B2B Preventive Care

1. "Oral health: A window to your overall health" Mayo Clinic, June 2019 2."Preventive Dental Treatment Associated with Lower Medical Utilization and Costs." National study of Cigna customers with dental and medical coverage, updated December 2020. 3. All group dental insurance policies and dental benefit plans contain exclusions and limitations. For costs and details of coverage, review your plan documents or contact a Cigna representative. 4. Customers do not have to meet DPPO or indemnity deductible to receive reimbursement for these services. However, reimbursement will apply to and is subject to the annual benefits maximum for traditional indemnity and DPPO plans as well as plan rules for visits to network dentists and out-of-network dentists. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. Cigna Dental Care plans are insured by 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. In other states, Cigna Dental Care plans are insured by Cigna Health and Life Insurance Company (CHLIC), or Cigna HealthCare of Connecticut, Inc., and administered by Cigna Dental Health, Inc. Cigna Dental PPO plans are insured or administered by CHLIC or Connecticut General Life Insurance Company, with network management services provided by Cigna Dental Health, Inc. and certain of its subsidiaries. In Texas, the insured dental plan is known as Cigna Dental Choice, and this plan uses the national Cigna DPPO network. CHLIC policy forms: OK –DPPO: HP-POL99/HP-POL388, DHMO: POL115; OR - DPPO: HP-POL68/HP-POL352, DHMO: HP-POL121 04-10; TN –DPPO: HP-POL69/HC-CER2V1/ HP-POL389 et al., DHMO: HP-POL134/HC-CER17V1 et al. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. 930030 06/21 © 2021 Cigna

Keeping employees healthy from their teeth to their toes.

How to reduce medical costs at the dentist

Routine dental exams can help detect signs of medical conditions such as diabetes, leukemia, heart disease and kidney disease that sometimes produce oral symptoms.

Maternity

How pregnancy and oral health are connected. Gum Disease Changing hormones can aggravate inflammation and cause gums to become red and swollen. Between 60 and 75% of pregnant women have gingivitis,* and if it goes untreated, the bone that supports the teeth can be lost and the gums can become infected. Gingivitis can advance to periodontitis, which can cause poor pregnancy outcomes, including preterm birth and low birth weight. Cavities Pregnant women may also be at risk for cavities due to changes in behaviors, such as eating habits. One in four women of childbearing age have untreated cavities.* Impact to baby Children of mothers who have high levels of untreated cavities or tooth loss are more than three times more likely to have cavities.*

Diabetes

How diabetes and oral health are connected. Periodontal Disease If your diabetes isn’t under control, you’re more prone to periodontal disease, which is an infection of the gum and bone that hold your teeth in place. It can cause pain, stubborn bad breath and tooth loss and make your blood sugar harder to control. Thrush Diabetes increases the level of sugar (glucose) in your saliva, which can lead to thrush, a fungal infection that causes painful white patches in your mouth. Dry Mouth When you don’t have enough saliva or have high glucose levels, you can get dry mouth, which causes soreness, ulcers, infections and tooth decay.

Heart Disease

How oral health and heart disease are connected. Gum Disease If bacteria stays on your teeth for too long, tartar and plaque start to form. Once it builds up and reaches your gums, it can lead to gingivitis (early gum disease), which causes red, swollen or bleeding gums. Gingivitis can progress to periodontitis (severe gum disease), which can destroy your jawbone and lead to serious infection beyond your mouth. Plaque Bacteria enter your bloodstream through your gums and become part of fatty plaques in blood vessels. When fatty plaques block a blood vessel leading to the heart, it can lead to a heart attack. When fatty plaques reach the brain and cut off its blood supply, it causes a stroke. That’s why it’s important to treat plaque at the source. Inflammation Inflammation starts a cycle: blood vessels swell, which reduces blood flow to the heart, which raises blood pressure, which affects the flow of blood and oxygen to the brain.

What's eligible for reimbursement

Rheumatoid Arthritis

How rheumatoid arthritis and oral health are connected. Gum Disease Tartar and plaque buildup can lead to gingivitis (early gum disease), which causes bleeding gums. Left untreated, it becomes periodontitis (severe gum disease), which can cause serious infection. Inflammation Patients with RA tend to have a higher level of an oral bacteria that triggers the production of proteins that the immune system attacks as foreign. Scientists believe the inflammatory response to the bacteria may spread throughout the body, triggering RA symptoms. Dry Mouth Dry mouth is one of the most common symptoms of Sjogren’s Syndrome which is often found in RA patients and can lead to mouth sores, gum disease and tooth decay.

