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Solera Dental Health Insurance in CALIFORNIA – Health Plan Options

Solera Dental — Salud PPO 15

A comparison of the Salud PPO 15 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Visit to physician (including specialist consultations)- $15 (deductible waived)	50% after deductible
Copay	Visit to physician (including specialist consultations)- $15 (deductible waived)	N/A
Deductible	$1,500 single/2 per family	$3,000 single/2 per family

Solera Dental — Salud PPO 25

A comparison of the Salud PPO 25 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Visit to physician (including specialist consultations)- $25 (deductible waived)	50% after deductible
Copay	Visit to physician (including specialist consultations)- $25 (deductible waived)	N/A
Deductible	$2,500 single/2 per family	$5,000 single/2 per family

Solera Dental — Salud HMO Y Mas 10

A comparison of the Salud HMO Y Mas 10 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Visit to physician (including specialist consultations)- $10	Visit to physician (including specialist consultations)- $10
Copay	Visit to physician (including specialist consultations)- $10	Visit to physician (including specialist consultations)- $10
Deductible	N/A	N/A

Solera Dental — Salud HMO Y Mas 25

A comparison of the Salud HMO Y Mas 25 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Visit to physician (including specialist consultations)- $25	Visit to physician (including specialist consultations)- $25
Copay	Visit to physician (including specialist consultations)- $25	Visit to physician (including specialist consultations)- $25
Deductible	N/A	N/A

Solera Dental — HMO 40

A comparison of the HMO 40 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Visit to physician: $40 Specialist consultations: $40 Prenatal and postnatal office visits: $40	Visit to physician: $40 Specialist consultations: $40 Prenatal and postnatal office visits: $40
Copay	$40	$40
Deductible	$1,500 per calendar year for inpatient hospital services only(prescription deductible applies)	$1,500 per calendar year for inpatient hospital services only(prescription deductible applies)

Solera Dental — HMO 15

A comparison of the HMO 15 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Visit to physician: $15 Specialist consultations: $15 Prenatal and postnatal office visits: $15	Visit to physician: $15 Specialist consultations: $15 Prenatal and postnatal office visits: $15
Copay	$15	$15
Deductible	$1,000 per calendar year for inpatient hospital services only(prescription deductible applies)	$1,000 per calendar year for inpatient hospital services only(prescription deductible applies)

Solera Dental — Optimum Advantage HSA 4500

A comparison of the Optimum Advantage HSA 4500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	100% after deductible	50%
Copay	N/A	N/A
Deductible	$4,500 ($9,000 per family)	$4,500 ($9,000 per family)

Solera Dental — Optimum Advantage HSA 2500

A comparison of the Optimum Advantage HSA 2500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	100% after deductible	50%
Copay	N/A	N/A
Deductible	Single: $2,500, Family: $5,000	Single: $2,500, Family: $5,000

Solera Dental — NetFirst Combo Rx

A comparison of the NetFirst Combo Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	65%	50%
Office Visit	$35 copay	50%
Copay	$35 copay	50%
Deductible	$0 (Individual only)	$0 (Individual only)

Solera Dental — NetFirst Generic Rx

A comparison of the NetFirst Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	65%	50%
Office Visit	$35 copay	50%
Copay	$35 copay	50%
Deductible	$0 (Individual only)	$0 (Individual only)

Solera Dental — ValueNet

A comparison of the ValueNet offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	65%	50%
Office Visit	$35 copay (deductible waived for first 2 visits of any combination of professional services and preventive care), additional visits- 65% after deductible	50%
Copay	$35 copay (deductible waived for first 2 visits of any combination of professional services and preventive care), additional visits- 65% after deductible	50%
Deductible	$4,000 (Individual only)	$4,000 (Individual only)

Solera Dental — BalanceNet

A comparison of the BalanceNet offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	65%	50%
Office Visit	$35 copay (deductible waived for first 2 visits of any combination of professional services and preventive care), additional visits- 65% after deductible	50%
Copay	$35 copay (deductible waived for first 2 visits of any combination of professional services and preventive care), additional visits- 65% after deductible	50%
Deductible	$3,500 Individual, $7,000 Family	$3,500 Individual, $7,000 Family

Solera Dental — CFB Saver II $1,800

A comparison of the CFB Saver II $1,800 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	No charge after deductible is met	50% after deductible is met
Copay	$40 (deductible waived)	Not covered
Deductible	$1,800 per member / $3,600 per family	$1,800 per member / $3,600 per family

Solera Dental — CFB Saver II $2,800

A comparison of the CFB Saver II $2,800 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	No charge after deductible is met	50% after deductible is met
Copay	$40 copay (deductible waived)	Not covered
Deductible	Individual: $2,800 per member, Family: $5,600 per family	Individual: $2,800 per member, Family: $5,600 per family

Solera Dental — CFB Saver II $3,800

A comparison of the CFB Saver II $3,800 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	No charge after deductible is met	50% after deductible is met
Copay	$40 copay (deductible waived)	Not Covered
Deductible	Individual: $3,800 per member, Family: $7,600 per family	Individual: $3,800 per member, Family: $7,600 per family

Solera Dental — CFB Saver II $4,800

A comparison of the CFB Saver II $4,800 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	No charge after deductible is met	50% after deductible is met
Copay	$40 copay (deductible waived)	50% after deductible is met
Deductible	Individual: $4,800 per member / Family: $9,600 per family	Individual: $4,800 per member / Family: $9,600 per family

