to file. You simply pay the set copays when you receive covered services.

  • There’s no coverage for specialty care, including orthodontia and implants. You’re responsible for paying the entire charge at the time of service in accordance with the specialist dentist’s billing procedures.

  • Out-of-network dental care is only covered in an emergency, and it requires prior administrator approval from Cigna.

  • You can use your health care flexible spending account to pay copays.

Helpful resources

To change your PCD, obtain prior approval, or find help of any kind, call Cigna customer care at 800-CIGNA24 (800-244-6224), available 24 hours a day, 7 days a week; visit the Cigna website, or check your plan summary document.

Rates per pay period
Based on 24 paychecks
Employee $2.83
Employee + spouse $5.30
Employee + child(ren) $4.81
Employee + family $6.91
Annual deductible

$0

Annual benefit maximum
Annual maximum benefit

Unlimited

Covered services You pay
check Preventive and diagnostic care

$0 - $70

check Basic care

$5 - $455 

check Major care

$10 - $355

check Implants & related procedures

No coverage

check Orthodontia

No coverage

Dental HMO Plus

An in-network dentist coordinates your care

With this plan, you must use Cigna Dental's DHMO network of dentists for your care. You also coordinate your care through one primary care dentist (PCD). If you receive care outside of the network, your care isn’t covered except in the case of an emergency.

  • When you sign up for this plan, Cigna assigns you a primary care dentist (PCD) close to your home who coordinates your care.
  • You can change your PCD at any time through Cigna. The change becomes effective the first of the following month. If you make the change prior to the 15th of a month, Cigna lets your PCD know. If you make the change after the 15th and have an appointment scheduled for the following month, the PCD may need to contact Cigna to verify change. The PCD's name is not printed on the card, but if you change your election, you can request a new card or a letter confirming change.
  • Your plan fully covers most preventive care, such as routine checkups and cleanings. You and your covered dependents can receive up to two cleanings each 12-month period, free of charge.
  • There are no deductibles to pay or claim forms to file. You simply pay the set copays when you receive covered services.
  • If you need specialty dental care, excluding pediatric or orthodontic, your PCD will refer you to a network specialist.
  • Out-of-network dental care is only covered in an emergency, and it requires prior administrator approval from Cigna.
Helpful resources

To change your PCD, obtain prior approval, or find help of any kind, call Cigna customer care at 800-CIGNA24 (800-244-6224), available 24 hours a day, 7 days a week; visit the Cigna website, or check your plan summary document.

Rates per pay period
Based on 24 paychecks
Employee $4.58
Employee + spouse $8.56
Employee $7.77
Employee $11.17
Annual deductible

$0

Annual benefit maximum
Annual maximum benefit

Unlimited

Covered services You pay
check Preventive and diagnostic care

$0 - $60

check Basic care

$5 - $300 

check Major care

$10 - $350

check Implants & related procedures

$60 - $1,725

check Orthodontia

24-month case copay:
Child $2,400
Adult $2,600

Dental PPO

See any dentist you like

After you’ve met the individual or family deductible, the Dental PPO option pays a percentage of the usual, customary and reasonable (UCR) cost of services. You’re responsible for the difference.

  • You can see any dental provider licensed in the US, including specialists, without a referral. You generally pay less when you see a provider in the Cigna network because these dentists are contracted with Cigna. If you go outside the Cigna network, you’re responsible for any costs that exceed the usual, customary and reasonable costs of services.
  • You can change dentists or see a specialist any time.
  • Your plan fully covers most preventive care, such as routine checkups and cleanings. You and your covered dependents can receive up to two exams and cleanings per calendar year, free of charge.
  • You pay a deductible before the plan begins to pay its share of covered expenses. Once you’ve met your deductible, you pay coinsurance, which is a percentage of costs for covered services. If you go to an out-of-network dentist, you must submit receipts and a claim form to Cigna Dental to receive reimbursement.
  • Some services that are done to improve the look of your teeth, such as teeth whitening, may not be covered by your plan.
  • Through the WellnessPlus feature, you and your covered dependents can increase your annual benefit maximum by $100 for the following year (up to a maximum of $1,800) by taking advantage of the plan’s preventive care.
  • You can use your health care flexible spending account to pay deductibles and coinsurance.
Missing tooth provision

If you’re a new enrollee, the plan only pays 50% of the normal cost for replacing missing teeth until you’ve been a plan participant for 12 months.

