DENTAL INSURANCE
National Aviation Academy offers dental coverage through Cigna. The Dental PPO Plan allows you to use in-network or out-of-network benefits. Find in-network providers on www.cigna.com by clicking on “Find Dentist” and searching within the “Options PPO 30” network. If out-of-network dentists are used, you will be responsible for paying the difference between Cigna’s allowed amount and what the dentist may charge, also known as “balance billing”. The chart below provides a brief overview of the plan.
BASE DPPO PLAN
HIGH DPPO PLAN
In-Network
Calendar Year Deductible (applies to basic & major services only)
Individual
$50
$50
Family
$150
$150
Annual Maximum (per covered member)
Per covered member
$1,000
$1,500
Preventive Services
Exams, Cleanings, & Fluoride
Covered in full
Covered in full
Basic Services
Fillings, Simple Extractions, Oral surgeries, Periodontics, & Endodontics
Covered 80% after deductible
Covered 80% after deductible
Major Services
Crowns, Bridges, & Dentures
Covered 50% after deductible
Covered 50% after deductible
Orthodontics
(Child only – 19 years and under)
Coverage Lifetime maximum
50% $1,000
None
Out-of Network 1
Calendar Year Deductible
$100 / $300
$100 / $300
Schedule of Services: Preventive
Covered 100% Covered 80% after deductible Covered 50% after deductible
Covered 100% Covered 80% after deductible Covered 50% after deductible
Basic Major
Annual Maximum (pre covered member)
$ 1,000
$ 1,500
Basis of Payment
Maximum Allowable Amount
Semi Monthly Cost for Coverage
$11.56
$13.94
Employee Only
$23.13
$27.87
Employee + Spouse
$22.99
$26.82
Employee + Child(ren)
$32.52
$42.10
Employee + Family
1 Subject to balance billing. Please refer to your plan document for specific details
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