Cigna DPPO

Plan Overview

The DPPO Dental Plan has a preferred provider (PPO) network that offers a broad network of dentists to choose from and two tiers of in-network benefits:  Cigna DPPO Advantage and Cigna DPPO.  The first tier, Cigna DPPO Advantage, offers the deepest discounts, greatest affordability and highest benefit level.  The second tier, Cigna DPPO, offers access to an expanded network of participating dentists at a reduced benefit level. You also have the freedom to select an out-of-network dentist of your choice , but if you use a preferred provider dentist, you receive a higher level of coverage.


In - Network

Out of Network


Network Names


Cigna DPPO Advantage

Cigna DPPO

Out of Network



Service Levels




Class 1 - Preventive & Diagnostic Care




Class 2 - Basic Restorative Care




Class 3 - Major Restorative




Class 4 - Orthodontia







Reimbursements paid to the dentist by Cigna

Contracted Rates - NO Balance Billing of outstanding charges

80% of Reasonable and Customary Charges + any balance not paid by Cigna

The plan has a $50 individual plan year deductible (no deductible for in-network preventive cleanings) before any payment will be made, $150 maximum deductible per family and a $1,500 plan year maximum benefit. Members who receive a preventive cleaning will have their annual maximum benefit increase by $200 the following plan year. Orthodontia coverage is available for dependent children younger than 19. The lifetime maximum orthodontia benefit is $1,500 for each covered dependent child.

The Cigna dental plan is structured to include both in-network and out-of-network benefits. In-network benefits apply if you use a PPO dentist; out-of-network benefits apply for non-PPO dentists. To search for a dentist, visit

Monthly Premiums - Cigna DPPO Dental Plan (FY 20/21)

Full- Time Employee Pays
Employee Only $5.18
Employee Spouse/Partner $48.82
Employee Children $34.28
Employee Family $77.96
Retirees and COBRA Participants Monthly Premiums differ

Cigna DPPO Summary of Benefits  (PDF)

Cigna Dental PPO Summary Plan Description  (PDF)

Frequently Asked Questions

Having a preferred provider network allows members to receive a higher level of coverage if you utilize one of the preferred providers. You still have the flexibility and freedom to use any dentist. If the dentist you elect to use is not a preferred provider, you still receive coverage just at a lower level.

That depends on the dental office. A majority of dental offices will file the insurance claim themselves. However, some dental offices will not work with insurance claims. In that case you would have to file the claim yourself. The Cigna DPPO plan does not determine how that works, it is strictly up to the dental office.

The deductible under the Cigna DPPO is $50 per person with a maximum deductible of $150 per family. The deductible is what you pay out of pocket first before there is any benefit coverage (no deductible for in-network preventive cleanings). Once you have met your deductible then the plan will pay according to the schedule of benefits of costs that are considered reasonable and customary, up until you have met your annual maximum of $1,500 per person. Once you have met your annual maximum then the dental PPO does not pay any additional claims for the remainder of the plan year for that person.

Produced by Human Resources:

This information represents a summary of benefits provided by the City of Scottsdale to benefited employees. Every effort has been made to report information accurately. All information, including the amount of any benefit and employee eligibility of benefits, is subject to and governed by the terms and conditions of the applicable policy or plan documents. In all cases where any of the information provided differs from the amount of benefit actually provided by the policy or plan, the terms of the legal documents will control.


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