Solera Dental — CFB Lifestyle II $2,000 3-Tier Rx

A comparison of the CFB Lifestyle II $2,000 3-Tier Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	$20 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Copay	$20 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Deductible	Individual: $2,000 per member, Family: $4,000 per family	Individual: $2,000 per member, Family: $4,000 per family

Solera Dental — CFB Lifestyle II $2,000 Generic Rx

A comparison of the CFB Lifestyle II $2,000 Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	$20 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Copay	$20 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Deductible	Individual: $2,000 per member, Family: $4,000 per family	Individual: $2,000 per member, Family: $4,000 per family

Solera Dental — CFB Lifestyle II $3,000 3-Tier Rx

A comparison of the CFB Lifestyle II $3,000 3-Tier Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	$30 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Copay	$30 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Deductible	see brochure	see brochure

Solera Dental — CFB Lifestyle II $3,000 Generic Rx

A comparison of the CFB Lifestyle II $3,000 Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	$30 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Copay	$30 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Deductible	Individual: $3,000 per member, Family: $6,000 per family	Individual: $3,000 per member, Family: $6,000 per family

Solera Dental — CFB Lifestyle II $4,000 3-Tier Rx

A comparison of the CFB Lifestyle II $4,000 3-Tier Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	$40 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Copay	$40 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Deductible	Individual: $4,000 per member, Family: $8,000 per family	Individual: $4,000 per member, Family: $8,000 per family

Solera Dental — CFB Lifestyle II $4,000 Generic Rx

A comparison of the CFB Lifestyle II $4,000 Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	$40 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Copay	$40 copay (deductible waived for first 4 visits of any combination of professional services and preventive care)	50% after deductible is met
Deductible	Individual: $4,000 per member, Family: $8,000 per family	Individual: $4,000 per member, Family: $8,000 per family

Solera Dental — CFB Primary

A comparison of the CFB Primary offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible is met	50% after deductible is met
Office Visit	$40 copay (deductible waived for first 2 visits of any combination of professional services and preventive care)	50% after deductible is met
Copay	$40 copay (deductible waived for first 2 visits of any combination of professional services and preventive care)	50% after deductible is met
Deductible	$6,000 (subscriber only contract)	$6,000 (subscriber only contract)

Solera Dental — Managed Choice Open Access First Dollar 30

A comparison of the Managed Choice Open Access First Dollar 30 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

Solera Dental — Managed Choice Open Access First Dollar 40

A comparison of the Managed Choice Open Access First Dollar 40 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-specialist Office Visit: $40 Copay, Specialist Visit: $50 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: $40 Copay, Specialist Visit: $50 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $0, Family: $0	Individual: $7,000, Family: $14,000

Solera Dental — Managed Choice Open Access 2500

A comparison of the Managed Choice Open Access 2500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — Managed Choice Open Access 5000

A comparison of the Managed Choice Open Access 5000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $40 copay deductible waived (Unlimited visits), Specialist Visit: $50 copay deductible waived (Unlimited visits)	Non-specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit: $40 copay deductible waived (Unlimited visits), Specialist Visit: $50 copay deductible waived (Unlimited visits)	Non-specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Managed Choice Open Access Value 1500

A comparison of the Managed Choice Open Access Value 1500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Non-specialist Office Visit: 75% after deductible, Specialist Visit: 75% after deductible	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Office Visit	Non-specialist Office Visit: 75% after deductible, Specialist Visit: 75% after deductible	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: 75% after deductible, Specialist Visit: 75% after deductible	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — Managed Choice Open Access Value 2500

A comparison of the Managed Choice Open Access Value 2500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: Visits 1-2: $40 copay, ded. Waived; Visits 3+: 70% after ded. Spec. and Non-Spec. share visit max. Specialist Visit: Visits 1-2: $40 copay, ded. Waived; Visits 3+: 70% after ded. Spec. and Non-Spec. share visit max.	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: Visits 1-2: $40 copay, ded. Waived; Visits 3+: 70% after ded. Spec. and Non-Spec. share visit max. Specialist Visit: Visits 1-2: $40 copay, ded. Waived; Visits 3+: 70% after ded. Spec. and Non-Spec. share visit max.	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — Managed Choice Open Access Value 5000

A comparison of the Managed Choice Open Access Value 5000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits); Specialist Visit: Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits). Specialist and Non-Specialist share visit max.	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits); Specialist Visit: Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits). Specialist and Non-Specialist share visit max.	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Managed Choice Open Access Value 8000

A comparison of the Managed Choice Open Access Value 8000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist: 70% after deductible, Specialist: 70% after deductible	Non-Specialist: 50% after deductible, Specialist: 50% after deductible
Copay	Non-Specialist: 70% after deductible, Specialist: 70% after deductible	Non-Specialist: 50% after deductible, Specialist: 50% after deductible
Deductible	Individual: $8,000, Family: $16,000	Individual: $10,000, Family: $20,000

Solera Dental — Managed Choice Open Access High Deductible 3000 (HSA Compatible)

A comparison of the Managed Choice Open Access High Deductible 3000 (HSA Compatible) offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: 100% after deductible (Unlimited Visits), Specialist Visit: 100% after deductible (Unlimited Visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: 100% after deductible (Unlimited Visits), Specialist Visit: 100% after deductible (Unlimited Visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — Managed Choice Open Access High Deductible 5000 (HSA Compatible)

A comparison of the Managed Choice Open Access High Deductible 5000 (HSA Compatible) offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: 100% after deductible (Unlimited visits), Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: 100% after deductible (Unlimited visits), Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Managed Choice Open Access Preventative and Hospital Care 1250