What's eligible for reimbursement

Opioid Misuse and Addiction

How opioid misuse/addiction and oral health are connected. Dry Mouth A side effect of opioids is dry mouth, which, when combined with increased sugar consumption, can even change the composition of saliva to make it more destructive.* This may lead to mouth sores, gum disease and tooth decay if it’s not addressed early.** Acid Reflux Opioids reduce a barrier in the esophagus that helps protect against acid reflux. The more that acids reach the teeth, the higher the chance of damaging the tooth enamel and gum tissues.**

What's eligible for reimbursement

Amyotrophic Lateral Sclerosis (ALS)

How ALS and oral health are connected. Trouble Maintaining Dental Routines Since ALS affects the functioning of the hands and arms, brushing and flossing aren’t as easy as they used to be and it’s more difficult to keep the mouth clean. Dry Mouth Mouth breathing, BIPAP use and certain ALS medications can cause dry mouth, which can lead to mouth sores, gum disease and tooth decay. Difficulty Swallowing If saliva isn’t swallowed, it accumulates in the mouth. This causes plaque and bacteria to build up and can lead to cavities, gum disease and, if bacteria enters the lungs, pneumonia.

What's eligible for reimbursement

Parkinson's Disease

How Parkinson's Disease and oral health are connected. Trouble Chewing and Swallowing Parkinson’s can cause stiffness in the jaw muscles and make it difficult to chew and swallow.* This makes it harder to break down food, which can lead to cavities and even pneumonia.** Saliva Irregularities Some people with Parkinson’s swallow less, which causes saliva to pool in the mouth and can lead to teeth problems and mouth infections. Others experience dry mouth as a side effect from medications, which can lead to tooth decay and mouth sores.** Periodontitis People with Parkinson’s are more likely to have bacteria that’s associated with periodontitis (severe gum disease). These bacteria can cause bleeding, pain and damage to the gums and easily infiltrate the bloodstream to harm other parts of the body.***

What's eligible for reimbursement

Lupus

How lupus and oral health are connected. Ulcers As many as 45% of people living with lupus can have either acute or chronic ulcers or lesions on the lips, on the tongue and inside of the mouth.* Ulcers are especially common during “flare-ups.” Periodontitis People with lupus are more likely to struggle with periodontitis (severe gum disease), which is particularly concerning because of the link between gum inflammation and the overall health of the rest of the body.** Dry Mouth Lupus attacks saliva-producing glands, and some medications cause dry mouth as a side effect, which can lead to mouth sores, gum disease and tooth decay. Fluoride treatments can help counter the damage.

What's eligible for reimbursement

Sjogren's Syndrome

How Sjogren's Syndrome and oral health are connected. Dry Mouth Dry mouth is one of the most common symptoms of Sjogren’s Syndrome and can lead to mouth sores, gum di*ease and tooth decay if it’s not addressed early. Oral Sensitivity Sjogren’s Syndrome makes it harder to chew certain foods and more uncomfortable to brush. But it’s important to maintain oral hygiene to counteract the lack of protection from decreased saliva. Thrush Since Sjogren’s Syndrome is an autoimmune disease, it can disrupt the balance of microorganisms in the mouth and lead to a yeast infection. Stay on top of thrush to prevent it from spreading to other parts of the body.

What's eligible for reimbursement

Radiation - Head and Neck Cancers

How head and neck cancer radiation and oral health are connected. Oral Mucositis Head and neck cancer treatment can make the tissue in your mouth swell, break down and form ulcers. It’s painful and can cause bleeding. Healing takes 2-4 weeks after chemotherapy and 6-8 weeks after radiation. Dry Mouth Head and neck chemotherapy and radiation damage the salivary glands and cause dry mouth, which can lead to mouth sores, gum disease and tooth decay. Jaw Problems The causes of jaw issues are twofold: loss of tissue and bone from treatment, and the growth of benign tumors. This can make it hard to eat and drink, which can cause further problems, such as malnutrition and dehydration.

