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Solera Dental Health Insurance in LOUISIANA – 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 — BLUE MAX PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	$20	Subject to deductible and coinsurance.
Copay	$20	60% after deductible
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Solera Dental — BLUE MAX PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	$20	Subject to deductible and coinsurance.
Copay	$20	60% after deductible
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Solera Dental — BLUE MAX PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	$20	Subject to deductible and coinsurance.
Copay	$20	60% after deductible
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Solera Dental — BLUE MAX PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	$20	Subject to deductible and coinsurance.
Copay	$20	60% after deductible
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Solera Dental — BLUE MAX PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	$20	Subject to deductible and coinsurance.
Copay	$20	60% after deductible
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Solera Dental — BLUE MAX PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	$20	Subject to deductible and coinsurance.
Copay	$20	60% after deductible
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Solera Dental — BLUE MAX PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	$20	Subject to deductible and coinsurance.
Copay	$20	60% after deductible
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Solera Dental — BLUE SAVER PPO 80/60

A comparison of the BLUE SAVER PPO 80/60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SAVER PPO 80/60

A comparison of the BLUE SAVER PPO 80/60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SAVER PPO 80/60

A comparison of the BLUE SAVER PPO 80/60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SAVER PPO 80/60

A comparison of the BLUE SAVER PPO 80/60 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SAVER PPO 100/80

A comparison of the BLUE SAVER PPO 100/80 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SAVER PPO 100/80

A comparison of the BLUE SAVER PPO 100/80 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SAVER PPO 100/80

A comparison of the BLUE SAVER PPO 100/80 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SAVER PPO 100/80

A comparison of the BLUE SAVER PPO 100/80 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SAVER PPO 100/80

A comparison of the BLUE SAVER PPO 100/80 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,900 Individual, $3,800 Family	$1,900 Individual, $3,800 Family

Solera Dental — BLUE SELECT PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE SELECT PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE SELECT PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE SELECT PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE SELECT PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE SELECT PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE SELECT PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE VALUE PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE VALUE PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE VALUE PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE VALUE PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE VALUE PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE VALUE PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — BLUE VALUE PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Solera Dental — HMO/POS Plan1

A comparison of the HMO/POS Plan1 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%	60% after deductible
Office Visit	Physician Office Visits (Including preventive & wellness services): $20 copayment. Specialists and Allied Health Professionals: $40 copayment.	Subject to deductible and coinsurance.
Copay	Physician Office Visits (Including preventive & wellness services): $20 copayment. Specialists and Allied Health Professionals: $40 copayment.	N/A
Deductible	N/A	$2,000 ($6,000 family)

Solera Dental — HMO/POS Plan2

A comparison of the HMO/POS Plan2 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%	60% after deductible
Office Visit	Physician Office Visits (Including preventive & wellness services): $25 copayment. Specialists and Allied Health Professionals: $45 copayment.	Subject to deductible and coinsurance.
Copay	Physician Office Visits (Including preventive & wellness services): $25 copayment. Specialists and Allied Health Professionals: $45 copayment.	N/A
Deductible	N/A	$2,000 ($6,000 family)

Solera Dental — HMO/POS Plan3

A comparison of the HMO/POS Plan3 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%	60% after deductible
Office Visit	Physician Office Visits (Including preventive & wellness services): $30 copayment. Specialists and Allied Health Professionals: $50 copayment.	Subject to deductible and coinsurance.
Copay	Physician Office Visits (Including preventive & wellness services): $30 copayment. Specialists and Allied Health Professionals: $50 copayment.	N/A
Deductible	N/A	$2,000 ($6,000 family)

Solera Dental — HMO/POS Plan4

A comparison of the HMO/POS Plan4 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%	60% after deductible
Office Visit	Physician Office Visits (Including preventive & wellness services): $35 copayment. Specialists and Allied Health Professionals: $55 copayment.	Subject to deductible and coinsurance.
Copay	Physician Office Visits (Including preventive & wellness services): $35 copayment. Specialists and Allied Health Professionals: $55 copayment.	N/A
Deductible	N/A	$1,000 ($3,000 family)

Solera Dental — HMO/POS Plan5

A comparison of the HMO/POS Plan5 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	60% after deductible
Office Visit	Physician Office Visits (Including preventive & wellness services): $35 copayment. Specialists and Allied Health Professionals: $55 copayment.	Subject to deductible and coinsurance.
Copay	Physician Office Visits (Including preventive & wellness services): $35 copayment. Specialists and Allied Health Professionals: $55 copayment.	N/A
Deductible	$1,000 ($3,000 family)	$2,000 ($6,000 family)

Solera Dental — POS Copay 500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	$40 Unlimited Visits	Subject to deductible and coinsurance.
Copay	$40 Unlimited Visits	N/A
Deductible	$500 Individual, $1,000 Family	$1,000 Individual, $2,000 Family

Solera Dental — POS Copay 750

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	$40 Unlimited Visits	Subject to deductible and coinsurance.
Copay	$40 Unlimited Visits	N/A
Deductible	$750 Individual, $1,500 Family	$1,500 Individual, $3,000 Family

