Retiree Dental

Senior at the dentist

We are proud to offer you a choice between two different dental plans.

  1. Cigna In-Network (Low) PPO Plan
  2. Cigna High PPO Plan

This plan offers you the freedom and flexibility to use the dentist of your choice. However, you will maximize your benefits and reduce your out-of-pocket costs if you choose a dentist who participates in the Cigna network. If you receive in-network services, you will be responsible for any applicable cost sharing, negotiated charges after benefit maximums are met and costs for non-covered services.

Dental Low Plan Rates (PDF)
Dental Plan Summary – Low Plan (PDF)
Cigna High and Low Plans Find a Dental Provider (PDF)
DHMO Schedule of Benefits (PDF)

DPPO Low - Dental Rates 

Coverage 
Employee Cost 
Employee
$26.33
Employee + Spouse
$71.10
Employee + Child(ren)
$52.11
Family
$104.86

Dental Plan Highlights

Benefits
Low Plan (PPO) High Plan (PPO)
Type I: Preventive Services
Reimbursement Level
X-rays
Cleanings (2 per year)
No waiting period
See Low Plan summary (PDF)
No deductible / 100%
No waiting period
See High Plan summary (PDF)
No deductible / 100%
Type II: Basic Services
Fillings
Extractions
Root canal   
$50 deductible / 80% $50 deductible / 90%
Type III: Major Services
Crowns
Removable / fixed bridgework
Partial or complete dentures
$50 deductible / 50% $50 deductible / 60%
Type IV: Orthodontia Child Only
$2,000
Child Only
$2,000
Annual Deductible   
   
Individual $50 $50
Family $150 $150
Annual Maximum    
Dental Annual Maximum $2,000 $2,000
Orthodontia Lifetime Maximum $2,000 $2,000