Retiree Dental Benefits

CONTACT CIGNA AT (800) 244-6224 TO GET ANSWERS TO YOUR BENEFIT QUESTIONS, FIND DENTISTS IN YOUR NETWORK AND UNDERSTAND YOUR COSTS.

Dental Plan Coverage

Dental coverage ends for dependent children at age 26 (unless disabled*). Cigna is the administrator for all State of Connecticut dental plans:

Total Care DHMO Plan.

This plan provides dental services only from a defined network of dentists and pays benefits only when you receive care from a network dentist (except in cases of emergency). You must select a primary care dentist; they will coordinate your care. Referrals are required for all specialist services. There’s no annual deductible or calendar-year maximum. When you need care, you pay coinsurance based on the service you receive.

Enhanced Plan.

This plan pays benefits for services received in- and out-of-network, without a referral. When you visit an out-of-network dentist, you are responsible for all charges above the maximum allowable charge—the amount the plan would have paid if you had visited an in-network dentist. That means your out-of-pocket expenses may be higher if you see a dentist who is not part of the Cigna PPO Network.

Cigna Dental Care DHMO Plan.

This plan requires you to select a primary care dentist to coordinate your care and refer you to other in-network specialists as needed. There’s an annual deductible or annual maximum. You will pay copays based on the service you receive.

Basic Plan.

This plan allows you to visit any dentist or dental specialist without a referral.

Contact Cigna

(800) 244-6224

PLAN DOCUMENTS

Compare Plans

Total Care DHMO Plan (network only) Enhanced Plan Cigna Dental Care DHMO Basic Plan
Annual deductible None Individual: $25


Family: $75


The deductible does not apply to routine exams, cleanings and x-rays

None None
Annual maximum None $3,000 per person
(excluding orthodontia)
None None; $500 per person for periodontics
Exams, cleanings and x-rays Plan pays 100% Plan pays 100% 1 Covered 2 Plan pays 100%
Periodontal maintenance 2 15% coinsurance, plan pays 85% Plan pays 100% 1 Covered 2 20% coinsurance,
plan pays 80%


If retired after 10/1/2011: Plan pays 100%

Periodontal root scaling and planing 2 15% coinsurance, plan pays 85% 20% coinsurance, plan pays 80% Covered 2 50% coinsurance, plan pays 50%
Other periodontal services 15% coinsurance, plan pays 85% 20% coinsurance, plan pays 80% Covered 2 50% coinsurance, plan pays 50%
Simple Restoration
Fillings 15% coinsurance,
plan pays 85%
20% coinsurance, plan pays 80% Covered 2 20% coinsurance, plan pays 80%
Oral surgery 15% coinsurance,
plan pays 85%
20% coinsurance, plan pays 80% Covered 2 33% coinsurance, plan pays 67%
Major Restorations
Crowns 30% coinsurance,
plan pays 70%
33% coinsurance, plan pays 67% Covered 2 33% coinsurance, plan pays 67%
Dentures, fixed bridges 45% coinsurance,
plan pays 55%
50% coinsurance, plan pays 50% Covered 2 Not covered 3
Implants 45% coinsurance, plan
pays 55% (one per year)
50% coinsurance, plan pays 50% (maximum of $500) Covered 2 Not covered 3
Orthodontia 45% coinsurance,
plan pays 55%
Plan pays a maximum of $1,500 per person per lifetime 4 Covered 2 Not covered 3

1 You must use an in-network dentist to receive 100% coverage; if you use an out-of-network dentist, you will be subject to balance billing if your dentist charges more than the maximum allowable charge.
2 Contact Cigna at 800-244-6224 for patient copay amounts.
3 While these services are not covered, you will get the discounted rate on these services if you visit an in-network dentist, unless prohibited by state law.
4 Benefits prorated over the course of treatment.

Oral Health Integration Program

Employees (including dependents) enrolled in a State of Connecticut dental plan are eligible for Cigna’s Oral Health Integration Program (OHIP). OHIP provides 100% reimbursement of copays for select covered services to members with qualifying medical conditions.

If you are pregnant or have a qualifying medical condition (heart disease, stroke, diabetes, maternity, chronic kidney disease, organ transplants, and head and neck cancer radiation), you are encouraged to enroll in this program to reduce your costs.

Savings on Non-Covered Services

Many of the Basic and Enhanced plan Cigna PPO network dentists have agreed to offer their discounted fees to you and your covered dependents for non-covered services. These savings may also apply to services that would not be covered because you reached your annual benefit maximum or due to other plan limitations such as frequency, age or missing tooth limitations.

You must visit a network dentist to receive these discounts. And you should verify that the procedure is listed on the dentist’s fee schedule before receiving treatment. You are responsible for paying the negotiated fee directly to the dentist.

Discounts on non-covered services may not be available in all states. Certain dentists may not offer discounts on non-covered services. Be sure to check with your dental care professional, or contact Cigna customer service before receiving care to determine if these discounts will apply to you.

Pretreatment Estimates

Before starting extensive dental procedures where charges may exceed $200, your dentist may submit a pretreatment estimate to the plan. You can also help to determine the amount you will be required to pay for a specific procedure.

Frequently Asked Questions

Can my children be covered under my dental plan until age 26, like they can under my medical plan?

Yes. The previous limit of age 19 has been adjusted to allow covered dependents to remain on your dental coverage until the end of the year in which they turn 26.*

* For your disabled child to remain an eligible dependent, they must be certified as disabled by your medical insurance carrier before they turn age 26. Contact Anthem’s Enhanced Dedicated Member Services team at 800-922-2232 for information.

Do any of the dental plans cover orthodontia for adults?

Yes, the Total Care DHMO plan, Enhanced plan and Cigna Dental Care DHMO plan all cover orthodontia for adults. The Total Care DHMO plan covers 55% of the cost with an in‐network provider. The Enhanced plan pays $1,500 per person per lifetime and covers 50% of the cost for adults and children. The Cigna Dental Care DHMO requires a set copay for in‐network providers. The Basic plan does not cover orthodontia for adults or children.

If I participate in HEP, are my regular dental cleanings 100% covered?

Yes, up to two per year. However, if you are in the Enhanced plan, you must use an in-network dentist to get the full coverage. If you go out of network, you may be subject to balance billing (if your out-of-network dentist charges more than the maximum allowable charge). In the DHMOs, you must use an in-network dentist, or your exam won’t be covered at all.