Solera Dental Health Insurance in CONNECTICUT – Health Plan Options

Solera Dental — BlueCare Direct with $2,000 Rx Max

A comparison of the BlueCare Direct with $2,000 Rx Max 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	$20 for PCP and $30 for specialist. No deductible.	$20 for PCP and $30 for specialist. No deductible.
Copay	$20 for PCP and $30 for specialist.	$20 for PCP and $30 for specialist.
Deductible	$1,500 Individual/$3,000 Family	$1,500 Individual/$3,000 Family

Solera Dental — Century Preferred Direct

A comparison of the Century Preferred Direct 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%	60%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$250 Individual/$500 Family	$250 Individual/$500 Family

Solera Dental — Century Preferred Direct

A comparison of the Century Preferred Direct 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%	80%
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 — Century Preferred Direct

A comparison of the Century Preferred Direct 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%	80%
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 — Century Preferred Direct

A comparison of the Century Preferred Direct 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%	80%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$10,000 Individual/$20,000 Family	$10,000 Individual/$20,000 Family

Solera Dental — Century Preferred Direct with $2,000 Rx Max

A comparison of the Century Preferred Direct with $2,000 Rx Max 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%	80%
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 — Century Preferred Direct with $2,000 Rx Max

A comparison of the Century Preferred Direct with $2,000 Rx Max 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%	80%
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 — Century Preferred Direct with $2,000 Rx Max

A comparison of the Century Preferred Direct with $2,000 Rx Max 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%	80%
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 — Century Preferred Direct with $2,000 Rx Max

A comparison of the Century Preferred Direct with $2,000 Rx Max 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%	80%
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	80%	60%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$2,500 Individual/$5,000 Family	$2,500 Individual/$5,000 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	$2,500 Individual/$5,000 Family	$2,500 Individual/$5,000 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	80%	60%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$2,500 Individual/$5,000 Family	$2,500 Individual/$5,000 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	80%	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

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	80%	60%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$2,500 Individual/$5,000 Family	$2,500 Individual/$5,000 Family

Solera Dental — Tonik 1500

A comparison of the Tonik 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	N/A	50% after deductible
Office Visit	Preventive and Medical Office visits- $30 Copayment (deductible waived)	50% after calendar year deductible
Copay	Preventive and Medical Office visits- $30 Copayment (deductible waived)	50% after calendar year deductible
Deductible	$1,500	$1,500

Solera Dental — Tonik 3000

A comparison of the Tonik 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	N/A	50% after deductible
Office Visit	Preventive and Medical Office visits- $25 Copayment (deductible waived for the combined total of the first 4 preventive, medical and/or mental health and substance abuse visits in a Calendar Year)	50% after calendar year deductible
Copay	Preventive and Medical Office visits- $25 Copayment (deductible waived for the combined total of the first 4 preventive, medical and/or mental health and substance abuse visits in a Calendar Year)	50% after calendar year deductible
Deductible	$3,000	$3,000

Solera Dental — Tonik 5000

A comparison of the Tonik 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	N/A	50% after deductible
Office Visit	Preventive and Medical Office visits- $20 Copayment (deductible waived for the combined total of the first 4 preventive, medical and/or mental health and substance abuse visits in a Calendar Year)	50% after calendar year deductible
Copay	Preventive and Medical Office visits- $20 Copayment (deductible waived for the combined total of the first 4 preventive, medical and/or mental health and substance abuse visits in a Calendar Year)	50% after calendar year deductible
Deductible	$5,000	$5,000

Solera Dental — BlueCare Direct with $500 Rx Max

A comparison of the BlueCare Direct with $500 Rx Max 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	$20 for PCP and $30 for specialist. No deductible.	$20 for PCP and $30 for specialist. No deductible.
Copay	$20 for PCP and $30 for specialist.	$20 for PCP and $30 for specialist.
Deductible	$1,500 Individual/$3,000 Family	$1,500 Individual/$3,000 Family

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 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician: CIGNA pays 80% after deductible is fulfilled Specialist: CIGNA pays 80% after deductible is fulfilled	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

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 2500

A comparison of the Health Savings 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	CIGNA pays 100% of eligible charges	CIGNA pays 70% of eligible charges
Office Visit	Primary Care Physician: CIGNA pays 100% after deductible is fulfilled, Specialist: CIGNA pays 100% after deductible is fulfilled	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled, Specialist: CIGNA pays 70% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — Health Savings 3500

A comparison of the Health Savings 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	CIGNA pays 100% of eligible charges	CIGNA pays 70% of eligible charges
Office Visit	Primary Care Physician: CIGNA pays 100% after deductible is fulfilled, Specialist: CIGNA pays 100% after deductible is fulfilled	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled, Specialist: CIGNA pays 70% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Solera Dental — Health Savings 5000

