Dental Coverage
Dental Plans
Saint Cloud State University offers dental insurance through our State Employee Group Insurance Program (SEGIP). Through SEGIP, we are able to offer comprehensive dental plans through Delta Dental Group 216 and Health Partners for all eligible employees.
Our dental plan offers comprehensive coverage for a wide range of dental needs, including 100% in-network coverage for preventive services (optional benefit), diagnostic and treatment services, basic and major restorative services, as well as orthodontic care for both adults and children covered at 80% with a separate lifetime maximum of $3,000 per person. Employees have the option to enroll in dental coverage for themselves, their spouse, children, and eligible dependents.
All dental plans include a variety of preventive services designed to support long-term oral health, such as:
- Routine dental exams
- Diagnostic X-rays
- Regular dental cleanings
- Fluoride treatments for children
Both dental plan options offer similar benefits, including the same annual maximum. However, there are differences in how certain benefits are administered. Similar to health insurance providers, dental insurance carriers may not be available in every county throughout the state. For a more detailed comparison, please refer to the Summary of Benefits for Health Partners or Delta Dental.
Dental Overview Video
Dental Schedule of Benefits
2024/2025 Dental Schedule of Benefits
Annual Maximum per person: $2,200 (does not apply to Preventive Care or Orthodontia).
Orthodontics Lifetime Maximum per person: $3,000 (does not start over if you change dental plans).
| In-network Benefits | Out-of-network Benefits | |
|---|---|---|
| Annual Deductible | $50 per person / $150 per family | $125 per person |
Diagnostic and Preventive Care (deductible does not apply)
| Covered Services | In-network Benefits | Out-of-network Benefits |
|---|---|---|
| Examinations, oral hygiene & teeth cleaning | 100% coverage | 50% coverage of the allowed amount |
| Fluoride treatment (to age 19) | 100% coverage | 50% coverage of the allowed amount |
| Space maintainers | 100% coverage | 50% coverage of the allowed amount |
| Sealants | 100% coverage | 50% coverage of the allowed amount |
Restorative Care and Prosthetics (deductible applies)
| Covered Services | In-network Benefits | Out-of-network Benefits |
|---|---|---|
| Fillings (customary restorative materials) | 80% coverage | 50% coverage of the allowed amount |
| Oral surgery | 80% coverage | 50% coverage of the allowed amount |
| Periodontics (gum disease therapy) | 80% coverage | 50% coverage of the allowed amount |
| Endodontics (root canal therapy) | 80% coverage | 50% coverage of the allowed amount |
| Inlays and overlays | 80% coverage | 50% coverage of the allowed amount |
| Restorative crowns | 80% coverage | 50% coverage of the allowed amount |
| Dental Implants | 80% coverage | 50% coverage of the allowed amount |
| Fixed or removable bridgework | 80% coverage | 50% coverage of the allowed amount |
| Full or partial dentures | 80% coverage | 50% coverage of the allowed amount |
| Dental relines or rebases | 80% coverage | 50% coverage of the allowed amount |
Orthodontics
| In-network Benefits | Out-of-network Benefits | |
|---|---|---|
| Orthodontics | 80% coverage (deductible does not apply) | 50% coverage of the allowed amount (deductible does not apply) |
Emergency services are covered at the same benefit level as non-emergency services.
See Summary of Benefits for Health Partners or Delta Dental for specific plan limitations.
Dental Plan Monthly Rates
2025 State Dental Plan monthly rates
The State Dental Plan is one plan serviced by two plan administrators. The rate is the same no matter which plan administrator is selected.
There are two coverage options:
- Employee coverage: covers the employee only as single coverage.
- Family coverage: covers the employee plus a spouse and/or dependents as family coverage.
Full Employer Contribution
|
Employee Coverage |
Additional cost to cover spouse and/or dependents |
Family Coverage |
||||||
|
Employee |
State |
Total |
Employee |
State |
Total |
Employee |
State |
Total |
|
$13.80 |
$32.24 |
$46.04 |
$45.10 |
$45.10 |
$90.20 |
$58.90 |
$77.34 |
$136.24 |
75% Employer Contribution
|
Employee Coverage |
Additional cost to cover spouse and/or dependents |
Family Coverage |
||||||
|
Employee |
State |
Total |
Employee |
State |
Total |
Employee |
State |
Total |
|
$21.86 |
$24.18 |
$46.04 |
$56.38 |
$33.82 |
$90.20 |
$78.24 |
$58.00 |
$136.24 |
50% Employer Contribution
|
Employee Coverage |
Additional cost to cover spouse and/or dependents |
Family Coverage |
||||||
|
Employee |
State |
Total |
Employee |
State |
Total |
Employee |
State |
Total |
|
$29.92 |
$16.12 |
$46.04 |
$67.64 |
$22.56 |
$90.20 |
$97.56 |
$38.68 |
$136.24 |
No Employer Contribution
|
Employee Coverage |
Additional cost to cover spouse and/or dependents |
Family Coverage |
||||||
|
Employee |
State |
Total |
Employee |
State |
Total |
Employee |
State |
Total |
|
$46.04 |
$0 |
$46.04 |
$90.20 |
$0 |
$90.20 |
$136.24 |
$0 |
$136.24 |
Provider Networks
- Each dental plan has a network of dentists and, in some cases, preferred specialists through which you receive in-network care.
- You can access directories of dental clinics and dentists on your plan administrator’s website
- To ask specific questions about dental clinics, call the plan administrator directly.
Cost Estimate for Dental Treatments
When planning for dental procedures beyond routine exams or cleanings, it's important to request a cost estimate in advance. This estimate, provided by your dental insurance, outlines what portion of the treatment will be covered and what your out-of-pocket costs may be.
This process is known by different names depending on your dental provider:
- HealthPartners Dental refers to it as a Predetermination.
- Delta Dental calls it a Pretreatment Estimate of Benefits.
Requesting this estimate before receiving care helps you make informed decisions and avoid unexpected expenses. This process does not prior authorize the treatment, nor does it determine its dental or medical necessity. The estimated payment is based on your current eligibility and contract benefits in effect at the time of the estimate. It is an estimate ONLY.
Go to your HealthPartners Dental or Delta Dental Summary of Benefits to review the rules for coverage.