The City provides all benefits-eligible employees with one free annual exam, one cleaning and one set of bite-wing x-rays per year, at no cost when you visit a BlueCross BlueShield DentalBlue provider.
Employees also have the option to purchase more comprehensive dental coverage for themselves and their families.
Choose from:
A low dental option, provided through BlueCross BlueShield
A high dental option including orthodontia, provided through BlueCross BlueShield
A dental HMO (DHMO), provided through CIGNA
BCBST High and Low Options
Whether you elect the Low or the High option, you are free to visit any provider you choose. The benefit percentages are the same for in and out of network, but the difference is you could be balance billed if you see a non-network provider. As long as you use a dentist in BlueCross BlueShield's DentalBlue network, you will not be billed for charges exceeding the maximum plan allowance. See the chart and footnotes below, or visit www.bcbst.com to locate network providers.
In addition, both options cover additional exams/cleanings (up to three per year) for diabetics and pregnant women with periodontal disease, individuals with renal failure or suppressed immune systems, head and neck radiation patients, and individuals at risk for infective endocarditis.
CIGNA DHMO Option
If you choose the DHMO, you must use a CIGNA network dentist to receive benefits. CIGNA's plan does not allow for out of network dental benefits. Their dental network is small, but their premiums are low with attractive copays for services. Visit www.cigna.com (if not enrolled) or www.mycigna.com (if enrolled) to search for providers.
Dental Options at a glance:
| |
BCBSTLow Option (1) |
BCBST High Option (1) |
CIGNA
DHMO |
| YOU PAY |
| Calendar Year Deductible |
$50/individual $150/family |
$50/individual $150/family |
$0 |
| THEN THE PLAN PAYS |
| Preventive care (exams, x-rays, cleanings) |
100%
no deductible
Does not apply towards Annual Max |
100%
no deductible
Does not apply towards Annual Max |
$0 copay (2) |
| Basic care (fillings) |
80%
after deductible |
80%
after deductible |
See charge schedule |
| Major care (crowns, dentures, bridges oral surgery, endo and perio) |
50%
after deductible |
50%
after deductible |
See charge schedule |
| Orthodontia |
None |
50%
no deductible
Child only to age 19 |
See charge schedule (adults and children) |
| Annual benefit maximum (3) |
$1,000 |
$1,500 |
N/A |
| Orthodontia lifetime maximum |
N/A |
$1,500 |
N/A |
(1) Providers in BCBST's DentalBlue Network have agreed not to accept the BCBST allowable rate. If you use providers outside this network, you're responsible for charges exceeding the 90th percentile of UCR. (2) The CIGNA DHMO covers up to four annual cleanings (two at 100% and two at a low scheduled cost). See the charge schedule for details. (3) Once Basic or Major charges reach the annual benefit maximum, no further benefits are payable for the remainder of the plan year, but you may still access the in-network discounts with BCBST.