260125_Chapter_1E_-_CIGNA_OHIP_Flyer_COT.pdf

830532 k 07/23 Offered by Cigna Health and Life Insurance Company

Cigna Dental Oral Health Integration Program®

Improved health starts with oral health.

What is the Cigna Dental Oral Health Integration Program (OHIP)?

OHIP is a Cigna Dental Health Connect® solution – a no additional cost program for people with certain medical conditions that lead to a higher risk of oral health issues. If customers qualify and participate in the program, they’ll get reimbursed for out-of-pocket costs for certain dental services used to prevent and treat gum disease and tooth decay.*

Eligible conditions include:

• Diabetes

• Heart disease

• Maternity

• Stroke

• � Radiation for head or neck cancers

• � Organ transplants

• � Chronic kidney disease

• Rheumatoid arthritis

• Sjogren’s syndrome

• Lupus

• Parkinson’s disease

• Amyotrophic lateral sclerosis (ALS)

• Huntington’s disease

• Opioid misuse and addiction

Preventive treatments promote positive outcomes.**

Overall customers

• 31% future savings

• 36% decrease in ER visits

• 39% decrease in hospital admissions

Customers with gum disease

• 23% decrease in ER visits

• 25% decrease in hospital admissions

Gum disease treatment can create significant savings.**

10.2%

12.25% savings on TMC PMPY for diabetics.

savings on total medical cost (TMC) per member per year (PMPY) with no chronic condition.

What dental services are covered under the Cigna Dental Oral Health Integration Program?

Heart disease Stroke Diabetes Maternity

Chronic kidney disease

Organ transplants

Radiation for head or neck cancers

Rheumçatoid arthritis

Sjogren's syndrome Lupus Parkinson's disease ALS Huntington's disease

Opiod misuse and addiction

Gum treatment1,2

D4341 D4342 D4910 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

Gum evaluation1,3 D0180 ✓

Oral evaluation1,3 D0120 D0140 D0150 ✓ ✓

Cleaning1,4 D1110 ✓

Scaling in the presence of inflammation1,4 D4346

Palliative treatment of dental pain1,5 D9110

Fluoride varnish1,6

D1206 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

Fluoride (no varnish)1,6 D1208

Sealants6 D1351 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

Sealant repair6 D1353 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

Interim application of caries arresting medicament D1354

Caries preventive medicament application D1355

1. Eligibility, reimbursement and coverage for eligible services are subject to plan year maximums. 2. Two additional treatments per year than the plan covers.

3. One additional evaluation. 4. One additional cleaning. 5. Unlimited visits. 6. Open to all ages, but plan limits apply.

Condition

Se rv ic es

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Encourage customers to sign up.

To get reimbursed, qualifying customers must enroll in the Cigna Dental Oral Health Integration Program by going to myCigna.com® > Coverage > Dental and complete the registration form. Or, they can call the number on their ID card and ask to be mailed a registration form.

Reimbursement is easy.

1. Enrolled customers go to their dentist and pay their usual copay or coinsurance for covered services.

2. � Dentists in our network will send us a claim for reimbursement. If customers see a dentist out of network, they may need to submit their own claim.

3. We’ll review the claim and mail reimbursements in about 30 days.

Questions? Speak with your Cigna HealthcareSM representative today.

* �Customers do not need to meet their DPPO or indemnity deductible to receive reimbursement for these services. However, reimbursement will apply to and is subject to annual benefit maximum for traditional indemnity and DPPO plans, as well as plan rules for visits to network and out-of-network dentists.

** �“Preventive Dental Treatment Associated with Lower Medical Utilization and Costs.” National study of Cigna customers with dental and medical coverage, updated December 2020 who had periodontal treatment followed by periodontal maintenance. First year TMC savings: 6%, second year cumulative TMC savings 8%, third year cumulative TMC savings 10.2%. 12.25% average TMC savings when preventive dental care is performed for three consecutive years for patients diagnosed with diabetes. Individual results may vary. separate from your dental benefits and you are required to pay the entire discounted charge. You should check any insurance or other benefits you have before using these discounts, as those benefits may result in lower costs to you.

Oral Health Integration Program may not be available in all areas. For Indemnity/DPPO plans, deductible does not apply and reimbursement counts toward and is subject to your plan annual benefits maximum. Product availability may vary by location and plan type and is subject to change. All group dental insurance policies and dental benefit plans contain exclusions and limitations.

For costs and details of coverage, contact a Cigna Healthcare representative.

Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT.)

(CHLIC), Cigna HealthCare of Connecticut, Inc., Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and Cigna Dental Health, Inc. and its subsidiaries, including Cigna Dental Health Plan of Arizona, Inc., Cigna Dental Health of California, Inc., Cigna Dental Health of Colorado, Inc., Cigna Dental Health of Delaware, Inc., Cigna Dental Health of Florida, Inc., a Prepaid Limited Health Services Organization licensed under Chapter 636, Florida Statutes, Cigna Dental Health of Kansas, Inc. (KS & NE), Cigna Dental Health of Kentucky, Inc. (KY & IL), Cigna Dental Health of Maryland, Inc., Cigna Dental Health of Missouri, Inc., Cigna Dental Health of New Jersey, Inc., Cigna Dental Health of North Carolina, Inc., Cigna Dental Health of Ohio, Inc., Cigna Dental Health of Pennsylvania, Inc., Cigna Dental Health of Texas, Inc., and Cigna Dental Health of Virginia, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. Policy forms: OK – HP-POL99/HP-POL-388, POL115; OR – HP-POL68/HP-POL352, HP-POL121 04-10; TN – HP-POL69/HC-CER2V1/HP-POL389, et al., HP-POL134/HC-CER17V1 et al.

830532 k 07/23 © 2023 Cigna Healthcare. Some content provided under license.