Dental
What You Pay For Services
XPO offers two dental plan options — Dental Basic and Dental Choice — and both are administered by Cigna. The table below outlines the features of each plan, which are the same in-network and out-of-network.You can see any dentist you want. However, in-network dentists agree to accept negotiated fees from Cigna. Out-of-network dentists can bill you for amounts above the negotiated in-network fees.
2023 | DENTAL BASIC | DENTAL CHOICE |
---|---|---|
Annual Deductible (per person) | $50 | $50 |
Preventive (twice a year) | 0% of MRC | 0% of MRC |
Basic (restorative) | 20% of MRC after deductible | 20% of MRC after deductible |
Major (restorative) | 50% of MRC after deductible | 50% of MRC after deductible |
Orthodontia (children to age 19, per person) | Not applicable | 50% of MRC, no deductible, up to $1,500 lifetime benefit maximum |
Annual Maximum (per person) | $1,000 | $2,000 |
A Note About MRC: Maximum Reimbursable Charge (MRC) fees are based on the 90th percentile of the customary allowance from a fee schedule selected by Cigna.
MEDICAL, DENTAL AND VISION PLAN RATES
You and XPO share the cost of medical and dental coverage. You pay the total cost for vision coverage. You’ll find benefit cost information on myXPO under My Benefits.
Contacts
Cigna
Provider for dental