A comparison of the Managed Choice Open Access Preventative and Hospital Care 1250 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Not Covered	Not Covered
Copay	Not Covered	Not Covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Solera Dental — Managed Choice Open Access Preventative and Hospital Care 3000 (HSA Compatible)

A comparison of the Managed Choice Open Access Preventative and Hospital Care 3000 (HSA Compatible) offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Not Covered	Not Covered
Copay	Not Covered	Not Covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — Managed Choice Open Access First Dollar 30 with Dental

A comparison of the Managed Choice Open Access First Dollar 30 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $500, Family: $1,000

Solera Dental — Managed Choice Open Access First Dollar 40 with Dental

A comparison of the Managed Choice Open Access First Dollar 40 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $500, Family: $1,000

Solera Dental — Managed Choice Open Access 2500 with Dental

A comparison of the Managed Choice Open Access 2500 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $30 copay deductible waived (Unlimited Visits), Specialist Visit: $40 copay deductible waived (Unlimited Visits)	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $30 copay deductible waived (Unlimited Visits), Specialist Visit: $40 copay deductible waived (Unlimited Visits)	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.mited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — Managed Choice Open Access 5000 with Dental

A comparison of the Managed Choice Open Access 5000 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $40 copay deductible waived (Unlimited visits), Specialist Visit: $50 copay deductible waived (Unlimited visits)	Non-specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit: $40 copay deductible waived (Unlimited visits), Specialist Visit: $50 copay deductible waived (Unlimited visits)Unlimited visits)	Non-specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Managed Choice Open Access Value 1500 with Dental

A comparison of the Managed Choice Open Access Value 1500 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Non-specialist Office Visit: 75% after deductible, Specialist Visit: 75% after deductible	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Office Visit	Non-specialist Office Visit: 75% after deductible, Specialist Visit: 75% after deductible	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: 75% after deductible, Specialist Visit: 75% after deductible	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — Managed Choice Open Access Value 2500 with Dental

A comparison of the Managed Choice Open Access Value 2500 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: Visits 1-2: $40 copay, ded. Waived; Visits 3+: 70% after ded. Spec. and Non-Spec. share visit max. Specialist Visit: Visits 1-2: $40 copay, ded. Waived; Visits 3+: 70% after ded. Spec. and Non-Spec. share visit max.	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: Visits 1-2: $40 copay, ded. Waived; Visits 3+: 70% after ded. Spec. and Non-Spec. share visit max. Specialist Visit: Visits 1-2: $40 copay, ded. Waived; Visits 3+: 70% after ded. Spec. and Non-Spec. share visit max.	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — Managed Choice Open Access Value 5000 with Dental

A comparison of the Managed Choice Open Access Value 5000 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist: 70% after deductible, Specialist: 70% after deductible	Non-Specialist: 50% after deductible (Unlimited visits), Specialist: 50% after deductible (Unlimited visits)
Copay	Non-Specialist: 70% after deductible, Specialist: 70% after deductible	Non-Specialist: 50% after deductible (Unlimited visits), Specialist: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Managed Choice Open Access Value 8000 with Dental

A comparison of the Managed Choice Open Access Value 8000 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist: 70% after deductible, Specialist: 70% after deductible	Non-Specialist: 50% after deductible, Specialist: 50% after deductible
Copay	Non-Specialist: 70% after deductible, Specialist: 70% after deductible	Non-Specialist: 50% after deductible, Specialist: 50% after deductible
Deductible	Individual: $8,000, Family: $16,000	Individual: $10,000, Family: $20,000

Solera Dental — Managed Choice Open Access High Deductible 3000 (HSA Compatible) with Dental

A comparison of the Managed Choice Open Access High Deductible 3000 (HSA Compatible) with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: 100% after deductible (Unlimited Visits), Specialist Visit: 100% after deductible (Unlimited Visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: 100% after deductible (Unlimited Visits), Specialist Visit: 100% after deductible (Unlimited Visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — Managed Choice Open Access High Deductible 5000 (HSA Compatible) with Dental

A comparison of the Managed Choice Open Access High Deductible 5000 (HSA Compatible) with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: 100% after deductible (Unlimited visits), Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited Visits), Specialist Visit: 70% after deductible (Unlimited Visits)Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialis
Copay	Non-Specialist Office Visit: 100% after deductible (Unlimited visits), Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited Visits), Specialist Visit: 70% after deductible (Unlimited Visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Managed Choice Open Access Preventative and Hospital Care 1250 with Dental

A comparison of the Managed Choice Open Access Preventative and Hospital Care 1250 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Not Covered	Not Covered
Copay	Not Covered	Not Covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Solera Dental — Managed Choice Open Access Preventative and Hospital Care 3000 (HSA Compatible) with Dental

A comparison of the Managed Choice Open Access Preventative and Hospital Care 3000 (HSA Compatible) with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Not Covered	Not Covered
Copay	Not Covered	Not Covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — Managed Choice Open Access 3500

A comparison of the Managed Choice Open Access 3500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $35 copay, deductible waived (Unlimited visits); Specialist Visit: $45 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $35 copay, deductible waived (Unlimited visits); Specialist Visit: $45 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Solera Dental — Managed Choice Open Access 3500 with Dental

A comparison of the Managed Choice Open Access 3500 with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $35 copay, deductible waived (Unlimited visits); Specialist Visit: $45 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $35 copay, deductible waived (Unlimited visits); Specialist Visit: $45 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Solera Dental — Open Access 1000

