It s easy to find a network dentist or specialist.

Transcription

1 Smile! It s easy to find a network dentist or specialist. Finding a Cigna Dental PPO (DPPO) network dentist or specialist is quick and easy whether you prefer searching online or speaking to a customer service representative. Let us show you how: You can find a DPPO network dentist from the online directory on Cigna.com Go to Cigna.com, click on Find a Doctor at the top of the screen. Then, choose a Directory by clicking on the If Your Insurance Plan is Offered through Work or School option. Next, click on Find a Dentist. Within the search results, you ll see labels to help you identify potential savings: Total Cigna DPPO When searching under a DPPO plan, all in-network dentists are labeled as Participates in Total Cigna DPPO. These dentists have all agreed to offer services at lower negotiated rates. Within this network, we offer two discount levels: Cigna DPPO Advantage Seeing a DPPO Advantage dentist may provide a better benefit level with greater savings. Individual plans may vary. Enter SEARCH LOCATION city, state or zip code. SELECT A PLAN by clicking on the Pick drop down icon and selecting Cigna Dental PPO or EPO under the Dental Plans section. Then press choose. Cigna DPPO Seeing a DPPO dentist may provide a lesser benefit level while still offering savings. Individual plans may vary. (continued on next page) Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company or their affiliates. This brochure is not intended for residents of New Mexico / Cigna. Some content provided under license.

2 If you want to narrow your search, you can also type in key words, like dentist name, specialist type or office name. Then, click Search. From the Search Results page, you can further refine your search results by distance, specialty, years in practice and additional languages. Click on a dentist s name for more details, including multiple location listings with map view. Call us at 800.Cigna24 ( ) For assistance locating a Cigna network dentist or specialist, use the automated Dental Office Locator or speak to a customer service representative. You can also request a customized directory based on the type of dentist you are looking for in your area. Call your current dentist to see if he or she participates When you call, be sure to ask if your dentist participates in the Cigna dental network for your plan. Call or click to find a network provider that s right for you At Cigna, we are dedicated to providing better savings, better health and a better customer experience. Our goal is to support you and your dental health. From full-service to self-service, Cigna has your provider search covered. Go to mycigna.com the easiest way! MyCigna.com automatically knows which Cigna dental plan you belong to. Your home zip code will be entered automatically, but you can change the zip if you are looking for a dentist in another area. Once you re enrolled, you can search for a network dentist by name, specialty or location at mycigna.com (registration is required). After logging in to mycigna.com, click on Find a Doctor or Service at the top of the page. Enter your search criteria and click Search, OR Click on Dentist under the Find a Person heading and double-click a specialty dentist by category. This information is also available on the mycigna mobile app. Dentists who participate in Cigna s network are independent contractors solely responsible for the treatment provided and are not agents of Cigna. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna HealthCare of Connecticut, Inc., and Cigna Dental Health, Inc. and its subsidiaries, and not by Cigna Corporation. In Texas, the insured dental product offered by CGLIC and CHLIC is referred to as the Cigna Dental Choice Plan. The Cigna Dental PPO network(s) is a national reference to our network; in Texas this network(s) will be utilized with the Cigna Dental Choice Plan. All models are used for illustrative purposes only. The Cigna name logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc / Cigna. Some content provided under license.

