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Solera Dental Health Insurance in IOWA – Health Plan Options

Solera Dental — Patriot Class 1

A comparison of the Patriot Class 1 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	see brochure	see brochure
Copay	see brochure	see brochure
Deductible	see brochure	see brochure

Solera Dental — Patriot Class 3

A comparison of the Patriot Class 3 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	see brochure	see brochure
Copay	see brochure	see brochure
Deductible	see brochure	see brochure

Solera Dental — Patriot Class 4

A comparison of the Patriot Class 4 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	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Copay	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Deductible	N/A	N/A

Solera Dental — Patriot Class 5

A comparison of the Patriot Class 5 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	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Copay	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Deductible	N/A	N/A

Solera Dental — Short Term Medical Expense Policy

A comparison of the Short Term Medical Expense Policy 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	$2,500 Deductible is per person, per term of insurance. Three person maximum.	$2,500 Deductible is per person, per term of insurance. Three person maximum.

Solera Dental — Short Term Medical Expense Policy

A comparison of the Short Term Medical Expense Policy 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	$2,500 Deductible is per person, per term of insurance. Three person maximum.	$2,500 Deductible is per person, per term of insurance. Three person maximum.

Solera Dental — Short Term Medical Expense Policy

A comparison of the Short Term Medical Expense Policy 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	$2,500 Deductible is per person, per term of insurance. Three person maximum.	$2,500 Deductible is per person, per term of insurance. Three person maximum.

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Short Term Medical Expense Policy

A comparison of the Short Term Medical Expense Policy 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	$2,500 Deductible is per person, per term of insurance. Three person maximum.	$2,500 Deductible is per person, per term of insurance. Three person maximum.

Solera Dental — Community Flex 100

A comparison of the Community Flex 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Deductible and benefit percentage	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Non-network deductible and benefit percentage
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 100

A comparison of the Community Flex 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Deductible and benefit percentage	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Non-network deductible and benefit percentage
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Short Term Medical Expense Policy

A comparison of the Short Term Medical Expense Policy 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	$2,500 Deductible is per person, per term of insurance. Three person maximum.	$2,500 Deductible is per person, per term of insurance. Three person maximum.

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 100

A comparison of the Community Flex 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Deductible and benefit percentage	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Non-network deductible and benefit percentage
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Short Term Medical Expense Policy

A comparison of the Short Term Medical Expense Policy 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	$2,500 Deductible is per person, per term of insurance. Three person maximum.	$2,500 Deductible is per person, per term of insurance. Three person maximum.

Solera Dental — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Short Term Medical Expense Policy

A comparison of the Short Term Medical Expense Policy 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	$2,500 Deductible is per person, per term of insurance. Three person maximum.	$2,500 Deductible is per person, per term of insurance. Three person maximum.

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Short Term Medical Expense Policy

A comparison of the Short Term Medical Expense Policy 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	$2,500 Deductible is per person, per term of insurance. Three person maximum.	$2,500 Deductible is per person, per term of insurance. Three person maximum.

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 60

A comparison of the Community Flex 60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $5,000	Individual:$2,000, Family: $4,000 $5,000

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $5,000	Individual:$2,000, Family: $4,000 $5,000

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Solera Dental — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Solera Dental — Generations One

A comparison of the Generations One 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	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

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	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
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	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
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	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
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	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
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	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
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 — 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	$1,250 (one per family, per calendar year)	$1,250 (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	$2,500 (one per family, per calendar year)	$2,500 (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	$3,000 (one per family, per calendar year)	$3,000 (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 70

A comparison of the Single HSA 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%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$1,250 (one per family, per calendar year)	$1,250 (one per family, per calendar year)

Solera Dental — Single HSA 70

A comparison of the Single HSA 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%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$2,500 (one per family, per calendar year)	$2,500 (one per family, per calendar year)

Solera Dental — Single HSA 70

A comparison of the Single HSA 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%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$3,000 (one per family, per calendar year)	$3,000 (one per family, per calendar year)

Solera Dental — Single HSA 70

A comparison of the Single HSA 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%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% 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 70

A comparison of the Single HSA 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%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% 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 — 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 — 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 — 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	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: 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	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: 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	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: 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	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: 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	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: 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	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: 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	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: 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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 Select

A comparison of the Copay Select 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%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
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 — 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