A comparison of the Open Access 1000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $30 copay, Specialist: $40 copay	Primary Care Physician: CIGNA pays 50% after deductible, Specialist: CIGNA pays 50% after deductible
Copay	Primary Care Physician: $30 copay, Specialist: $40 copay	Primary Care Physician: CIGNA pays 50% after deductible, Specialist: CIGNA pays 50% after deductible
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

Solera Dental — Open Access 1500

A comparison of the Open Access 1500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charge	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $30 copay, Specialist: $40 copay	Primary Care Physician: CIGNA pays 50% after deductible, Specialist: CIGNA pays 50% after deductible
Copay	Primary Care Physician: $30 copay, Specialist: $40 copay	Primary Care Physician: CIGNA pays 50% after deductible, Specialist: CIGNA pays 50% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — Open Access 2000

A comparison of the Open Access 2000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician: $25 copay, deductible waived, Specialist: $45 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician: $25 copay, deductible waived, Specialist: $45 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $2,000, Family: $4,000	Individual: $4,000, Family: $8,000

Solera Dental — Open Access 3000

A comparison of the Open Access 3000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% after plan deductible	CIGNA pays 60% after plan deductible
Office Visit	Primary Care Physician - $30 copay (deductible waived), Specialist - $60 copay (deductible waived)	CIGNA pays 60% after plan deductible
Copay	Primary Care Physician - $30, Specialist - $60	CIGNA pays 60% after plan deductible
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — Open Access 5000

A comparison of the Open Access 5000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician: $40 copay, deductible waived, Specialist: $60 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician: $40 copay, deductible waived, Specialist: $60 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Health Savings 1900

A comparison of the Health Savings 1900 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: CIGNA pays 70% after deductible, Specialist: CIGNA pays 70% after deductible	Primary Care Physician: CIGNA pays 50% after deductible, Specialist: CIGNA pays 50% after deductible
Copay	N/A	N/A
Deductible	Individual: $1,900, Family: $3,800	Individual: $3,800, Family: $7,600

Solera Dental — Health Savings 3400

A comparison of the Health Savings 3400 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: CIGNA pays 100% after deductible, Specialist: CIGNA pays 100% after deductible	Primary Care Physician: CIGNA pays 50% after deductible, Specialist: CIGNA pays 50% after deductible
Copay	N/A	N/A
Deductible	Individual: $3,400, Family: $6,800	Individual: $6,000, Family: $13,600

Solera Dental — Health Savings 4900

A comparison of the Health Savings 4900 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: CIGNA pays 100% after deductible, Specialist: CIGNA pays 100% after deductible	Primary Care Physician: CIGNA pays 50% after deductible, Specialist: CIGNA pays 50% after deductible
Copay	N/A	N/A
Deductible	Individual: $4,900, Family: $9,800	Individual: $9,800, Family: $19,600

Solera Dental — Personal Benefit HDHP $1,500/100-50

A comparison of the Personal Benefit HDHP $1,500/100-50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Deductible, then Coinsurance	Deductible, then Coinsurance
Copay	N/A	N/A
Deductible	$1,500 Individual, $3,000 Family	$3,000 Individual, $6,000 Family

Solera Dental — Personal Benefit HDHP $2,700/100-50

A comparison of the Personal Benefit HDHP $2,700/100-50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Deductible, then Coinsurance	Deductible, then Coinsurance
Copay	N/A	N/A
Deductible	$2,700 Individual, $5,400 Family	$5,400 Individual, $10,800 Family

Solera Dental — Personal Benefit HDHP $5,000/100-50

A comparison of the Personal Benefit HDHP $5,000/100-50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Deductible, then Coinsurance	Deductible, then Coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individuals, $10,000 Family	$10,000 Individuals, $20,000 Family

Solera Dental — SignatureValue 10-35/250

A comparison of the SignatureValue 10-35/250 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Primary Doctor- $10 Copay Specialist- $35 Copay	Primary Doctor- $10 Copay Specialist- $35 Copay
Copay	Primary Doctor- $10 Copay Specialist- $35 Copay	Primary Doctor- $10 Copay Specialist- $35 Copay
Deductible	N/A	N/A

Solera Dental — SignatureValue 20-35/80

A comparison of the SignatureValue 20-35/80 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% Cost Copayment	80% Cost Copayment
Office Visit	Primary Doctor- $20 Copay Specialist- $35 Copay	Primary Doctor- $20 Copay Specialist- $35 Copay
Copay	Primary Doctor- $20 Copay Specialist- $35 Copay	Primary Doctor- $20 Copay Specialist- $35 Copay
Deductible	N/A	N/A

Solera Dental — SignatureValue 35/70

A comparison of the SignatureValue 35/70 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% Cost Copayment	70% Cost Copayment
Office Visit	$35 Copay	$35 Copay
Copay	$35 Copay	$35 Copay
Deductible	N/A	N/A

Solera Dental — SignatureValue 35/50

A comparison of the SignatureValue 35/50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% Cost Copayment	50% Cost Copayment
Office Visit	$35 Copay	$35 Copay
Copay	$35 Copay	$35 Copay
Deductible	N/A	N/A

Solera Dental — Personal Select $40/$5,000/70-50

A comparison of the Personal Select $40/$5,000/70-50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	$40 Copay	Deductible, then Coinsurance
Copay	$40	N/A
Deductible	$5,000 Individual, $10,000 Family	$10,000 Individual, $20,000 Family

Solera Dental — Personal Select $40/$3,000/70-50

A comparison of the Personal Select $40/$3,000/70-50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	$40 Copay	Deductible, then Coinsurance
Copay	$40	N/A
Deductible	$3,000 Individual, $6,000 Family	$6,000 Individual, $12,000 Family