3 Cigna Dental PPO YOUR QUESTIONS ANSWERED? Q: Can I go to any dentist? A: Yes. You will typically spend less when you visit a Cigna network dentist because Cigna has negotiated discounted rates with these dentists. When you stay in the network you ll save as long as the procedure is listed on the dentist s discount schedule. 1 These savings apply even if you reach your plan maximum. Out-of-network dentists do not offer discounted rates and may bill you for the difference between the payment they receive from Cigna and their usual fees. Q: Do I choose a dentist when I sign up for the plan? A: No, you choose a dentist when you are ready to make an appointment. You can go to any licensed dentist at any time. You do not need a referral to see a specialist. You can find a network dentist or specialist online at Cigna.com before you sign up, or go to your personalized website at mycigna.com after you sign up. You can also call Customer Service at 800.Cigna24 ( ) and we will help you find a network dentist in your area. Q: Do I pay up-front and submit a claim or will the dentist submit claims for me? A: In most instances, if you are using an in-network dentist, that provider will submit claims on your behalf and will bill you for any deductible or co-insurance payment that you owe. If you use an out-ofnetwork dentist, you may need to file your own claims after payment. Q: What information is available to help me choose a dentist? A: Cigna gives you personalized online tools to help you make informed decisions about your dental health. These tools provide information about dental care and cost savings, allowing transparent information sharing that saves you time and money. The online tools include: Cost-effectiveness designation: Within the mycigna directory, customers can research dentists using Cigna s star rating system to determine the level of potential savings. A dentist receives one, two or three stars from Cigna. The more stars, the greater the savings. Dental care distinction: Cigna helps you make dental care decisions by adding information within the online network directory to identify dentists who meet certain practice criteria. Dental treatment cost estimator: Customers can obtain personalized out-of-pocket cost estimates for over 400 common dental procedures and treatments. Dental procedure estimates will be specific to the dentist s contract and product with Cigna. Estimates are calculated in realtime and personalized using your specific plan benefits, deductibles, and applicable copay or coinsurance fees /14 Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company or their affiliates.

4 Q: Can you explain the deductible, maximum, and percentages listed on my enrollment materials? A: The deductible is the amount you need to pay for covered services before your benefits begin. 2 You will pay for your dental treatment until you reach that amount. Then, you and your plan begin to share a percentage of your covered dental costs, known as coinsurance. The percentage shown on your plan materials is the percentage the plan pays for the listed procedures, and then you pay the difference. The maximum is the most your plan will pay for your dental claims during the plan year. Once you reach that maximum, your plan will no longer pay a percentage of your costs for the rest of that plan year. Even after you reach the maximum, however, dentists in the network will continue to offer you discounted fees for all services on their schedules. Once you enroll, register on mycigna.com and get access to: Plan information Network directory of dentists Oral health assessments and quizzes Out-of-pocket dental cost estimates ID card information Claim information Discounts on a variety of health and wellness products and services 1. Discounts on non-covered services may not be available in all states. 2. Waiting periods may apply. All group dental plans and insurance policies have exclusions and limitations. For costs and details about the services covered under your plan, review your enrollment materials. Dentists who participate in Cigna s network are independent contractors solely responsible for the treatment provided and are not agents of Cigna. Cigna and the Tree of Life logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company (CGLIC), Cigna Health and Life Insurance Company, and Cigna Dental Health, Inc. and its subsidiaries. Cigna Dental PPO plans are underwritten or administered by CGLIC or CHLIC, with network management services provided by Cigna Dental Health, Inc. and certain of its subsidiaries. In Arizona and Louisiana, the insured Dental PPO plan offered by CGLIC is known as the CG Dental PPO. In Texas, the insured dental product is referred to as the Cigna Dental Choice Plan. DPPO/Traditional insurance coverage is set forth on the following policy form numbers, respectively: DPPO/ Traditional insurance coverage is set forth on the following policy form numbers, respectively: DE: HP-POL79; ID: HP-POL82; LA: HP-POL86; MA: HP-POL63; NV: HP-POL93; NY: HP-POL67; OK: HP-POL99; OR: HP-POL68; SC: HP-POL102; SD: HP-POL103; TN: HP-POL60; and VT: HP-POL / Cigna. Some content provided under license.

5 Your health has met its appsm Introducing the simple, personalized mycigna Mobile App. mycigna You re busier than ever. At Cigna, we get that. While we can t wave a magic wand and make all the frustrating, time-consuming aspects of your life go away, we can give you a tool to help make your life easier. And healthier. The all-new mycigna Mobile App gives you a simple way to personalize, organize and access your important dental information on the go. It puts you in control of your health, so you can get more out of life /13 Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates.

