| Deductibles and Benefits Maximum |
$75 per person, $225 per family per plan year. Maximum benefit paid per plan year is $1250 per person. |
| Diagnostic and Preventive Benefits: oral examinations, x-rays, cleanings, fluoride treatment, specialist consultation |
90% of Cigna’s allowed (UCR) amount. Deductible is waived.
|
| Crowns, Jackets, Cast Restorations |
80% of Cigna’s allowed (UCR) amount.
Deductible is waived
|
| Prosthodontics Benefits: bridges, partial dentures, full dentures |
80% of Cigna’s allowed (UCR) amount.
|
| Orthodontic Benefits: covers both adult and child(ren) |
50% of Cigna's allowed amount--$2000 lifetime maximum
|