What's eligible for reimbursement

Organ Transplant

How organ transplants and oral health are connected. Gum Disease Anti-rejection medications make it harder to fight off bacteria, which can lead to gingivitis (early gum disease), which causes red, swollen or bleeding gums. Gingivitis can progress to periodontitis (severe gum disease), which can destroy your jawbone and lead to serious infection beyond your mouth. Dry Mouth Anti-rejection medications suppress the immune system and cause dry mouth, which can lead to mouth sores, gum disease and tooth decay. Ulcers Anti-rejection medications also make the mouth lining more susceptible to sores that can make chewing, speaking or swallowing painful.

What's eligible for reimbursement

Kidney Disease

How kidney disease and oral health are connected. Gum Disease If bacteria stays on your teeth for too long, tartar and plaque can form. Once it reaches your gums, it can lead to gingivitis (early gum disease), which causes red, swollen or bleeding gums. Gingivitis can progress to periodontitis (severe gum disease), which can destroy your jawbone and lead to serious infection beyond your mouth, especially if your immune system is weakened from kidney disease. Inflammation Cavities and gum diseases are chronic bacterial infections that cause pain, difficulty eating and harmful chronic inflammation. If you have chronic kidney disease, this inflammation can lead to heart disease, so it’s key to treat it at the source. Transplant delays Medications to prevent kidney rejection further weaken the body’s defenses against infection. Taking care of any oral infections beforehand allows the transplant to proceed as planned.

What's eligible for reimbursement

Huntington's Disease

How Huntington's Disease and oral health are connected. Trouble Maintaining Dental Routines Huntington’s Disease affects the functioning of the hands and arms, making it more difficult to brush, floss and keep the mouth clean. Preventive care can help. Tooth Decay Since many people with Huntington’s disease benefit from a high-energy (and high-sugar) diet, they’re more susceptible to tooth decay. It’s important to stay on top of dental hygiene because chorea in the state stages of the disease requires anesthesia for routine procedures and brings a higher risk for pulmonary aspiration. Bruxism Bruxism is the grinding and clenching of teeth and can be part of the involuntary movements seen in typical patients with Huntington’s Disease. It can lead to pain, tooth fractures, headaches and TMJ.

What's eligible for reimbursement

Frequently Asked Questions

Do I only have to enroll in the program once or, do I have to contact Cigna each time I go to the dentist? You only enroll once in the program. Once enrolled, Cigna will automatically reimburse you for the eligible dental services covered for your medical condition. How and when will I get reimbursed for my out-of-pocket expenses? As with any dental service, you will pay your dentist at the time the service is performed. A claim form is typically submitted to Cigna by your dentist. Once we receive the claim form from the dentist, we pay him/her for their services and you will then receive reimbursement for the amount of your coinsurance or copay. This may take 2-4 weeks, depending on when the dentist submits the claim. Please keep in mind that only dental services eligible under the Cigna Dental Oral Health Integration Program will be reimbursed. How do I know if my enrollment has been processed? Once your enrollment has been approved, Cigna will send you a program welcome letter. What procedures are eligible for reimbursement? Please refer to the list of procedures for each qualifying condition on the homepage. If my dental coverage has a plan maximum or deductible, how do procedures covered under the program get applied? Any procedures covered under the program are not applied toward your plan's annual deductible; however, they do count towards your plan's annual maximum. If I go out-of-network, will the services covered under this program still apply? If your plan does not include coverage for out-of-network services, then you must use a dentist in your plan's network for coverage under this program to apply. If your plan includes out-of-network coverage, you will be reimbursed for your covered expenses whether you choose to use an in-network or out-of-network dentist. However, if you use an out-of-network dentist you may have out-of-pocket costs because the dentist may choose to bill you for charges that are in excess of what your plan reimburses for covered expenses. If I'm a dependent (spouse, partner or child), do I provide my ID number or the person who is the primary covered individual? Please provide the ID number of the person who is the primary covered individual. Where can I find my Group/Account Number? Please check a previous Explanation of Benefits, your dental page on mycigna.com, call Customer Service at the number on your ID card and follow the prompts to get your Group/Account Number. You can also provide your ID and/or social security number and a Customer Service Representative will identify your Group/Account Number for you. If you have a Cigna Medical or Dental ID card the Group/Account Number is listed on the cards. If I don't have an e-mail address but still want information on behavioral conditions affecting my oral health, how can I get the information? Please include a note when you submit your Cigna Dental Oral Health Integration Registration Form indicating the address where you would like the information mailed and it will be sent through the U.S. Postal Service. Do I have to include anything that proves I have a condition and does Cigna have the right to verify my condition? You do not have to include any documentation with your Registration Form that proves you have a specific condition. However, at the bottom of the form you must sign your name verifying that you have the condition and acknowledge that Cigna reserves the right to request medical records or check with your physician prior to reimbursement. If I have questions about the Cigna Dental Oral Health Integration Program or how to complete and submit the Registration Form who do I call? Please call Customer Service at the number on your ID card with any questions. One of our associates will be happy to help you, 24 hours a day, 7 days a week.