Solera Dental — Personal Select $40/$2,000/70-50

A comparison of the Personal Select $40/$2,000/70-50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	$40 Copay	Deductible, then Coinsurance
Copay	$40	N/A
Deductible	$2,000 Individual, $4,000 Family	$4,000 Individual, $8,000 Family

Solera Dental — Personal Select $40/$1,000/70-50

A comparison of the Personal Select $40/$1,000/70-50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	$40 Copay	Deductible, then Coinsurance
Copay	$40	N/A
Deductible	$1,000 Individual, $2,000 Family	$2,000 Individual, $4,000 Family

Solera Dental — Personal Select $40/$500/70-50

A comparison of the Personal Select $40/$500/70-50 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	$40 Copay	Deductible, then Coinsurance
Copay	$40	N/A
Deductible	$500 Individual, $1,000 Family	$1,000 Individual, $2,000 Family

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — Short Term Medical

A comparison of the Short Term Medical offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Solera Dental — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Solera Dental — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Solera Dental — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Solera Dental — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Solera Dental — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Solera Dental — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Solera Dental — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Solera Dental — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Solera Dental — Blue Cross of California PPO Share 3500

A comparison of the Blue Cross of California PPO Share 3500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% of negotiated fee	50% of negotiated fee
Office Visit	$40 copay (Deductible waived)	50% of negotiated fee, plus all excess charges (Deductible waived)
Copay	$40	N/A
Deductible	$3,500 per member Each member has an individual deductible, once 2 members reach the deductible, the deductible is satisfied for the entire family	$3,500 per member Each member has an individual deductible, once 2 members reach the deductible, the deductible is satisfied for the entire family

Solera Dental — Blue Cross of California PPO Share 7500

A comparison of the Blue Cross of California PPO Share 7500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	$40 copay (Deductible waived)	50% of negotiated fee, plus all excess charges (Deductible waived)
Copay	$40	N/A
Deductible	$7,500 per member Each member has an individual deductible, once 2 members reach the deductible, the deductible is satisfied for the entire family	$7,500 per member Each member has an individual deductible, once 2 members reach the deductible, the deductible is satisfied for the entire family

Solera Dental — Blue Cross of California HMO Saver

A comparison of the Blue Cross of California HMO Saver offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Unlimited office visits, $10 copay	Unlimited office visits, $10 copay
Copay	$10	$10
Deductible	$1,500/member Inpatient hospital services, outpatient Ambulatory Surgical Centers only	$1,500/member Inpatient hospital services, outpatient Ambulatory Surgical Centers only

Solera Dental — Blue Cross of California Individual HMO

A comparison of the Blue Cross of California Individual HMO offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Unlimited office visits, $10 copay	Unlimited office visits, $10 copay
Copay	$10	$10
Deductible	No deductible	No deductible

Solera Dental — Individual Select HMO

A comparison of the Individual Select HMO offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% Covered	80% Covered
Office Visit	Unlimited office visits, $25 copay	Unlimited office visits, $25 copay
Copay	$25	$25
Deductible	No deductible	No deductible

Solera Dental — BC Life & Health PPO Share 5000

A comparison of the BC Life & Health PPO Share 5000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	$40 copy, deductible waived	Covered at 50% of negotiated fee plus all excess charges(deductible waived).
Copay	$40 copay (deductible waived)	N/A
Deductible	$5,000/member Once 2 members each reach the deductible, the deductible is satisfied for the entire family.	$5,000/member Once 2 members each reach the deductible, the deductible is satisfied for the entire family.

Solera Dental — CORE 5000

A comparison of the CORE 5000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	No office benefit until out-of-pocket maximum is met, then you pay $0 of negotiated fee	No office benefit until out-of-pocket maximum is met, then you pay 50% of negotiated fee plus all excess charges
Copay	N/A	N/A
Deductible	$5,000 per member, inpatient or surgical procedures only (Once 2 members each reach the deductible, the deductible is satisfied for the entire family.)	$5,000 per member, inpatient or surgical procedures only (Once 2 members each reach the deductible, the deductible is satisfied for the entire family.)

Solera Dental — BC Life & Health Basic PPO 2500

A comparison of the BC Life & Health Basic PPO 2500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	No office visit benefituntil out-of-pocket maximum is met, then covered at 100% ofnegotiated fee.	No office visit benefit until out-of-pocket maximum is met, then covered at 50% of negotiated fee plus excess
Copay	N/A	N/A
Deductible	$2,500/member, inpatient or surgical procedures only Once 2 members each reach the deductible, the deductible is satisfied for the entire family.	$2,500/member, inpatient or surgical procedures only Once 2 members each reach the deductible, the deductible is satisfied for the entire family.

Solera Dental — BC Life & Health Basic PPO 1000

A comparison of the BC Life & Health Basic PPO 1000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	No office visit benefituntil out-of-pocket maximum is met, then covered at 100% ofnegotiated fee.	No office visit benefit until out-of-pocket maximum is met, then covered at 50% of negotiated fee plus excess
Copay	N/A	N/A
Deductible	$1,000/member, inpatient or surgical procedures only Once 2 members each reach the deductible, the deductible is satisfied for the entire family.	$1,000/member, inpatient or surgical procedures only Once 2 members each reach the deductible, the deductible is satisfied for the entire family.

