When PEIP dental insurance is elected by the employer, coverage is provided through Delta Dental, Minnesota's largest dental insurer.
Depending on the employer's location, employees are eligible for either the standard Delta Dental Plan or the DeltaPreferred Option Plan. Both the standard Delta Plan and the DeltaPreferred Option Plan offer basic preventive coverage; and both offer optional comprehensive coverage. Optional dependent coverage may also be available.
Standard Delta Dental Plan
Employees who enroll in the standard Delta Dental Plan may go to any licensed dentist for dental care.*
Preventive Coverage
Coinsurance*: 90% coverage
Routine Oral Exams: One per six-month interval
Teeth Cleaning: One per six-month interval
Topical Fluoride Treatment: One per 12-month interval (for dependents under age 19)
Full Mouth X-rays: One per 36-month interval
Bite-wing X-rays: One per 12-month interval
Dental X-rays: As required for diagnosis of specific conditions requiring treatment (excluding X-rays for orthodontic treatment)
All Other Services Not Listed: Not covered
Calendar Year Maximum: $200 per covered person
Optional Comprehensive Coverage
Deductible*: Single $50, Family $100
Basic Coverage: 80% coverage for fillings, extractions, routine oral surgery, endodontics, and periodontics.
Major Coverage: 50% coverage for inlays, onlays, crowns, dentures, fixed bridgework, and denture adjustments.
Calendar Year Maximum: $1,000 per covered person
Participation Requirements
The employer must contribute at least 50% toward the cost of dental coverage.
If the employer offers dental coverage, at least 50% of eligible employees must enroll. If dependent coverage is offered, family dental will be packaged with family medical. That means employees who choose family medical must also choose family dental.
*You may receive greater benefits if you receive services from a DeltaPreferred Option network dentist. Also, if you use a dentist who is not a participating Delta Dental provider, you may pay more out-of-pocket for your care.
DeltaPreferred Option Plan
Employees who are enrolled in the DeltaPreferred Option Plan use the extensive network of DeltaPreferred Option network dentists for maximum payment coverage. Employees may use a dentist outside the DeltaPreferred Option network, but must pay more out-of-pocket costs when care is provided by a non-network dentist.
Preventive Coverage
Coinsurance: 100% coverage (80% for non Preferred Option-network coverage)
Routine Oral Exams: One per six-month interval
Teeth Cleaning: One per six-month interval
Topical Fluoride Treatment: One per 12-month interval (for dependents under age 19)
Full Mouth X-rays: One per 36-month consecutive interval
Bite-wing X-rays: One per 12-month interval
Dental X-rays: As required for diagnosis of specific conditions requiring treatment (excluding X-rays for orthodontic treatment)
Optional Comprehensive Coverage
Deductible*: Single $25, Family $50
Basic Coverage: 80% coverage for fillings, extractions, routine oral surgery, endodontics, and periodontics.
Major Coverage: 50% coverage for inlays, onlays, crowns, dentures, fixed bridgework, and denture adjustments.
Calendar Year Maximum: $1,000 per covered person