*Colgate. (n.d.). Lupus Symptoms and Oral Health. www.colgate.com/en-us/oral-health/immune-disorders/lupus-symtoms-and-oral-health **ProHEALTH Dental. (2019, May 23). Lupus Your Oral Health. www.phdental.com/patient-resources/oral-health-news/2019/may/lupus-your-oralhealth

*Titsas, A, and Ferguson, MM. (2002). Impact of opioid use on dentistry. Australian Dental Journal 2002;47:(2):94-98. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1834-7819.2002.tb00311.x **American Addiction Centers. (2020, February 3). How Drug Abuse Affects Dental Health. https://americanaddictioncenters.org/health-complications-addiction/dental-health

*Ellis, Sarah. (2020, July 28). The Link Between Rheumatoid Arthritis and Dental Health. HealthCentral, www.healthcentral.com/slideshow/link-between-dental-health-and-rheumatoid-arthritis **Johns Hopkins Arthritis Center. (2016, January 11). Dental Tips for the Rheumatoid Arthritis Patient. www.hopkinsarthritis.org/arthritis-news/5-dental-tips-forthe-ra-patient

*Parkinson’s Victoria Ltd. (n.d.). Eating, Swallowing and Saliva Management. www.parkinsonsvic.org.au/parkinsons-and-you/eating-swallowing-and-saliva-management **Parkinson’s Foundation. (n.d.). Dental Health. www.parkinson.org/Living-with-Parkinsons/Managing-Parkinsons/Dental-Health ***Adams B, Nunes JM, Page, MJ, et al. (2019, August 27). Parkinson’s Disease: A Systemic Inflammatory Disease Accompanied by Bacterial Inflammagens. Frontiers in Aging Neuroscience. www.frontiersin.org/articles/10.3389/fnagi.2019.00210/full

Stroke

How oral health and strokes are connected. Gum Disease If bacteria stays on your teeth for too long, tartar and plaque start to form. Once it builds up and reaches your gums, it can lead to gingivitis (early gum disease), which causes red, swollen or bleeding gums. Gingivitis can progress to periodontitis (severe gum disease), which can destroy your jawbone and lead to serious infection beyond your mouth. Plaque Bacteria enter your bloodstream through your gums and become part of fatty plaques in blood vessels. When fatty plaques block a blood vessel leading to the heart, it can lead to a heart attack. When fatty plaques reach the brain and cut off its blood supply, it causes a stroke. That’s why it’s important to treat plaque at the source. Inflammation Inflammation starts a cycle: blood vessels swell, which reduces blood flow to the heart, which raises blood pressure, which affects the flow of blood and oxygen to the brain.

What's eligible for reimbursement

*Centers for Disease Control and Prevention (CDC). (2019, February 19). Pregnancy and Oral Health. www.cdc.gov/oralhealth/publications/features/pregnancy-and-oralhealth.