A comparison of the Health Savings 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 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Office Visit	Primary Care Physician - CIGNA pays 100% after deductible is fulfilled, Specialist – CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Plan 80

A comparison of the Plan 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%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Plan 80

A comparison of the Plan 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%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Plan 80

A comparison of the Plan 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%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Plan 80

A comparison of the Plan 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%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Solera Dental — Plan 80

A comparison of the Plan 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%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Solera Dental — Plan 80

A comparison of the Plan 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%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Solera Dental — Plan 100

A comparison of the Plan 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Plan 100

A comparison of the Plan 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Plan 100

A comparison of the Plan 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Plan 100

A comparison of the Plan 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Solera Dental — Plan 100

A comparison of the Plan 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Solera Dental — Plan 100

A comparison of the Plan 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

A comparison of the Saver 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%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

A comparison of the Saver 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%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

A comparison of the Saver 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%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

A comparison of the Saver 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%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

A comparison of the Saver 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%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

A comparison of the Saver 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%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

A comparison of the Saver 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%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

A comparison of the Copay 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	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

A comparison of the Copay 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	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

A comparison of the Copay 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	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

A comparison of the Copay 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	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

A comparison of the Copay 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	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits	Office Visit - History and Exam: You pay: $30 copay - 2 visits per person, per calendar year, including wellness office visits
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay 80 Plan

A comparison of the Copay 80 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 copay - no deductible	Office Visit - History and Exam: You pay: $30 copay - no deductible
Copay	$30	$30
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay 80 Plan

A comparison of the Copay 80 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 copay - no deductible	Office Visit - History and Exam: You pay: $30 copay - no deductible
Copay	$30	$30
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay 80 Plan

A comparison of the Copay 80 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 copay - no deductible	Office Visit - History and Exam: You pay: $30 copay - no deductible
Copay	$30	$30
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay 80 Plan

A comparison of the Copay 80 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 copay - no deductible	Office Visit - History and Exam: You pay: $30 copay - no deductible
Copay	$30	$30
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay 80 Plan

A comparison of the Copay 80 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 copay - no deductible	Office Visit - History and Exam: You pay: $30 copay - no deductible
Copay	$30	$30
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay 80 Plan

A comparison of the Copay 80 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 copay - no deductible	Office Visit - History and Exam: You pay: $30 copay - no deductible
Copay	$30	$30
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay 80 Plan

A comparison of the Copay 80 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 copay - no deductible	Office Visit - History and Exam: You pay: $30 copay - no deductible
Copay	$30	$30
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay 100 Plan

A comparison of the Copay 100 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%	100%
Office Visit	Office Visit - History and Exam: You pay: $25 copay - no deductible	Office Visit - History and Exam: You pay: $25 copay - no deductible
Copay	$25	$25
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay 100 Plan

A comparison of the Copay 100 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%	100%
Office Visit	Office Visit - History and Exam: You pay: $25 copay - no deductible	Office Visit - History and Exam: You pay: $25 copay - no deductible
Copay	$25	$25
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay 100 Plan

A comparison of the Copay 100 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%	100%
Office Visit	Office Visit - History and Exam: You pay: $25 copay - no deductible	Office Visit - History and Exam: You pay: $25 copay - no deductible
Copay	$25	$25
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay 100 Plan

A comparison of the Copay 100 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%	100%
Office Visit	Office Visit - History and Exam: You pay: $25 copay - no deductible	Office Visit - History and Exam: You pay: $25 copay - no deductible
Copay	$25	$25
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay 100 Plan

A comparison of the Copay 100 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%	100%
Office Visit	Office Visit - History and Exam: You pay: $25 copay - no deductible	Office Visit - History and Exam: You pay: $25 copay - no deductible
Copay	$25	$25
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay 100 Plan

A comparison of the Copay 100 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%	100%
Office Visit	Office Visit - History and Exam: You pay: $25 copay - no deductible	Office Visit - History and Exam: You pay: $25 copay - no deductible
Copay	$25	$25
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay 100 Plan

A comparison of the Copay 100 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%	100%
Office Visit	Office Visit - History and Exam: You pay: $25 copay - no deductible	Office Visit - History and Exam: You pay: $25 copay - no deductible
Copay	$25	$25
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$1,150 (one per family, per calendar year)	$1,150 (one per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$1,900 (one per family, per calendar year)	$1,900 (one per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$2,900 (one per family, per calendar year)	$2,900 (one per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 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	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Solera Dental — Single HSA Saver

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,150 (one per family, per calendar year)	$1,150 (one per family, per calendar year)

Solera Dental — Single HSA Saver

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,900 (one per family, per calendar year)	$1,900 (one per family, per calendar year)

