Dental Plan

The plan pays benefits for covered preventive and diagnostic services with no need for you to pay a deductible (whether services are obtained in-network or out-of-network). NOTE: You may elect dental coverage whether or not you elect medical coverage.

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Carlisle Cigna DPPO Plan
Calendar Year Deductible
Individual $50 $50
Family $150 $150
Calendar Year Benefits Maximum
Per Individual $1,500 per individual (Basic and Major Services combined)
Preventive Care

Cleanings, exams, X-rays twice per year
Fluoride Treatment under age 19, one per year

0% Member will be balance billed
Basic Services

Fillings, Space Maintainers, Sealants,
Extractions, Oral Surgery, Simple Endodontics,
Periodontics, Emergency Exams


20%* or more if charges are more than maximum allowable charges

Major Procedures

Crowns, Inlays/Outlays, Dentures and
Bridgework, Repairs, Surgical Implants

50%* 50%* or more if charges are more than maximum allowable charges
24-Month Treatment Fee. Additional fees will apply for pre-ortho visits and treatment, records and retention, and banding.

Children and Adults

50% up to a lifetime maximum benefit of $1,500 per individual;
deductible waived. Out-of-network providers may cost more if charges
exceed maximum allowable charges.

*After Deductible