One whole-mouth periodontal (Gum) treatment every 24 months Two additional periodontal (Gum) maintenance procedures Codes: D4341, D4342, D4910

One Whole-Mouth Periodontal (Gum) Treatment Every 24 Months Two Additional Periodontal (Gum) Maintenance Procedures One Additional Oral Evaluation One Periodontal Evaluation One Additional Cleaning One Additional Full-Mouth Scaling Unlimited Emergency Palliative Treatment Codes: D4341, D4342, D4910, D0180, D0120, D0140, D0150, D1110, D4346, D9110

One whole-mouth periodontal (Gum) treatment every 24 months Two additional periodontal (Gum) maintenance procedures One topical application of fluoride varnish Sealants and sealant repair - one treatment per tooth every 36 months Tooth decay/cavity prevention - two treatments per tooth per year Codes: D4341, D4342, D4910, D1206, D1208, D1351, D1353, D1354, D1355

One whole-mouth periodontal (Gum) treatment every 24 months Two additional periodontal (Gum) maintenance procedures One topical application of fluoride varnish Sealants and sealant repair - one treatment per tooth every 36 months Tooth decay/cavity prevention - two treatments per tooth per year One additional oral evaluation Codes: D0120, D0140, D0150, D4341, D4342, D4910, D1206, D1208, D1351, D1353, D1354, D1355

One whole-mouth periodontal (Gum) treatment every 24 months Two additional periodontal (Gum) maintenance procedures Codes: D4341, D4342, D4910

Preventive dental care services do more than just brighten smiles. They can help maintain good overall health, too, which can lower medical and dental costs. Did you know?

Cigna dental plans cover certain preventive dental care services at no additional cost when performed by a network dentist.³

When employees have a chronic medical condition such as diabetes, heart disease or a history of stroke, getting the appropriate preventive dental care is even more important, because studies show a connection between certain chronic conditions and gum disease.¹

Having regular preventive dental check-ups can help employees avoid emergency room and urgent care visits. People who don't get regular dental care have 22% more visits to emergency rooms and urgent care centers.²

With over 150,000 dentists in our Total DPPO network, the search tools on each employee's personalized myCigna.com account make it easy to find the right dentist. When your employees activate and use their personalized myCigna.com account, they can read verified patient reviews and compare Brighter Scores which rate dentists on affordability, patient experience and professional history. Plus, they can compare costs for hundreds of other procedures, specific to their plan.

Cigna Dental Oral Health Integration Program

This program is for customers with certain medical conditions that have been found to be associated with gum disease and other oral health conditions. The Cigna Dental Oral Health Integration Program reimburses out-of-pocket costs for specific dental services used to treat gum disease and tooth decay. There's no additional cost for the program - if an employee qualifies and enrolls, they get reimbursed!

LEARN MORE

®4

Total Medical Cost Savings

AVERAGE SAVINGS PMPY

4.4%

REDUCTION IN ER VISITS

22%

AVERAGE SAVINGS PMPY FOR CUSTOMERS WITH DIABETES

12.25%

READ THE STUDY

National study of Cigna customers with dental and medical coverage, December 2020.

Preventive Dental Treatment Associated with Lower Medical Utilization and Costs

Those regular visits to the dentist for an exam, cleaning and a “No Cavities for Me!” sticker help keep your teeth and gums healthy and your smile bright. But they also help with much more – including your likelihood of needing emergency or urgent medical care services and your chances of developing periodontal (gum) disease. Just like going for an annual medical exam is important, preventive dental care visits also play a critical role in overall health and wellness. The connection between oral and overall health is a guiding principle for everything we do, and it’s reflected in how we view dental health and the products we offer to help improve and maintain it. In today’s world, an effective dental plan is one that goes beyond just offering a list of covered procedures and discounted dentists. Dental plans should offer services and programs that reflect the connection between oral and overall health, and they should connect customers to the right solutions when, how and where they need them most, in a way that’s simple, affordable and predictable. Our dental programs are designed to help reduce dental and medical costs, and help deliver better outcomes for all customers, including those who may need extra support to be their healthiest or who may be at a greater disadvantage due to social factors that impact health and access to care. Critical to our approach is our clinical expertise which allows us to evaluate customers’ needs. One of the ways we do this is by harnessing the power of data and using insights from data analytics to deliver solutions that overcome barriers to good oral and overall health. Our ongoing, multi-year studies – initially begun in 2011 – on the impact for periodontal care on customers who also have medical coverage with us have enabled us to identify opportunities to help improve outcomes. It’s also enabled us to demonstrate the long-term, positive impact dental care has, not only on a person’s oral heath, but also on their health but on their medical costs, too.