6 Little App. BIG FEATURES. Health care professional directory Search for a dentist from the Cigna national network Access maps for instant driving directions Coverage Get important details on your plan, like what you ll pay in- and out-of-network Track and manage plan deductibles and coinsurance ID cards Quickly view dental ID cards (front and back) for everyone on your plan Easily print, or scan right from smartphone Claims View and search recent and past dental claims Bookmark and group dental claims for easy reference Health wallet Store and organize all important contact info for dentists and dental facilities Add dentists to contact list right from a claim or directory search Get the mycigna Mobile App from the App Store SM or Google Play TM. The Apple logo is a trademark of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. Android and Google Play are trademarks of Google Inc. The downloading and use of the App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply. Actual Mobile App features available may vary depending on your plan. The listing of a health care professional or facility in the mobile directories available through the mycigna Mobile App does not guarantee that the services rendered by that professional or facility are covered under your specific dental plan. Check your official plan documents, or call the number listed on your ID card, for information about the services covered under your plan benefits. Cigna and the Tree of Life logo are registered service marks, and GO YOU and Your Health Has Met Its App are service marks, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Cigna HealthCare of Connecticut, Inc., and Cigna Dental Health, Inc. and its subsidiaries / Cigna. Some content provided under license.

7 Cigna Dental Benefit Summary OrthoSynetics Plan Renewal Date: 1/1/2018 Insured by: Cigna Health and Life Insurance Company This material is for informational purposes only and is designed to highlight some of the benefits available under this plan. Consult the plan documents to determine specific terms of coverage relating to your plan. Terms include covered procedures, applicable waiting periods, exclusions and limitations. Network Options Cigna Dental Choice Plan In-Network: Total Cigna DPPO Network Out-of-Network: See Non-Network Reimbursement Reimbursement Levels Based on Contracted Fees Maximum Reimbursable charge Calendar Year Benefits Maximum Applies to: Class I, II, III & IX expenses $2,000 $2,000 Calendar Year Deductible Individual Family $50 $150 $50 $150 Benefit Highlights Plan Pays You Pay Plan Pays You Pay Class I: Diagnostic & Preventive Oral Evaluations Prophylaxis: routine cleanings X-rays: routine X-rays: non-routine Fluoride Application Sealants: per tooth Space Maintainers: non-orthodontic Emergency Care to Relieve Pain 100% No Deductible No Charge 100% No Deductible No Charge Class II: Basic Restorative Restorative: fillings Endodontics: minor and major Periodontics: minor and major Oral Surgery: minor and major Anesthesia: general and IV sedation Class III: Major Restorative Repairs: Bridges, Crowns and Inlays Repairs: Dentures Denture Relines, Rebases and Adjustments Inlays and Onlays Prosthesis Over Implant Crowns: prefabricated stainless steel / resin Crowns: permanent cast and porcelain Bridges and Dentures 80% Class IX: Implants Benefit Plan Provisions: In-Network Reimbursement Non-Network Reimbursement Cross Accumulation Calendar Year Benefits Maximum Calendar Year Deductible Late Entrant Limitation Provision Pretreatment Review 20% 80% 20% For services provided by a Cigna Dental PPO network dentist, Cigna Dental will reimburse the dentist according to a Fee Schedule or Discount Schedule. For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider charges in the geographic area. The dentist may balance bill up to their usual fees. 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. The plan will only pay for covered charges up to the yearly Benefits Maximum, when applicable. Benefit-specific Maximums may also apply. This is the amount you must pay before the plan begins to pay for covered charges, when applicable. Benefit-specific deductibles may also apply. Payment will be reduced by for Class III and IX services for 24 months for eligible members that are allowed to enroll in this plan outside of the designated open enrollment period. This provision does not apply to new hires. Pretreatment review is available on a voluntary basis when dental work in excess of $200 is proposed.

