Eligible employees can choose from two Voluntary Dental Insurance plans:
- Prepaid Dental Plan
- Dental Preferred Provider Organization
(Note: Local education and local government members should check with their agency benefits coordinator to see if dental insurance is available.)
Prepaid (DHMO) Plan — Cigna
- The network is Cigna Dental Care DHMO.
- You must select a General Dentist from the Prepaid (DHMO) Dental Plan list and let Cigna know of your choice.
- You must use your selected dentist to receive benefits.
- You may select a network Pediatric Dentist as the network General Dentist for your dependent child under age seven. At age seven, you must switch the child to a network General Dentist or pay the full charge from the pediatric dentist.
- You must use your selected General Dentist to receive benefits. There may be some areas in the state where network General Dentists are limited or not available. Before enrolling, carefully check the network for your location.
- With the prepaid dental plan, you may be able to cancel this coverage if you enroll and later there are no network General Dentists within a 40-mile radius of your home.
- You pay copays for dental treatments.
- No deductibles to meet, no claims to file, no waiting periods, no annual dollar maximum.
- Preexisting conditions are covered.
- Referrals to Specialists are required.
- Orthodontic treatment is not covered if the treatment plan began prior to the member’s effective date of coverage with Cigna.
- Premiums will increase by 3.5% in 2018.
Dental Preferred Provider Organization (DPPO) — MetLife
- The network is PDP.
- You can use any Dentist, but you receive maximum benefits when visiting an in-network MetLife DPPO provider. Deductible applies for Basic and Major dental care.
- You pay coinsurance for Basic, Major, Orthodontic and out-of-network covered services.
- You or your Dentist will file claims for covered services.
- Some services (e.g., crowns, dentures, implants and complete or partial dentures) require a six-month Waiting Period from the member’s coverage start date before benefits begin.
- There is a 12-month Waiting Period from the member’s coverage start date for both the replacement of a missing tooth and also Orthodontics.
- Referrals to Specialists are not required.
- Pre-treatment estimates are recommended for more expensive services.
- Dental treatment in progress at time of member’s effective date with MetLife may have pro-rated benefits under the MetLife plan.
- Premiums will increase by 3.6% in 2018.
You pay coinsurance for many covered services and your share is based on the "maximum allowable charge" (MAC) for a given service. MAC is the lesser of the amount charged by the dentist or the maximum payment amount that in-network dentists have agreed to accept in full for the dental service. When you receive dental services from an out-of-network provider, MetLife will reimburse a percentage of the MAC. You are then responsible for everything over the percentage of MAC reimbursed up to the charge submitted by the out-of-network dentist. Out-of-network providers typically charge more than the allowable charge, resulting in higher costs for you.
Cigna Prepaid — Cigna's website
(select the Cigna Dental DHMO network)
View instructions on locating a Cigna dental provider
MetLife DPPO — MetLife's website
Additional Enrollment Information
Please see the Publications section of this website to view a comparison of covered services and a detailed member handbook.
Continuation of dental coverage through COBRA versus the retiree dental plan
If you are enrolled in dental coverage as an ACTIVE employee under a state sponsored plan and your employment is terminated, you will be given the opportunity to continue your dental coverage for 18 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA). A COBRA notification will be mailed to your home upon the termination of your active coverage. Continuation of dental insurance is NOT automatic at retirement. To continue dental through COBRA, you must complete and return the COBRA enrollment form to Benefits Administration within 60 days of your active coverage terminating. Please indicate if you are a TCRS retiree via a hand written note on the signature page of the COBRA enrollment form.
If you do not qualify to continue dental insurance through COBRA or simply wish to enroll in the retiree dental plan upon the termination of your active insurance coverage, you should submit an application directly to Benefits Administration. Please note, you must be a TCRS retiree or an ORP (optional retirement plan) retiree from a higher education agency. You must submit your enrollment application within 30 days of your active insurance terminating or you will have to wait until the next annual enrollment period to enroll.