Helpful resources

Check here to see if your current dentist is in the Cigna network.

Use this handy guide or call Cigna customer care at 800-CIGNA24 (800-244-6224), available 24 hours a day, 7 days a week.

Rates per pay period
Based on 24 pay periods
Employee $16.37
Employee + spouse $30.98
Employee + child(ren) $32.36
Employee + family $50.61
Annual deductible
Individual $50
Family $150
Annual benefit maximum
Individual

$1,500

Covered services You pay
check Preventive and diagnostic care

$0 (deductible waived)

check Basic care

20% of covered expenses after annual deductible 

check Major care

50% of covered expenses after annual deductible 

check Implants and related procedures

50% of covered expenses after annual deductible 

check Orthodontia

50% of covered expenses, up to $1,000 individual lifetime max

Discount Dental

No premiums, deductibles or claims to file

  • This option is provided free of charge for employee-only coverage and is available for a per-paycheck premium for all other coverage levels.
  • You can see any QCD of America provider for your care without a referral. Just give the provider your membership ID number when you make an appointment, and take your card with you.
  • You don’t pay deductibles, file claim forms or have restrictions for pre-existing conditions or number of visits.
  • You pay set fees for select services and receive a 20% discount for other services.
  • There’s no coverage for out-of-network care. If you choose not to use a QCD provider, you pay full price.
  • QCD of America guarantees the QCD fee schedule. If your dentist’s bill doesn’t match it, call QCD immediately.
  • This plan also includes access to discounted vision services and materials called Clear Vision administered through Davis Vision. For more information on this coverage, click here.
Helpful resources

To find a dentist or specialist near you, use the QCD Find Your Dentist tool, or call the QCD membership services department at 800-229-0304.

Rates per pay period
Based on 24 pay periods
Employee $0.00
Employee + spouse $4.00
Employee + child(ren) $4.00
Employee + family $6.00
Annual deductible
Individual $0
Family $0
Annual benefit maximum
Individual

Unlimited

Covered services You pay
check Preventive & diagnostic care

$5 - $75

check Basic care

$16 - $350

check Major care

$15 - $420 

check Implants & related procedures

Reduced fees for services with QCD dentists only

check Orthodontia

QCD general dentist:
Child $2,200
Adult $2,400

QCD orthodontist:
20% discount

Who do you want to cover?

  Dental HMO - Basic Dental HMO Plus Dental PPO Discount Dental
Rates per pay period
Based on 24 paychecks $2.83 $4.58 $16.37 $0.00
Annual deductible

$0

$0

Individual $50
Family $150
Individual $0
Family $0
Annual benefit maximum
Annual maximum benefit

Unlimited

Unlimited

$1,500

Unlimited

Covered services
Preventive and diagnostic care

$0 - $70

$0 - $60

$0 (deductible waived)

$5 - $75

Basic care

$5 - $455 

$5 - $300 

20% of covered expenses after annual deductible 

$16 - $350

Major care

$10 - $355

$10 - $350

50% of covered expenses after annual deductible 

$15 - $420 

Implants & related procedures

No coverage

$60 - $1,725

50% of covered expenses after annual deductible 

Reduced fees for services with QCD dentists only

Orthodontia

No coverage

24-month case copay:
Child $2,400
Adult $2,600

50% of covered expenses, up to $1,000 individual lifetime max

QCD general dentist:
Child $2,200
Adult $2,400

QCD orthodontist:
20% discount

Find a network provider

For any benefits question or concern, including 24/7 Nurse Line access, one call does it all.
Call us at 866-284-AISD (2473)