Dental PPO

Premium

There will be no change to the premiums for the CIGNA dental plan this year. The premium rates and related percentages of salary contribution are shown on the 2008 Schedule of Premiums.

Benefits

With effect from 1 July 2005, the Dental programme is simplified to a single PPO, having an in-network benefit and an out-of-network benefit.

In-network benefit

The in-network benefit is identical to the in-network benefit of the former Option A. It provides for 100 per cent coverage for most dental procedures without any deductible if the dental treatment is rendered by a dentist participating in the CIGNA provider network (a few dental procedures involving costly materials may require additional payment to the dentist by the participant). The CIGNA participating provider network is nationwide, and includes a total of over 62,000 dentists, with approximately 7,300 in New York State (4,200 in New York City), 3,200 in New Jersey and 1,035 in Connecticut.

Out-of-network benefit

The out-of-network benefit is identical to the out-of-network benefit of the former Option B. Out-of-network dental treatment will be reimbursed as a percentage of the "reasonable and customary" charges of the dentist, depending on the type of service, and subject to an annual deductible of $50 per person or $150 per family. CIGNA determines the reasonable and customary fee levels by reference to a national database maintained by the Health Insurance Association of America (HIAA) that provides the prevailing dental fees where the dentist practices, e.g., the office zip code. The percentage reimbursement rates are as follows: 90 per cent for preventive/diagnostic treatment; 80 per cent for major and minor restorative treatment; 70 per cent for orthodontics.

In summary, there is no change in benefits for individuals who are currently enrolled in Option A and who use the CIGNA network. There is no change in benefits for individuals who are currently enrolled in Option B and who do not use the CIGNA network. Individuals who are enrolled in Option A and do not use a CIGNA dentist will become responsible for the out-of-network deductibles and co-insurance that were part of the old Option B. Members are entitled to choose whether to use an in-network or out-of-network dentist.

Pre-treatment review (pre-determination of benefits)

If a course of treatment can reasonably be expected to involve covered dental expenses of $300 or more, a description of the procedures to be performed and an estimate of the dentist's charges should be filed with CIGNA before the course of treatment begins. The dentist should be sure to include the American Dental Association (ADA) procedure code for each procedure claimed. This process will inform the participant as to whether the proposed dental fee is within reasonable and customary norms and exactly how much will be reimbursed. Please note the Insurance and Disbursement Service has no information in regard to reasonable and customary charge norms.

Dental treatment outside the United States

Participants who obtain dental treatment outside the United States may file their claims with CIGNA and are eligible for reimbursement on the same basis as a participant who visits a non-participating dentist in the United States.

CIGNA web site

Access to CIGNA's nationwide network of participating dentists is also available through the Insurance home page of the Insurance Service on the United Nations Intranet. In addition, the CIGNA dental provider directory can be accessed directly from the CIGNA Internet web site at: www.cigna.com/providerdirectory.