Health :: Dental

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.
2021DENTAL BASICDENTAL CHOICE
Annual Deductible
(per person)
$50$50
Preventive
(twice a year)
0% of MRC0% of MRC
Basic
(restorative)
20% of MRC after deductible20% of MRC after deductible
Major
(restorative)
50% of MRC after deductible50% of MRC after deductible
Orthodontia
(children to age 19, per person)
Not applicable50% 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. Log onto myXPO Portal, click on Your Benefits, then Benefits for rate information on all of your benefits.

Contacts

Cigna

Provider for dental