Benefits Eligible Faculty and Administrators
In-Network | Out-of-Network | |
Annual Deductible | $50 Employee Only/ $150 Family | $50 Employee Only/ $150 Family |
Preventive and Diagnostic Care | No cost to you | You pay 20% after deductible |
Basic Restorative Care | You pay 20% after deductible | You pay 40% after deductible |
Major Restorative Care | You pay 50% after deductible | You pay 60% after deductible |
Orthodontia | You pay 50%, no deductible $1,500 lifetime maximum benefit | |
Calendar Year Maximum | $1,500 |
In-Network | Out-of-Network | |
Annual Deductible | None | Plan does not provide out-of-network benefits |
Preventive and Diagnostic Care Basic Restorative Care Major Restorative Care Orthodontia | No cost to you for preventive/diagnostic care and basic fillings. You share the cost of other services based on Cigna’s Dental Patient Charge Schedule | Plan does not provide out-of-network benefits |
Calendar Year Maximum | No maximum plan benefit | No maximum plan benefit |