USD offers four dental plan options that are designed to provide quality care for you and your family:
Before you choose your dental plan, it’s important to understand the differences between Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).
| What is unique about a Dental HMO? | What is unique about a Dental PPO? |
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Good dental care improves your overall health. Our dental plans help you maintain a healthy smile through regular preventive care and offer coverage to fix problems as soon as they occur. When choosing a plan, consider your anticipated dental needs, as well as the network, deductibles, copays, and services each plan covers.
| Plan Features | CIGNA High Dental PPO | CIGNA Low Dental PPO | CIGNA Dental HMO3 | SIMNSA Dental HMO4 | ||
|---|---|---|---|---|---|---|
| In-Network | Out-of-Network1 | In-Network | Out-of-Network1 | In-Network | In-Network | |
| Calendar Year Benefit Maximum | $2,000/ individual |
$1,500/ individual |
$1,000/ individual |
$1,000/ individual |
None | None |
| Orthodontia Lifetime Maximum | $1,500 | $1,500 | N/A | N/A | None | None |
| You pay: | ||||||
| Calendar Year Deductible (waived for Preventive Services) |
$50/individual $100/family | $75/individual $150/family | $50/individual $100/family | $75/individual $150/family | None | None |
| Diagnostic & Preventive Services (e.g., x-rays, cleanings, exams) | No charge | 20% | No charge | 20% | No charge | No charge |
| Basic & Restorative Services (e.g., fillings, extractions, root canals) | 20% after deductible | 30% of UCR after deductible1 | 20% after deductible | 30% of MAC after deductible2 | See copay schedule | See copay schedule |
| Major Services (e.g., dentures, crowns, bridges) |
50% after deductible | 50% of UCR after deductible1 | 50% after deductible | 50% of MAC after deductible2 | See copay schedule | See copay schedule |
| Orthodontia (adults and children) | 50% | 50% | Not covered | Child: $1,224 copay Adult: $1,728 copay | $1,200 copay (full-banded) | |
1You are responsible for amounts over the usual, customary, and reasonable (UCR) charges.
2The maximum allowable charge (MAC) is the out-of-network payment that is calculated by the insurance company based on the coinsurance coverage and the contracted fees that would be paid to a network dentist in that same area.
3Not available in all states. If you are living outside of California, contact the Benefits team to see if you are in a DHMO coverage area.
4Services available in Mexico only. You must be a Mexican National in order to enroll in this plan, which means 1. A person born in Mexico; 2. A person born in another country with a Mexican mother, father, or both; 3. A person who marries someone from Mexico and lives in Mexico; or 4. A foreigner who becomes naturalized in Mexico. Contact the Benefits team for more details.
If you enroll in either the Cigna High Dental PPO or Cigna Low Dental PPO and utilize out-of-network care, your out-of-pocket cost for services will be based on the Maximum Allowable Charge (MAC) for the Low plan, or Usual, Customary, and Reasonable (UCR) charges for the High plan.
Both UCR and MAC refer to the maximum your dental plan will pay for out-of-network services. When receiving out-of-network care, you are responsible for your share of the cost (coinsurance) up to MAC/UCR, and are 100% responsible for any charge that exceeds MAC/UCR. You’ll typically save the most by staying in-network.
The Cigna dental plans feature a WellnessPlus Progressive Maximum Benefit. When you or a family member get preventive care (like a cleaning), $100 is added to your annual benefit maximum for the next year (up to plan limits).