What is the group number/ account number / or plan ID for the dental plan?
The group number/ plan ID for the dental plan is 3215812.
What is my member ID?
Member Id is on the DMO dental card or employee’s social security number can be used.
What is the claims mailing address?
Claims mailing address CIGNA DENTAL, PO Box 188037, Chattanooga, TN 37422-8037
What number do I give to providers to verify I have the coverage?
CIGNA Customer Service (toll-free) 1-800-244-6224 - used to verify coverage
What number do I call if I have questions about my insurance and coverage?
CIGNA Customer Service (toll-free) 1-800-244-6224 - used to ask questions.
What do I do if I don’t have my card and I’m seeing the dentist today?
To request another DHMO card call CIGNA Customer Service 1-800-244-6224 or go to http://www.mycigna.com to request another card. The web site will also let you print a temporary ID card. Note: ID cards for the Dental PPO (TDL) plan are available in the HR office.
I don’t remember if I am on the DMO or the PPO / TDL dental plan how do I find out which one I chose?
There are several ways to find out which dental plan you are on.
- If you have a CIGNA Dental card and it has a dentist name on it you are on the DMO plan.
- You can sign onto Employee Self Service / HR-Self-Service Home / Benefits Summary / look to the right of Dental and you will see either TDL or DMO. TDL is the dental PPO plan.
- Look on your paycheck under Employer Paid Benefits it will show either Traditional Dental Before Tax or DMO Dental Before Tax.
- Or you can call CIGNA Customer Service 1-800-244-6224 .
I am on the DMO plan and I need to know what dentist I signed up for or how to change to a different dentist?
With the DMO dental plan you must go to the primary care dentist you choose when you signed up. The name of the dentist should be on your dental card or you can call CIGNA Customer Service 1-800-244-6224 to find out who you are assigned to. To change to another dentist on the network call CIGNA Customer Service 1-800-244-6224. (Note: when changing dentist some dentist will not see you till they receive a printed roster from CIGNA.
I am on the PPO / TDL dental plan and I never received a card. How do I get a card?
The insurance company did not mail cards for the PPO/ TDL dental plan. The information that you would need from the card is on answers 1 – 4 above. Human Resources has generic PPO dental cards or http://www.mycigna.com lets you print an ID card.
When I look at the CIGNA Dental PPO Benefit Summary the percent paid In-network and Out-of-network look the same. What is the difference?
PPO / TDL members that use a Network dentist will be paying the percentage of a contracted reduced rate. When using a Non-network dentist, the dentists hasn’t agreed to reduce their rates, and you pay the percentage of his regular charges. If the non-network dentist’s fees are higher than the rates network dentists have agreed to charge, you will be responsible for the difference.
I just received a bill do I really owe this amount?
To find out how much you owe on a dental bill you need to see the EOB (Explanation of Benefits) from the insurance company. This will show the submitted charges, how much if any was paid to the provider and how much you actually owe. Not only do you get the EOB by mail, but you can also see all EOBs for the year on www.mycigna.com. If your claim is not on the insurance system make sure the provider filed the claim. If your provider does not file claims you will need to file the claim (go to Section 3. Dental Claim Form)
How do I see what Dentist are on the DMO plan or that are In-Network for the PPO plan?
To view the Network Directory (members & potential members): Go to www.cigna.com
- Click on Provider Directory (menu across top of screen)
- Click on Dentist
- If you know the Dentist’s name you can enter it or leave this field blank.
- Enter your zip code (this will also show whose In Network for out of state)
- If you can’t find someone within 25 miles you can increase the miles
- Select Dental Plan: CIGNA Dental DHMO or CIGNA Dental PPO (you can narrow the search further by selecting Specialty form the drop down list)
- The provider list can also be accessed on http://www.mycigna.com/
Why would I want to sign onto www.mycigna.com?
Members of the dental plan can sign onto www.mycigna.com. It will require you to create a password because this site is specific to each member and their dependents. Use this resource to manage your dental needs.
- Click on Dental (Under My Plans, across the top )
- Print forms (Dental Claim Form)
- Print a temporary ID Card & request new ID cards
- See all dental claims that have been processed through the insurance
- Track how much you have paid towards your deductibles and accumulated towards plan maximums
- View your dental benefit details. Take a look at who’s covered and what your plan covers, including answers to questions about preventative, restorative and diagnostic care.
- Dental treatment cost estimator
- Find a dentist
- Answers to common questions
I don’t want to call CIGNA Customer Service because it is an automated system, how do I speak to a person?
To ask a person about any of the above information call CIGNA Customer Service (toll-free) 1-800-244-6224. This is an English / Spanish automated phone. The following is an example of some of the questions and responses:
- Say whether you are a “Member”, Provider, Pharmacist or Enrollment Information
- Questions about a Bill or Claim? (“no” – go to letter c) (“yes” - go to letter d)
- Find out when eligibility begins or what benefits are covered or none of these.
- Member ID begins with a letter?
- Respond “no” if you are going to use your social security number
- Respond “yes” if you are going to use the id # on your medical card
- Respond “I don’t know it”
- Enter your number or say your number and the system will repeat it back to you
- Enter or say your Date of Birth (month, day and year)
- She will repeat your name
- From this point onward if you want to speak to a person say “Associate” than the system will ask if you want Medical or Dental and you will be transferred to speak to a person.
How do I make changes to my Dental Plan?
After you are on the dental coverage you can drop, add, or change dental plans during Open Enrollment. Benefit packet with next years options will be sent out around October/ November and the changes take effect January 1 of the next year. The only other way to make changes during the plan year is if you have a Qualifying Event. See the next answer.
What is a Qualifying Event and what do I need to prove it?
The only way during the plan year to make changes to your dental coverage is during a qualifying event. Examples of qualifying events and proof required:
- Adding newborns (hospital record showing name & date of birth)
- Adopted children (adoption papers)
- Marriage (marriage certificate)
- Divorce (requires final divorce decree)
- Loss of alternate health coverage (on company letter head - letter stating when job and benefits terminated or when COBRA coverage exhausted)
- Death (death certificate or newspaper notice)
You have 31 days from the date of the qualifying event to make changes, except for newborns and newly adopted children have 60 days. Since this change affects the employee paycheck, the employee will need to bring into Human Resources the proof of the qualifying event and fill out a Benefit Enrollment Form.
What happens to my dental insurance when I terminate employment?
On termination of employment if you currently had dental insurance:
- Your insurance will terminate the end of the month.
- You will receive a Cobra letter within 1 – 2 weeks of termination. Among other things the Cobra letter will state how long you have to decide whether you want to continue the coverage. When Cobra will begin, end, and cost of coverage (102% of premiums – TCU no longer shares the cost of premiums), and how monthly payments are made.
How long can my dependent child / children stay on my coverage?
If a dependent child on the coverage becomes ineligible (they get married, no longer dependent on the Employee for at least 50% of the child’s living expenses, attain age 25, gets their own coverage, serves on extended active duty in the Armed Forces) than the employee needs to bring in proof or sign a statement that the child is no longer eligible and fill out a benefit enrollment form dropping the child within 31 days of the event. Under this years plan eligible dependent children can be covered till they reach the age of 25. The system will automatically drop them from the coverage and create a COBRA letter on their 25th birthday.
