Local 153 Clerical

Fordham University DHMO Dental Plan Booklet

Dental Benefits for Local 153

For complete descriptions of your benefit options, as well as an explanation of how to make your choices, please see the 2021 Benefits Guide for Local 153.

We offer a stand-alone dental plan that is not a part of the medical plan option you choose.

  • DHMO Benefit Summary

     

    In-Network

    Out-of-Network

    Annual Deductible

    None

    Plan does not provide out-of-network benefits

    Preventive and Diagnostic Care

    No cost to you for preventive/diagnostic care and basic fillings. You share the cost of other services based on Cigna’s Dental Patient Charge Schedule

    Plan does not provide out-of-network benefits

    Basic Restorative Care

    No cost to you for preventive/diagnostic care and basic fillings. You share the cost of other services based on Cigna’s Dental Patient Charge Schedule

    Plan does not provide out-of-network benefits

    Major Restorative Care

    No cost to you for preventive/diagnostic care and basic fillings. You share the cost of other services based on Cigna’s Dental Patient Charge Schedule

    Plan does not provide out-of-network benefits

    Orthodontia

    No cost to you for preventive/diagnostic care and basic fillings. You share the cost of other services based on Cigna’s Dental Patient Charge Schedule

    Plan does not provide out-of-network benefits

    Calendar Year Maximum

    No maximum plan benefit

    No maximum plan benefit