Solera Dental — Tonik 1500 - Calculated Risk-Taker

A comparison of the Tonik 1500 - Calculated Risk-Taker offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Member pays a $40 copayment for each office visit.	After meeting the annual deductible, member pays 50% of covered expense plus all excess charges for each office visit.
Copay	$40	You pay 50% of covered expenses plus all charges in excess of Covered Expense
Deductible	$1,500	$1,500

Solera Dental — Tonik 3000 - Part-Time Daredevil

A comparison of the Tonik 3000 - Part-Time Daredevil offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Member pays a $30 copayment for the first four (4) office visits in a calendar year.	After meeting the annual deductible, member pays 50% of covered expense plus all excess charges for each office visit.
Copay	$30	$30
Deductible	$3,000	$3,000

Solera Dental — Tonik 5000 - Thrill-Seeker

A comparison of the Tonik 5000 - Thrill-Seeker offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Member pays a $20 copayment for the first four (4) office visits in a calendar year.	After meeting the annual deductible, member pays 50% of covered expense plus all excess charges for each office visit.
Copay	$20	$20
Deductible	$5,000	$5,000

Solera Dental — RightPlan PPO 40 full Rx

A comparison of the RightPlan PPO 40 full Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60%	50%
Office Visit	Doctors' Office Visits- $40	Doctors' Office Visits- 50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $40	Doctors' Office Visits- 50% of negotiated fee plus all excess charges
Deductible	$0	$0

Solera Dental — RightPlan PPO 40 generic only Rx

A comparison of the RightPlan PPO 40 generic only Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60%	50%
Office Visit	Doctors' Office Visits- $40	Doctors' Office Visits- 50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $40	Doctors' Office Visits- 50% of negotiated fee plus all excess charges
Deductible	$0	$0

Solera Dental — RightPlan PPO 40 no Rx

A comparison of the RightPlan PPO 40 no Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60%	50%
Office Visit	Doctors' Office Visits- $40	Doctors' Office Visits- 50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $40	Doctors' Office Visits- 50% of negotiated fee plus all excess charges
Deductible	$0	$0

Solera Dental — BC Life & Health 3500 Deductible PPO

A comparison of the BC Life & Health 3500 Deductible PPO offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	$0	50% of negotiated fee plus all excess charges
Copay	N/A	N/A
Deductible	$3,500/member (2 family member maximum)	$3,500/member (2 family member maximum)

Solera Dental — PPO 3500 HSA Compatible Plan

A comparison of the PPO 3500 HSA Compatible Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	$0	50% of negotiated fee plus all excess charges.
Copay	N/A	N/A
Deductible	Single member: $3,500 Families: $7,000 aggregate	Single member: $3,500 Families: $7,000 aggregate

Solera Dental — BC Life & Health PPO Saver

A comparison of the BC Life & Health PPO Saver offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Children: 4 office visitsper year at $30 copay/visit Adults: 2 office visits per year at $30 copay/visit (deductible waived)	Children: 4 office visitsper year. Adults: 2 office visits per year; 50% of negotiated fee plus excess (deductible waived)
Copay	$30	N/A
Deductible	$500 inpatient or surgical procedures only, $5,000 other covered services (2-member maximum) All covered benefits	$500 inpatient or surgical procedures only, $5,000 other covered services (2-member maximum) All covered benefits

Solera Dental — SmartSense 500 with Generic Only

A comparison of the SmartSense 500 with Generic Only offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived); after three visits and once deductible is met, then 70% of negotiated fee	50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived)	N/A
Deductible	$500 Single, $1,000 Family	$5,000 Single, $10,000 Family

Solera Dental — SmartSense 1500 with Generic Only

A comparison of the SmartSense 1500 with Generic Only offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived); after three visits and once deductible is met, then 70% of negotiated fee	50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived)	N/A
Deductible	$1,500 Single, $3,000 Family	$5,000 Single, $10,000 Family

Solera Dental — SmartSense 2500 with Generic Only

A comparison of the SmartSense 2500 with Generic Only offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived); after three visits and once deductible is met, then 70% of negotiated fee	50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived)	N/A
Deductible	$2,500 Single, $5,000 Family	$5,000 Single, $10,000 Family

Solera Dental — SmartSense 5000 with Generic Only

A comparison of the SmartSense 5000 with Generic Only offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived); after three visits and once deductible is met, then 70% of negotiated fee	50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived)	N/A
Deductible	$5,000 Single, $10,000 Family	$5,000 Single, $10,000 Family

Solera Dental — SmartSense 500 with Comprehensive Rx

A comparison of the SmartSense 500 with Comprehensive Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived); after three visits and once deductible is met, then 70% of negotiated fee	50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived)	N/A
Deductible	$500 Single, $1,000 Family	$5,000 Single, $10,000 Family

Solera Dental — SmartSense 1500 with Comprehensive Rx

A comparison of the SmartSense 1500 with Comprehensive Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived); after three visits and once deductible is met, then 70% of negotiated fee	50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived)	N/A
Deductible	$1,500 Single, $3,000 Family	$5,000 Single, $10,000 Family

Solera Dental — SmartSense 2500 with Comprehensive Rx

A comparison of the SmartSense 2500 with Comprehensive Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived); after three visits and once deductible is met, then 70% of negotiated fee	50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived)	N/A
Deductible	$2,500 Single, $5,000 Family	$5,000 Single, $10,000 Family

Solera Dental — SmartSense 5000 with Comprehensive Rx

A comparison of the SmartSense 5000 with Comprehensive Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived); after three visits and once deductible is met, then 70% of negotiated fee	50% of negotiated fee plus all excess charges
Copay	Doctors' Office Visits- $30 copay for the first three visits (applies to first three preventive care visits and/or doctors' office visits) per member per year (deductible waived)	N/A
Deductible	$5,000 Single, $10,000 Family	$5,000 Single, $10,000 Family

