Dental Benefits

Like brushing and flossing, visiting your dentist is an essential part of your oral health. Hormel Foods offers affordable plan options from Delta Dental of MN for routine care and beyond.

Dental Plan Summary

	DELTA DENTAL PPO IN-NETWORK	OUT-OF-NETWORK
Annual Deductible - Individual	$0	$75
Annual Deductible - Family	$0	$150
Annual Maximum - Per Person	$3,000	$2,500
Preventive Services - Oral Exams, Routine Cleanings, Bitewing X-rays, Panoramic X-rays	90%	80%
Basic Services - Full Mouth X-rays, Fillings, Oral Surgery, Simple Extractions	80%	80%
Major Services - Oral Surgery, Complex Extractions, Denture Adjustments and Repairs, Root Canal Therapy, Periodontics, Crowns, Dentures, Bridges	80%	80%
Orthodontics	50%	50%
Orthodontic Lifetime Maximum	Delta Dental PPO Provider: 50%, up to $3,000Delta Dental Premier: 50%, up to $2,500	50%, up to $2,500

Annual Deductible - Individual

DELTA DENTAL PPO IN-NETWORK$0

OUT-OF-NETWORK$75

Annual Deductible - Family

DELTA DENTAL PPO IN-NETWORK$0

OUT-OF-NETWORK$150

Annual Maximum - Per Person

DELTA DENTAL PPO IN-NETWORK$3,000

OUT-OF-NETWORK$2,500

Preventive Services - Oral Exams, Routine Cleanings, Bitewing X-rays, Panoramic X-rays

DELTA DENTAL PPO IN-NETWORK90%

OUT-OF-NETWORK80%

Basic Services - Full Mouth X-rays, Fillings, Oral Surgery, Simple Extractions

DELTA DENTAL PPO IN-NETWORK80%

OUT-OF-NETWORK80%

Major Services - Oral Surgery, Complex Extractions, Denture Adjustments and Repairs, Root Canal Therapy, Periodontics, Crowns, Dentures, Bridges

DELTA DENTAL PPO IN-NETWORK80%

OUT-OF-NETWORK80%

Orthodontics

DELTA DENTAL PPO IN-NETWORK50%

OUT-OF-NETWORK50%

Orthodontic Lifetime Maximum

DELTA DENTAL PPO IN-NETWORK

Delta Dental PPO Provider: 50%, up to $3,000Delta Dental Premier: 50%, up to $2,500

OUT-OF-NETWORK50%, up to $2,500

Dental premium contributions are deducted from your paycheck on a pre-tax basis. Your tier of coverage determines your premium.

Plan Notes

After you have satisfied the deductible, if any, the Dental Plan pays the following percentages of the treatment cost, up to a maximum fee per procedure. The maximum fee allowed by Delta Dental is different for Delta Dental PPO™ dentists, Delta Dental Premier® dentists, and nonparticipating dentists. If you see a nonparticipating dentist, your out-of-pocket expenses may increase. If a Delta Dental PPO™ dentist provides dental services, the deductible will be waived and the payment percentages may increase, resulting in lower out-of-pocket costs. To find a network dentist, visit Delta Dental of MN at deltadentalmn.org.
Dental premium contributions are deducted from your paycheck on a pre-tax basis. Your tier of coverage determines your premium.
Preventive services are covered at 90% in-network (80% out-of-network), and orthodontics are covered at 50% up to a lifetime maximum of $3,000 with a Delta Dental PPO provider ($2,500 with Delta Dental Premier or out-of-network).