Dental Plan

Eligibility

Group Dental Plan coverage is available to all permanent employees scheduled to work a minimum of 20 hours per week. You have a choice of two dental plans from Cigna.

All documents are in PDF format.

IMPORTANT NOTICE
Pinellas County's dental HMO provider changed from MetLife/Safeguard to Cigna as of 1/1/17. Some dental ID cards were sent in error by Safeguard Insurance. Safeguard Insurance ID cards should not be used. See notice.

Comparison Chart

	Cigna HMO	Cigna PPO
Cost	No premium	Premium required
Benefits	No maximum annual benefit	100% for first $150 then 50% of next $2,700 (maximum plan year benefit $1,500)
Network	Must choose a network dentist	Use any provider

Cigna Health Maintenance Organization (HMO) Plan

Cigna HMO Premiums Per Pay Period
Employee Only	$ 0
Employee + 1	$ 0
Employee + 2 or more	$ 0

No contributions are charged for employees or dependents.

Network benefits only. You are required to choose a dentist from the network. To locate one:

Call your dentist to ask if they participate in the plan.
Visit www.mycigna.com for the most current listing of providers. For easy navigation, see Finding a Cigna DHMO Dentist or Specialist.
View the Cigna DHMO Network Directory (as of Fall 2016)

Preventive services such as annual exams, x-rays, and cleanings are free.

Routine cleanings are limited to two per calendar year.

No maximum annual benefit.

Copayments apply based on the procedure and the established fee schedule.

Network specialist services including orthodontic care provide a 25% discount.

ID cards are issued. Once you receive your card, contact Cigna to select your dental provider.

For more info, visit www.mycigna.com or call Cigna Member Services at (800) 244-6224.

Cigna Preferred Provider Organization (PPO) Plan

Cigna PPO Premiums Per Pay Period
Employee Only	$5.54
Employee + 1	$16.82
Employee + 2 or more	$22.77

The contributions charged for employees and dependents are shown above.
You can use any dentist or specialist.
For additional savings, use a Cigna Radius Network provider.
Plan reimburses 100% of first $150 of covered expenses, and 50% thereafter in the plan year up to a $1,500 maximum reimbursement per each covered member per calendar year.
No deductibles or pre-existing condition limitations.
Orthodontics covered within the $1,500 maximum.
Routine cleanings are limited to three per calendar year.
No ID cards are issued. Register at www.mycigna.com to get a subscriber ID number to provide to your dental office.
Forms:
- CIGNA Dental Claim form
- Orthodontics Claim form
For more info:
- See Cigna Dental Plan Description.
- Visit www.mycigna.com.
- Call Cigna Member Services at (800) 244-6224.

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