Cigna Dental HMO is fully insured and operates like a health maintenance organization: Once enrolled, you must receive all services from the Cigna Dental HMO provider you selected. Except for emergency treatment for pain, you will not be covered for any dental services you receive outside the Cigna Dental HMO network. (Note: Coverage may vary slightly by state depending on where you are located. Members located in AK, DC, IN, LA, MN, NV, OK, OR, SC, UT, and WA should refer to the Cigna plan documents for a list of exceptions and limitations available in the "Forms and Documents" section at citibenefits.com).

As a Cigna Dental HMO Plan member, you may be eligible for various discounts, benefits and other considerations to promote your general health and well-being. Upon enrollment, members will receive a welcome kit, ID card and copy of Cigna plan documents. Visit the Cigna website at www.myCigna.com for more information.

Enrollment in the Cigna Dental HMO allows the release of your and your covered dependents' dental records to Cigna Dental for administrative purposes.

The Cigna Dental HMO has no annual individual or family deductibles and no lifetime dollar maximums. Most preventive services are paid at 100% when you use a network general dentist. You pay a patient charge when you use a network general dentist for other services. See "Patient Charge Schedule" for more information. You can obtain a schedule of charges when you enroll in the Cigna Dental HMO by calling Cigna Dental at 1 (800) Cigna24 (1 (800) 244-6224) or by visiting www.myCigna.com/dental. It is also available at www.citibenefits.com.

Please note: In the event this document conflicts with Cigna's plan documents, including applicable insurance certificates, service agreements, policies and patient charge schedules, Cigna's plan documents and administration will prevail.

Cigna Dental contracts with network dentists in most areas of the country. Network dentists provide covered services to Cigna Dental HMO members at independently owned network dental offices. You can request a list of network dental offices in your area by calling Cigna Dental at 1 (800) Cigna24 (1 (800) 244-6224). You can also find a provider on the Cigna website at www.Cigna.com.

If you want to enroll in the Cigna Dental HMO but have a dentist whom you want to continue using, you should verify that he or she is in the Cigna Dental HMO. Because there are no out-of-network benefits, other than for emergency treatment for pain, you will not be reimbursed for any dental services if you continue to visit your current dentist and he or she is not in the Cigna Dental HMO network. Coverage may vary slightly by state depending on where you are located. (Members located in AK, DC, IN, LA, MN, NV, OK, OR, SC, UT, and WA should refer to the Cigna plan documents for a list of exceptions and limitations available in the "Forms and Documents" section at citibenefits.com).

Cigna Dental HMO confirms that each dentist in its network is properly licensed, certified and insured, and complies with government health standards.