Dental Coverage

Healthy teeth and gums are important for your overall wellness. Colonial Group offers a competitive dental plan to help you maintain your oral health. You have access to discounted services when you see a Cigna dental network provider.

Find a dentist at www.cignadentalsa.com and select Cigna Dental PPO Shared Administration Plus

IN-NETWORK BENEFIT
DENTAL PLAN
Annual Deductible (Individual / Family)

$50 / $150

Annual Plan Maximum (per member)
$1,500
Preventive Services
No cost
Basic Services
20% after deductible
Major Services
50% after deductible
Orthodontia (for dependent child(ren) up to age 19)
20% after deducitble
Ortho Lifetime Max (per member)
$1,000
TMJ Appliances & Follow-up Lifetime Max (per member)
$1,000

Covered Procedures by Care Type

PREVENTIVE
BASIC
MAJOR
Routine exams & Prophylaxis Cleanings (2 per calendar year)

Extractions (non-orthodontic)

Bridges (initial installation and fix)
X-Rays
  • Bitewing X-Rays (2 per calendar year)
  • Full mouth/panoramic (1 per 36 months)
Restorative/fillings
Dentures (installation of full and partial)
Under age 19 services
  • Space maintainers
  • Sealants (one application/tooth)
General and local anesthetics
Crowns/Inlays/Onlays
Periodontal maintenance
TMJ (appliances and follow up only)
Injections of antibiotics
Root Canals/Endodontic Treatment if "open" while insured
All other peripherical x-rays not included in preventive

Vision Coverage

The EyeMed Insight Network plan provides coverage for routine eye care needs including a routine eye exam, glasses, and contact lenses. You may choose any provider; however, you can save money by using an EyeMed in-network provider who will file claims on your behalf.

Important notes:

  • In lieu of a vision card, the optometrist office can find your coverage with your SSN
  • Find a network provider at https://www.eyemed.com/en-us/provider
  • Nationwide provider network (Select): LensCrafters, Walmart, Sam's Club, MyEyeDr, America's Best
PLAN FEATURES
IN-NETWORK (Amount you will pay)
OUT-OF-NETWORK (Reimbursement)
Frequency: Exam | Lenses | Frames

12 | 12 | 24 months

12 | 12 | 24 months
Deductible: Exam | Lenses
$10 | $10
Up to $40 | Reimbursement Schedule
Frame Allowance
$0 copay; $130 allowance + 20% discount
Up to $91

Contact Lenses Allowance (in lieu of frames)

  • Elective
  • Medically Necessary
Up to $130 + 15% discount
Covered in full
Up to $91
Up to $300
Money-saving tip: You can use your HSA or FSA dollars for qualified out-of-pocket dental and vision expenses!
FSA & HSA
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