Solera Dental — Lumenos HSA w/out Maternity

A comparison of the Lumenos HSA w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,500 Individual, $3,000 Family	$1,500 Individual, $3,000 Family

Solera Dental — Lumenos HSA w/out Maternity

A comparison of the Lumenos HSA w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,000 Individual, $6,000 Family	$3,000 Individual, $6,000 Family

Solera Dental — Lumenos HSA w/out Maternity

A comparison of the Lumenos HSA w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — Lumenos HIA w/out Maternity

A comparison of the Lumenos HIA w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,500 Individual, $3,000 Family	$1,500 Individual, $3,000 Family

Solera Dental — Lumenos HIA w/out Maternity

A comparison of the Lumenos HIA w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,000 Individual, $6,000 Family	$3,000 Individual, $6,000 Family

Solera Dental — Lumenos HIA w/out Maternity

A comparison of the Lumenos HIA w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — Lumenos HIA Plus w/out Maternity

A comparison of the Lumenos HIA Plus w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	60%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,500 Individual, $3,000 Family	$1,500 Individual, $3,000 Family

Solera Dental — Lumenos HIA Plus w/out Maternity

A comparison of the Lumenos HIA Plus w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	60%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,000 Individual, $6,000 Family	$3,000 Individual, $6,000 Family

Solera Dental — Lumenos HIA Plus w/out Maternity

A comparison of the Lumenos HIA Plus w/out Maternity offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — Lumenos HSA

A comparison of the Lumenos HSA offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — Lumenos HIA

A comparison of the Lumenos HIA offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — Lumenos HIA Plus

A comparison of the Lumenos HIA Plus offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — Celtic Basic

A comparison of the Celtic Basic offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — Celtic Basic

A comparison of the Celtic Basic offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — Celtic Basic

A comparison of the Celtic Basic offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$5,000	$5,000

Solera Dental — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$2,600	$2,600

Solera Dental — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$1,500	$1,500

Solera Dental — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$2,600	$2,600

Solera Dental — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$1,500	$1,500

Solera Dental — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Solera Dental — Access+ HMO

A comparison of the Access+ HMO offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Professional Services: Personal Physician office visits: $20/visit Injectable medications, lab, and X-ray: $20 Access+ Specialist (self-referred physician office visits or other consultations only): $35/visit Physician home visits: $35	Professional Services: Personal Physician office visits: $20/visit Injectable medications, lab, and X-ray: $20 Access+ Specialist (self-referred physician office visits or other consultations only): $35/visit Physician home visits: $35
Copay	Professional Services: Personal Physician office visits: $20/visit Injectable medications, lab, and X-ray: $20 Access+ Specialist (self-referred physician office visits or other consultations only): $35/visit Physician home visits: $35	Professional Services: Personal Physician office visits: $20/visit Injectable medications, lab, and X-ray: $20 Access+ Specialist (self-referred physician office visits or other consultations only): $35/visit Physician home visits: $35
Deductible	$2,000 ($4,000 family)	$2,000 ($4,000 family)

Solera Dental — Access+ Value HMO

A comparison of the Access+ Value HMO offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Professional Services: Personal Physician office visits: $35/visit Injectable medications, lab, and X-ray: $35 Access+ Specialist (self-referred physician office visits or other consultations only): $50/visit Physician home visits: $50	Professional Services: Personal Physician office visits: $35/visit Injectable medications, lab, and X-ray: $35 Access+ Specialist (self-referred physician office visits or other consultations only): $50/visit Physician home visits: $50
Copay	Professional Services: Personal Physician office visits: $35/visit Injectable medications, lab, and X-ray: $35 Access+ Specialist (self-referred physician office visits or other consultations only): $50/visit Physician home visits: $50	Professional Services: Personal Physician office visits: $35/visit Injectable medications, lab, and X-ray: $35 Access+ Specialist (self-referred physician office visits or other consultations only): $50/visit Physician home visits: $50
Deductible	$2,000 ($4,000 family)	$2,000 ($4,000 family)

Solera Dental — Active Start Plan 25

A comparison of the Active Start Plan 25 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $25	Office Visits: 50%
Copay	$25 with preferred providers	Not applicable with non-preferred providers
Deductible	$0	$0

Solera Dental — Active Start Plan 25 Generic Rx

A comparison of the Active Start Plan 25 Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $25	Office Visits: 50%
Copay	$25 with preferred providers	Not applicable with non-preferred providers
Deductible	$0	$0

Solera Dental — Active Start Plan 35

A comparison of the Active Start Plan 35 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $35	Office Visits: 50%
Copay	$35 with preferred providers	Not applicable with non-preferred providers
Deductible	$0	$0

Solera Dental — Active Start Plan 35 Generic Rx

A comparison of the Active Start Plan 35 Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $35	Office Visits: 50%
Copay	$35 with preferred providers	Not applicable with non-preferred providers
Deductible	$0	$0

Solera Dental — Balance Plan 1000

A comparison of the Balance Plan 1000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visit: $30	Office Visit: 50%
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,000 ($2,000 family)	$1,000 ($2,000 family)

Solera Dental — Balance Plan 1700

A comparison of the Balance Plan 1700 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visit: $30	Office Visit: 50%
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,700 ($3,400 family)	$1,700 ($3,400 family)

Solera Dental — Balance Plan 2500

A comparison of the Balance Plan 2500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visit: $30	Office Visit: 50%
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	$2,500 ($5,000 family)	$2,500 ($5,000 family)

