Dental
Rates
Plan A
| Tier | Monthly Rates |
| Employee Only | $66.99 |
| Employee + Spouse | $105.45 |
| Employee + Child(ren) | $130.99 |
| Employee + Family | $179.48 |
Plan B
| Tier | Monthly Rates |
| Employee Only | $52.37 |
| Employee + Spouse | $81.64 |
| Employee + Child(ren) | $101.27 |
| Employee + Family | $138.78 |
REMINDER: Your member number is 000 + Your 6-digit Employee ID #.
Dental
Find a Dentist
Plan A: High Option
Plan B: Moderate Option
2024-2025 Dental Rates
What Is Covered
What Is Not Covered
Orthodontia
When Coverage Ends
When Coverage Ends for a Dependent Child
Glossary
Related Forms
Related Links
Cigna