Cigna is the administrator for all State of Connecticut dental plans. To get answers to your questions, please call CIGNA at 800-244-6224.
dental plan features
You can choose from four dental plans to suit your needs and those of your family. Plans include various coverages on dental services.
View the Plan Coverage Chart on the Benefits Enrollment Page for a full list of covered dental services for each plan.
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.
View the Plan Coverage Chart on the Benefits Enrollment Page for a full list of covered dental services for each plan.
Orthodontia Coverage
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.
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 such as:
- Maternity
- Heart disease
- Diabetes
- Stroke
- Chronic Kidney Disease
Cigna PPO network dentists offer discounts on non-covered services for Basic and Enhanced plan members. Visit a network dentist, confirm the procedure is discounted, and pay the negotiated fee directly to them. Discounts may vary by state; check with your dentist or Cigna to confirm eligibility.
Before starting extensive dental procedures where charges may exceed $200, your dentist may submit a pretreatment estimate to the plan.
OUR 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 no 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.
dental plan Information
ELIGIBLE DEPENDENTS GENERALLY INCLUDE:
- Your legally married spouse or civil union partner.
- Your children: Medical and dental coverage through the end of the year they turn age 26.
- Children residing with you for whom you are legal guardian (to age 18) unless proof of continued dependency is provided. Disabled children may be covered beyond age 26 for medial and dental, with proper documentation from the medical insurance carrier. Documentation of an eligible relationship is required when you enroll a family member. It is your responsibility to notify your agency Payroll/Human Resources office when any dependent is no longer eligible for coverage.
You can make changes to your dental plan, add or drop coverage for your eligible family members or enroll if you previously waived coverage during the following times:
- Qualifying Life Event
- If you have a Qualifying Life event, changes can be made on Core-CT and the required documentation must be provided within 31 days of the qualifying event.
- Open Enrollment
- This is your annual chance to adjust your health care benefit choices. It’s a good time to take a fresh look at the plans, consider how your and your family’s needs may have changed, and choose the best plan option for you. Open Enrollment usually takes place in May.
Several plans are available with varying levels of coverage. Below are resources to assist you in choosing the right plan. View the Plan Coverage Chart on the Benefits Enrollment Page Take the Plan Match Quiz which asks key questions about your dental coverage needs and plan design preference
Find A Dentist to confirm your dental providers are in the plan you choose before selecting it during open enrollment or a Qualifying Life Event.
Watch the Cigna Dental Plan Options Video
HOW TO PICK A PLAN
Find medical and dental rates on the Benefits Enrollment page. If you participate in HEP, up to two regular dental cleanings per year are 100% covered 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.
Benefits Enrollment