Solera Dental — BS Life PPO 1500

A comparison of the BS Life PPO 1500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $40	Office Visits: 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,500 ($3,000 family)	$1,500 ($3,000 family)

Solera Dental — BS Life PPO 2000

A comparison of the BS Life PPO 2000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $45	Office Visits: 50%
Copay	$45 with preferred providers	Not applicable with non-preferred providers
Deductible	$2,000 ($4,000 family)	$2,000 ($4,000 family)

Solera Dental — Essential Plan 1750

A comparison of the Essential Plan 1750 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): $40 (No charge after deductible)	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,750	$1,750

Solera Dental — Essential Plan 3000

A comparison of the Essential Plan 3000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): $40 (No charge after deductible)	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$3,000	$3,000

Solera Dental — Essential Plan 4500

A comparison of the Essential Plan 4500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): $40 (No charge after deductible)	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$4,500	$4,500

Solera Dental — Shield Spectrum PPO Savings Plan 3500

A comparison of the Shield Spectrum PPO Savings Plan 3500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	No charge after deductible with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: No charge after deductible	Office Visits: 50%
Copay	see brochure	see brochure
Deductible	Services with preferred providers: $3,500 ($7,000 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Solera Dental — Shield Spectrum PPO Savings Plan 5200

A comparison of the Shield Spectrum PPO Savings Plan 5200 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	No charge after deductible with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: No charge after deductible	Office Visits: 50% after deductible
Copay	N/A	N/A
Deductible	Services with preferred providers: $5,200 ($10,400 family)	Services with non-preferred providers: $5,200 ($10,400 family)

Solera Dental — Shield Spectrum PPO 1500

A comparison of the Shield Spectrum PPO 1500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $40	Office Visits: 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,500 ($3,000 family)	$1,500 ($3,000 family)

Solera Dental — Shield Spectrum PPO 2000

A comparison of the Shield Spectrum PPO 2000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visit: $45	Office Visits: 50%
Copay	$45 with preferred providers	Not applicable with non-preferred providers
Deductible	$2,000 ($4,000 family)	$2,000 ($4,000 family)

Solera Dental — Shield Spectrum PPO 500

A comparison of the Shield Spectrum PPO 500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $30	Office Visits: 50%
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	$500 ($1,000 family)	$500 ($1,000 family)

Solera Dental — Shield Spectrum PPO 5000

A comparison of the Shield Spectrum PPO 5000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $35	Office Visits: 50%
Copay	$35 with preferred providers	Not applicable with non-preferred providers
Deductible	$5,000 ($10,000 family)	$5,000 ($10,000 family)

Solera Dental — Shield Spectrum PPO 750

A comparison of the Shield Spectrum PPO 750 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $35	Office Visits: 50%
Copay	$35 with preferred providers	Not applicable with non-preferred providers
Deductible	$750 ($1,500 family)	$750 ($1,500 family)

Solera Dental — Shield Spectrum PPO Savings Plan 1800

A comparison of the Shield Spectrum PPO Savings Plan 1800 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% at preferred providers	50% at non-preferred providers
Office Visit	Office Visits: $35 after deductible	Office Visits: 50% after deductible
Copay	$35 after deductible	50% after deductible
Deductible	$1,800 ($3,600 family)	$1,800 ($3,600 family)

Solera Dental — Shield Spectrum PPO Savings Plan 2400

A comparison of the Shield Spectrum PPO Savings Plan 2400 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% at preferred providers	50% at non-preferred providers
Office Visit	Office Visits: $35 after deductible	Office Visits: 50% after deductible
Copay	$35 after deductible	50% after deductible
Deductible	$2,400 ($4,800 family)	$2,400 ($4,800 family)

Solera Dental — Shield Spectrum PPO Savings Plan 4000

A comparison of the Shield Spectrum PPO Savings Plan 4000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	No charge after deductible at preferred providers	50% with non-preferred providers
Office Visit	Office Visits: No charge after deductible	Office Visits: 50% after deductible
Copay	N/A	N/A
Deductible	Services with preferred providers: $4,000 ($8,000 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Solera Dental — Vital Shield 2900

A comparison of the Vital Shield 2900 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 2 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum: $40	No charge after copay maximum
Copay	First 2 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum: $40	No charge after copay maximum
Deductible	$2,900	$2,900

Solera Dental — Vital Shield 900

A comparison of the Vital Shield 900 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 2 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum: $40	No charge after copay maximum
Copay	First 2 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum: $40	No charge after copay maximum
Deductible	$900	$900

Solera Dental — Vital Shield Plus 2900

A comparison of the Vital Shield Plus 2900 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $2,900 ($5,800 family)	Services with non-preferred providers: $5,000 ($10,000)

Solera Dental — Vital Shield Plus 2900 Generic Rx

A comparison of the Vital Shield Plus 2900 Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $2,900 ($5,800 family)	Services with non-preferred providers: $5,000 ($10,000)

Solera Dental — Vital Shield Plus 400

A comparison of the Vital Shield Plus 400 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers.	50% with non-preferred providers.
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $400 ($800 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Solera Dental — Vital Shield Plus 400 Generic Rx

A comparison of the Vital Shield Plus 400 Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $400 ($800 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Solera Dental — Vital Shield Plus 900

A comparison of the Vital Shield Plus 900 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $900 ($1,800 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Solera Dental — Vital Shield Plus 900 Generic Rx

A comparison of the Vital Shield Plus 900 Generic Rx offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers.
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $900 ($1,800 family)	Services with non-preferred providers: $5,000 ($10,000 family)