Solera Dental — Single HSA Saver

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$2,900 (one per family, per calendar year)	$2,900 (one per family, per calendar year)

Solera Dental — Single HSA Saver

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Solera Dental — Single HSA Saver

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Solera Dental — Managed Choice Open Access 1500

A comparison of the Managed Choice 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	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): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 copay, deductible waived (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): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 copay, deductible waived (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: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

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 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 — Preventive and Hospital Care 1250

A comparison of the Preventive 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	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Solera Dental — Preventive and Hospital Care 3000 (HSA Compatible)

A comparison of the Preventive 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 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 — First Dollar Managed Choice Open Access 30

A comparison of the First Dollar Managed Choice Open Access 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% 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 (Unlimited Visits), Specialist Visit: $40 copay (Unlimited Visits)	Non-Specialist Office Visits: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: $30 copay (Unlimited Visits), Specialist Visit: $40 copay (Unlimited Visits)	Non-Specialist Office Visits: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $0, Family: $0	Individual: $250, Family: $750

Solera Dental — First Dollar Managed Choice Open Access 40

A comparison of the First Dollar Managed Choice Open Access 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: $30 copay (Unlimited Visits), Specialist Visit: $45 copay (Unlimited Visits)	Non-Specialist Visit Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: $30 copay (Unlimited Visits), Specialist Visit: $45 copay (Unlimited Visits)	Non-Specialist Visit Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $0, Family: $0	Individual: $7,000, Family: $14,000

Solera Dental — Managed Choice Open Access 1500 with Dental

A comparison of the Managed Choice Open Access 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	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): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 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): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 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: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

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 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 — Preventive and Hospital Care 1250 with Dental

A comparison of the Preventive 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 — Preventive and Hospital Care 3000 (HSA Compatible) with Dental

A comparison of the Preventive 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.	50% after deductible up to out-of-pocket max.
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

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 — First Dollar Managed Choice Open Access 30 with Dental

A comparison of the First Dollar Managed Choice Open Access 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% 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 (Unlimited Visits), Specialist Visit: $40 copay (Unlimited Visits)	Non-Specialist Office Visits: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: $30 copay (Unlimited Visits), Specialist Visit: $40 copay (Unlimited Visits)	Non-Specialist Office Visits: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

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

A comparison of the First Dollar Managed Choice Open Access 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% 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 (Unlimited Visits), Specialist Visit: $45 copay (Unlimited Visits)	Non-Specialist Visit Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: $30 copay (Unlimited Visits), Specialist Visit: $45 copay (Unlimited Visits)	Non-Specialist Visit Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $0, Family: $0	Individual: $7,000, Family: $14,000

Solera Dental — Managed Choice Open Access 750 with Medical $50K CYM

A comparison of the Managed Choice Open Access 750 with Medical $50K CYM 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, $0 once out-of-pocket max is satisfied.	50% after deductible, $0 once out-of-pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Deductible	Individual: $750, Family: $1,500	Individual: $1,500, Family: $3,000

Solera Dental — Managed Choice Open Access 1500 with Medical $50K CYM

A comparison of the Managed Choice Open Access 1500 with Medical $50K CYM 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, $0 once out-of-pocket max is satisfied.	50% after deductible, $0 once out-of-pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	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 2500 with Medical $50K CYM

A comparison of the Managed Choice Open Access 2500 with Medical $50K CYM 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 $0 once out-of-pocket max is satisfied.	50% after deductible $0 once out-of-pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — Managed Choice Open Access 750 with Medical $50K CYM with Dental

A comparison of the Managed Choice Open Access 750 with Medical $50K CYM 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, $0 once out-of-pocket max is satisfied.	50% after deductible, $0 once out-of-pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Deductible	Individual: $750, Family: $1,500	Individual: $1,500, Family: $3,000

Solera Dental — Managed Choice Open Access 1500 with Medical $50K CYM with Dental

A comparison of the Managed Choice Open Access 1500 with Medical $50K CYM 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, $0 once out-of-pocket max is satisfied.	50% after deductible, $0 once out-of-pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,00

Solera Dental — Managed Choice Open Access 2500 with Medical $50K CYM with Dental

A comparison of the Managed Choice Open Access 2500 with Medical $50K CYM 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 $0 once out-of-pocket max is satisfied.	50% after deductible $0 once out-of-pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $25 copay, Specialist Visit: $45 copay.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — Managed Choice Open Access 7500 with Unlimited Primary Care Visits plus Dental

A comparison of the Managed Choice Open Access 7500 with Unlimited Primary Care Visits plus 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, Specialist Visit: 80% after deductible.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $30 copay deductible waived, Specialist Visit: 80% after deductible.	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Deductible	Individual: $7,500, Family: $15,000	Individual: $10,000, Family: $20,000

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