Dental
NEW DHMO DENTAL PLAN FOR 2023 - UHC SOLSTICE S800B
- The Cigna DHMO Dental plan is changing to the UnitedHealthcare Solstice S800B DHMO (UHC Solstice). The premiums remain the same.
- We will automatically move you to the UHC Solstice plan if you are enrolled in the Cigna DHMO. You do not have to take any action.
- Check to see if your provider is on the plan and see the plan coverage by visiting smilestateofaz.com. Use plan code S800B.
- UHC Solstice S800B Enrollment Booklet with Schedule of Benefits
- Note: Coverage is not available in these states/territories: AK, AL, AR, DE, HI, IA, ID, LA, ME, MS, MT, ND, NE, NH, OK, RI, SD, VT, WV, WY, GU, USVI, and PR.
- Note: Enrollment in the UHC Medical Plan is not required to enroll in the UHC Dental Plan.
- Note: You do not have to be enrolled in a UHC medical plan to be enrolled in the UHC Solstice plan.
PLANS
Benefit Options offers two dental plan options.
CIGNA DENTAL Care Access DHMO - Plan Ends 12/31/2022 - See "New DHMO Dental Plan for 2023" above
- A Dental Health Maintenance Organization Plan with no deductibles or dollar limits.
- Services must be obtained from an in-Network provider.
- Out-of-Network services are only covered in emergency situations.
- Residents of these states cannot enroll in the Cigna DHMO: AK, ME, MT, NH, NM, ND, PR, SD, VT, USVI, and WY.
DELTA DENTAL PPO PLUS PREMIER
- A Dental Preferred Provider Organization Plan.
- Services can be obtained in-Network or out-of-Network but will have higher costs for out-of-Network services.
- Additionally, there are in-Network and out-of-Network deductibles that must be met.
ID Cards
- When you enroll in dental benefits, you will receive a dental ID card within a few weeks. You can also access your ID card via the insurance company’s website or app. Contact your carrier if you need assistance before you can retrieve your card information. See the information below.
POLICIES | SUMMARY PLAN DESCRIPTIONS - SPD
- Cigna Dental Care Access | Patient Charge ScheduleSummary Plan Description
- Delta Dental PPO Plus Premier | 2022
PREMIUMS & COPAYS
| 2021 & 2022 Dental Plan Premiums Per Pay Period | Cigna Dental Care Access | Delta PPO Plus Premier |
|---|---|---|
| Employee Only | $1.64 | $14.30 |
| Employee + Adult | $3.29 | $30.33 |
| Employee + Child | $3.08 | $23.34 |
| Employee + Family | $5.46 | $48.26 |
CONTACT
Cigna | 800-968-7366 | view.ceros.com/cigna/stateofaz/ | Group: 2500541
Delta Dental of Arizona | 602-588-3620 | 866-978-2839 | deltadentalaz.com | Group: 77777-0000