How can a visit to the dentist help lower medical costs and improve health outcomes?

Multi-year study validates impact of preventive dental care

Study Groups

In 2011, Cigna’s team of dental directors began what would become a multi-year study on the impact that dental care has on various costs and outcomes. For the updated and expanded studies, our clinical dental team identified two groups of Cigna customers with dental and medical coverage: those who had three consecutive years of preventive dental care* (2012-2014) and those who received periodontal (gum disease) treatment** (2017) and subsequent maintenance for both years (2018-2019) following initial treatment. These groups were matched to similar customers who did not have consecutive years of preventive care, or periodontal treatment followed by maintenance, and a comparison was made on annual medical costs for each group beginning in 2015 through 2019 and year 2019, respectively. A sub-segment of the preventive care study was also identified to determine the impact preventive care has on those with diabetes. This work continues today, with more data and insights coming from the cumulative reporting each year. All findings validate the profound impact that preventive and periodontal care can have on medical outcomes and costs. This paper summarizes our most recent findings as measured during 2020 including the role social determinants of health can play when it comes to costs and savings.

Unexpected ways to reduce medical costs

How a visit to the dentist can help improve medical outcomes

Consecutive years of preventive dental care Periodontal treatment followed by consecutive years of maintenance

No preventive care No treatment

Long-term impact of dental care and the social factors that contribute to higher costs and greater savings

Increase in risk for periodontal disease

Periodontal maintenance following periodontal treatment is key to lowering medical costs

Social factors impact cost and savings for those who get routine preventive dental care

What are Social Determinants of Health (SDoH)?

Through the latest study results, we’re learning more about the long-term impact that routine preventive dental care and periodontal maintenance after treatment can have on adverse events, including emergency room and urgent care visits. By getting what may be perceived as “standard and routine” (e.g. routine exams, cleanings and x-rays) care at their dentist, customers are not only helping to improve and maintain good oral health, they are also helping to reduce medical costs by avoiding the ER and urgent care centers. Routine preventive dental care can help reduce medical costs for five years following three consecutive years of care in customers with diabetes and those who are otherwise healthy The average annual savings on total medical costs (TMC) over five years is 4.4% per member, per year (PMPY). These savings include a 22% reduction in emergency room and urgent care visits for this study group. The savings is higher for those diagnosed with diabetes. TMC is reduced by an average of 12.25% over five years for the study sub-segment of customers diagnosed with diabetes, with the highest savings – 17.8% – measured in the first year following three consecutive years of preventive care. The impact of these results go beyond just medical cost savings. Customers with diabetes are at greater risk for developing periodontal disease due to the impact diabetes can have on the immune system. And once periodontal disease is present, it can make it harder to manage blood sugar levels. Helping those customers with diabetes who are at a higher risk of periodontal disease is one of the reasons we launched the Cigna Dental Oral Health Integration Program®.*** By providing these customers with enhanced dental services at no extra cost, we are able to connect them to care and help them manage their disease.

TREATMENT

MAINTENANCE

YEAR ONE

YEAR TWO

YEAR THREE

Total Medical Costs

Three Years of Preventive Dental Care

AVERAGE SAVINGS PMPY

4.4%

REDUCTION IN ER VISITS

22%

During the analysis of results, we also determined that customers who did not have consecutive years of routine preventive care are 1.5 times more likely to develop periodontal disease over the course of the following five years compared to those who did get care. Helping to reduce the risks of periodontal disease is critical to helping customers mitigate potential complications to existing medical conditions such as diabetes. By proactively connecting them to dental services that can help manage certain diseases, we can help deliver better health outcomes and more savings to employers.

For customers with periodontal disease, meaningful savings on medical costs were seen in the final year (2019) following initial treatment and care totaling $759.40 (10.2%) PMPY. In addition, there was a reduction in the number of adverse events. Customers who completed periodontal maintenance following treatment average 21.8% fewer emergency or urgency care visits than those who don’t get maintenance. Ongoing periodontal maintenance following initial treatment is key to driving cumulative medical cost savings.

