Dental Insurance

With the Delta Dental DPPO:

• Use any dentist, but you’ll save money and receive maximum benefits when visiting an in-network provider.
• You pay deductibles and coinsurance for some dental care. The deductible does not apply to diagnostic and preventive benefits such as your periodic oral evaluation.
• You or your dentist will file claims for covered services. Discuss any estimated expenses with your dentist or specialist. Your dentist and you may want to request a pre-treatment cost estimate for some procedures. Charges for dental procedures are subject to change.
• Teledentistry is offered and claims are handled as if the patient received dental services in a dental office. Charges are considered as Type A: Diagnostic and Preventive and are subject to frequency limitations.
• Referrals to specialists are not required.
• To learn about all DPPO benefits, including information on waiting periods and coverage for services in progress, find the Delta Dental DPPO handbook under Publications and Dental PPO on the Partners for Health website. See the certificate of coverage for coverage details.

With the Cigna DHMO:

• You must select and use a Cigna network general dentist from the DHMO list for the state’s dental plan 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 13. The pediatric dentist will be considered a “specialist” for plan benefits. At age 13, you must switch the child to a network general dentist or pay the full charge from the pediatric dentist.
• 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 DHMO, you may be able to cancel this coverage if you enroll and later there are no network general dentists within a 25-mile radius of your home address.
• You pay copays for dental treatments. Review the patient charge schedule under Publications and Dental HMO - Prepaid Provider at https://www.tn.gov/partnersforhealth/publications/publications.html before having procedures performed.
• Lab fees may apply for some procedures and are the responsibility of the member to pay.
• No deductibles to meet, no claims to file, no waiting periods, no annual dollar maximum.
• Preexisting conditions are covered.
• Referrals to specialists by network general dentists are required.
• Teledentistry is available to members at a $0 copay with no frequency limit.
• To learn about all DHMO benefits, including information on waiting periods and coverage for services in progress, find the Cigna DHMO Handbook under Publications and Dental HMO – Prepaid Provider. See the certificate of coverage for coverage details.

If you are enrolled in dental coverage as an ACTIVE employee under a state-sponsored plan and your employment is terminated (separation of service or retirement), you will be given the opportunity to continue your dental coverage for 18 months under the Consolidated Omnibus Budget Reconciliation Act, or COBRA. A COBRA notification will be mailed to your home address listed in Edison upon the termination of your active coverage. To continue dental coverage through COBRA, you must complete and return the COBRA enrollment form to Benefits Administration within 60 days of the latter of the date active coverage would end or the date on the COBRA notification letter. Please indicate if you are a Tennessee Consolidated Retirement System retiree via a handwritten note on the signature page of the COBRA enrollment form. Continuation of dental insurance is NOT automatic at retirement.

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 Tennessee Consolidated Retirement System retiree or an optional retirement plan retiree from a higher education agency.

Upon expiration of your COBRA coverage, if you enrolled in this option and you are a retiree receiving a monthly Tennessee Consolidated Retirement System pension or a higher education optional retirement plan participant, you may enroll in the retiree dental plan.

NOTICE: A complete description of the benefits, provisions, conditions, limitations and exclusions for both the Delta Dental and Cigna dental plans will be included in their respective Certificate of Insurance. If any discrepancies exist between the information listed above and the certificates of coverage, the certificates will govern. We recommend you review these documents.