8 Alternate Benefit Provision Oral Health Integration Program (OHIP) Timely Filing Benefit Limitations: 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. Cigna Dental Oral Health Integration Program offers enhanced dental coverage for customers with the following medical conditions: diabetes, heart disease, stroke, maternity, head and neck cancer radiation, organ transplants and chronic kidney disease. There s no additional charge for the program, those who qualify get reimbursed 100% of coinsurance for certain related dental procedures. Eligible customers can also receive guidance on behavioral issues related to oral health and discounts on prescription and non-prescription dental products. Reimbursements under this program are not subject to the plan deductible, but will be applied to and are subject to the plan annual maximum. Discounts on certain prescription and non-prescription dental products are available through Cigna Home Delivery Pharmacy only, and you are required to pay the entire discounted charge. For more information including how to enroll in this program and a complete list of program terms and eligible medical conditions, go to or call customer service 24/7 at CIGNA24. Out of network claims submitted to Cigna after 365 days from date of service will be denied. Missing Tooth Limitation For teeth missing prior to coverage with Cigna, the amount payable is of the amount otherwise payable until covered for 24 months; thereafter, considered a Class III expense. Oral Evaluations 2 per calendar year X-rays (routine) Bitewings: 2 per calendar year X-rays (non-routine) Complete series of radiographic images and panoramic radiographic images: Limited to a combined total of 1 per 36 months Cleanings 2 per calendar year, including periodontal maintenance procedures following active therapy Fluoride Application 1 per calendar year for children under age 19 Sealants (per tooth) Limited to posterior tooth. 1 treatment per tooth every 36 months for children under age 14 Space Maintainers Limited to non-orthodontic treatment for children under age 19 Replacement every 60 months if unserviceable and cannot be repaired. Benefits are based on the Inlays, Crowns, Bridges, Dentures and Partials amount payable for non-precious metals. No porcelain or white/tooth-colored material on molar crowns or bridges. Denture and Bridge Repairs Reviewed if more than once Denture Adjustments, Rebases and Relines Covered if more than 6 months after installation 1 every 60 months if unserviceable and cannot be repaired. Benefits are based on the amount Prosthesis Over Implant payable for non-precious metals. No porcelain or white/tooth colored material on molar crowns or bridges. Benefit Exclusions: Covered Expenses will not include, and no payment will be made for the following: Procedures and services not included in the list of covered dental expenses; Diagnostic: cone beam imaging; Preventive Services: instruction for plaque control, oral hygiene and diet; Restorative: veneers of porcelain, ceramic, resin, or acrylic materials on crowns or pontics on or replacing the upper and or lower first, second and/or third molars; Periodontics: bite registrations; splinting; Prosthodontics: precision or semi-precision attachments; initial placement of a complete or partial denture per plan guidelines; Orthodontics: orthodontic treatment; Procedures, appliances or restorations, except full dentures, whose main purpose is to: change vertical dimension; diagnose or treat conditions or dysfunction of the temporomandibular joint (TMJ); stabilize periodontally involved teeth; or restore occlusion; Athletic mouth guards; services performed primarily for cosmetic reasons; personalization; replacement of an appliance per benefit guidelines; Services that are deemed to be medical in nature; services and supplies received from a hospital; Drugs: prescription drugs Charges in excess of the Maximum Reimbursable Charge. This document provides a summary only. It is not a contract. If there are any differences between this summary and the official plan documents, the terms of the official plan documents will prevail. Cigna Dental PPO plans are insured and/or administered by Cigna Health and Life Insurance Company (CHLIC) or Connecticut General Life Insurance Company (CGLIC), with network management services provided by Cigna Dental Health, Inc. and certain of its subsidiaries. In Texas, the insured dental plan is known as Cigna Dental Choice, and this plan uses the national Cigna DPPO network. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation Cigna Home Delivery Pharmacy refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. Policy forms (for insured dental plans) in OK: HP-POL99 (CHLIC), GM6000 ELI288 et al (CGLIC); OR: HP-POL68; TN: HP-POL69/HC-CER2V1 et al (CHLIC). The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. BSD Cigna / version