In the most recent analysis of findings, we also gained insight into the impact social factors can have on oral health. This information is critical to our commitment to connecting customers to care when, how and where they need it most. When social factors create barriers to important preventive dental care, we must look for ways to overcome those barriers and help ensure that everyone is able to access care. A deeper look at the medical cost savings among study group individuals who are impacted by “very high social determinant factors” illustrates the connection between cost and access to care, and social factors. This sub-group had additional savings of 37.3% over those customers who are not impacted by a high social index.

Social factors impact Americans of all ages, but can have an especially negative influence on children’s oral health. Oral health is critical to a child’s overall health and development, school attendance and performance, speech development and nutritional intake. Therefore, eliminating or minimizing the impact that social factors such as poverty or the suspension of school- and community-based dental programs due to COVID-19 becomes even more important to delivering improved outcomes for all Americans. These insights clearly illustrate the critical impact social factors can have on an individual’s health outcomes, and the cost savings realized when preventive care is performed. But they also underscore the importance of moving the center of care in a way that brings affordable, simple and predictable dental care services to those who may not have the ability or means to access it. This can mean better overall health regardless of the challenges created by social factors, and more savings to employers.

Insights from studies like this help guide the work we do to develop dental solutions that can help improve whole health. Looking to the future, key learnings such as the impact that social determinants of health can have on an individual’s access to care are critical to developing dental solutions that help reduce disparities and ensure equity for all Americans. By moving the center of care to where it’s needed most within our communities, we are committed to making access to important preventive dental care services equally simple and affordable for all of our customers. Cigna’s Study: Demographics Preventive Care Study Group – 60,015 DPPO members who received preventive care services consecutively between 2012-2014. Control Group – 60,015 DPPO members who did not receive preventive care services consecutively between 2012-2014. Medical outcomes measured for period 2015-2019. Result statistically significant with p-value<0.05 Diabetic Segment of Preventive Care Study Group – 6,934 DPPO members diagnosed with diabetes who received preventive care services consecutively between 2012-2014. Control Group – 6,934 DPPO members diagnosed with diabetes who did not receive preventive care services consecutively between 2012-2014. Medical outcomes measured for period 2015-2019. Result statistically significant with p-value<0.05 Periodontal Maintenance Study Group – 15,177 DPPO members who received periodontal treatment in 2017 and maintenance care in both 2018 and 2019. Consecutively between 2017-2019. Control Group – 15,177 DPPO members who received periodontal treatment. Medical outcomes measured concurrently with years treatment was received. Cumulative savings reflects updated data for medical outcomes in 2019. Result statistically significant with p-value<0.05

Clinical insights that help inform meaningful solutions Identify, educate, treat and prevent. The path to better health.

AVERAGE SAVINGS PMPY FOR CUSTOMERS WITH DIABETES

12.25%

Periodontal Disease Risk

Three Years of Preventive Dental Care

LESS LIKELY TO DEVELOP

Average TMC Savings PMPY

Average Cumulative TMC Savings PMPY

1.5X

10.2%

+2%

+2.2%

The Centers for Disease Control (CDC) defines SDOH as “conditions in the places where people live, learn, work and play that affect a wide range of health risks and outcomes.” These include five key, place-based areas such as healthcare access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment. In simpler terms, SDOH are conditions in which people are born, grow, live, work and age and they are shaped by the distribution of money, power and resources at all levels within society.

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, review your plan documents or contact a Cigna representative. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. Cigna Dental Care plans are insured by 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. In other states, Cigna Dental Care plans are insured by Cigna Health and Life Insurance Company (CHLIC), or Cigna HealthCare of Connecticut, Inc., and administered by Cigna Dental Health, Inc. Cigna Dental PPO plans are insured or administered by CHLIC or Connecticut General Life Insurance Company, with network management services provided by Cigna Dental Health, Inc. and certain of its subsidiaries. In Texas, the insured dental plan is known as Cigna Dental Choice, and this plan uses the national Cigna DPPO network. CHLIC policy forms: OK –DPPO: HP-POL99/HP-POL388, DHMO: POL115; OR - DPPO: HP-POL68/HP-POL352, DHMO: HP-POL121 04-10; TN –DPPO: HP-POL69/HC-CER2V1/ HP-POL389 et al., DHMO: HP-POL134/HC-CER17V1 et al. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Offered by Cigna Health and Life Insurance Company or its affiliates

For more information, contact your Cigna representative.

Download PDF

Go back