Solera Dental — POS Copay 1000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	$40 Unlimited Visits	Subject to deductible and coinsurance.
Copay	$40 Unlimited Visits	N/A
Deductible	$1,000 Individual, $2,000 Family	$2,000 Individual, $4,000 Family

Solera Dental — POS Copay 1500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	$40 Unlimited Visits	Subject to deductible and coinsurance.
Copay	$40 Unlimited Visits	N/A
Deductible	$1,500 Individual, $3,000 Family	$3,000 Individual, $6,000 Family

Solera Dental — POS Copay 2500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	$40 Unlimited Visits	Subject to deductible and coinsurance.
Copay	$40 Unlimited Visits	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — POS Copay 5000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	$40 Unlimited Visits	Subject to deductible and coinsurance.
Copay	$40 Unlimited Visits	N/A
Deductible	$5,000 Individual, $10,000 Family	$10,000 Individual, $20,000 Family

Solera Dental — POS Copay Value 500 Rx A

A comparison of the POS Copay Value 500 Rx A offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$500 Individual, $1,000 Family	$1,000 Individual, $2,000 Family

Solera Dental — POS Copay Value 1000 Rx A

A comparison of the POS Copay Value 1000 Rx A offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$1,000 Individual, $2,000 Family	$2,000 Individual, $4,000 Family

Solera Dental — POS Copay Value 2500 Rx A

A comparison of the POS Copay Value 2500 Rx A offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — POS Copay Value 5000 Rx A

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$5,000 Individual, $10,000 Family	$10,000 Individual, $20,000 Family

Solera Dental — POS Copay Value 7500 Rx A

A comparison of the POS Copay Value 7500 Rx A offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$7,500 Individual, $15,000 Family	$15,000 Individual, $30,000 Family

Solera Dental — POS Copay Value 500 Rx B

A comparison of the POS Copay Value 500 Rx B offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$500 Individual, $1,000 Family	$1,000 Individual, $2,000 Family

Solera Dental — POS Copay Value 1000 Rx B

A comparison of the POS Copay Value 1000 Rx B offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$1,000 Individual, $2,000 Family	$2,000 Individual, $4,000 Family

Solera Dental — POS Copay Value 2500 Rx B

A comparison of the POS Copay Value 2500 Rx B offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — POS Copay Value 5000 Rx B

A comparison of the POS Copay Value 5000 Rx B offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$5,000 Individual, $10,000 Family	$10,000 Individual, $20,000 Family

Solera Dental — POS Copay Value 7500 Rx B

A comparison of the POS Copay Value 7500 Rx B offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$45 Primary Care Physician $65 Specialist Unlimited Visits	Subject to deductible and coinsurance.
Copay	$45 Primary Care Physician $65 Specialist Unlimited Visits	N/A
Deductible	$7,500 Individual, $15,000 Family	$15,000 Individual, $30,000 Family

Solera Dental — HDHP $1500/0%

A comparison of the HDHP $1500/0% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,500 Individual, $3,000 Family	$3,000 Individual, $6,000 Family

Solera Dental — HDHP $1500/20%

A comparison of the HDHP $1500/20% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,500 Individual, $3,000 Family	$3,000 Individual, $6,000 Family

Solera Dental — HDHP $1700/0%

A comparison of the HDHP $1700/0% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,700 Individual, $3,400 Family	$3,400 Individual, $6,800 Family

Solera Dental — HDHP $1700/20%

A comparison of the HDHP $1700/20% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,700 Individual, $3,400 Family	$3,400 Individual, $6,800 Family

Solera Dental — HDHP $2500/0%

A comparison of the HDHP $2500/0% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — HDHP $2500/20%

A comparison of the HDHP $2500/20% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Solera Dental — HDHP $5000/0%

A comparison of the HDHP $5000/0% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$10,000 Individual, $20,000 Family

Solera Dental — HDHP $5000/20%

A comparison of the HDHP $5000/20% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$10,000 Individual, $20,000 Family

Solera Dental — HDHP $2500/0% Universal

A comparison of the HDHP $2500/0% Universal offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500	$5,000

Solera Dental — HDHP $2500/20% Universal

A comparison of the HDHP $2500/20% Universal offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500	$5,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — Short Term Medical

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$1,000	$1,000

Solera Dental — HealthSaver Limited-Benefit

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$2,500	$2,500

Solera Dental — HealthSaver Limited-Benefit

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$2,500	$2,500

Solera Dental — HealthSaver Limited-Benefit

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$2,500	$2,500

Solera Dental — HealthSaver Limited-Benefit

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$2,500	$2,500

Solera Dental — HealthSaver Limited-Benefit

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$2,500	$2,500

Solera Dental — HealthSaver Limited-Benefit

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$2,500	$2,500

Solera Dental — HealthSaver Limited-Benefit

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$2,500	$2,500

Solera Dental — HealthSaver Limited-Benefit

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$2,500	$2,500

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	You pay: 20% after deductible	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	You pay: 20% after deductible	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	You pay: 20% after deductible	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	You pay: 20% after deductible	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	You pay: 20% after deductible	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 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	$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	$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	$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	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 copay - no deductible, 2 visits per person, per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: You pay: $30 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 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: You pay: $30 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 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: You pay: $30 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 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: You pay: $30 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	80%	80%
Office Visit	Office Visit - History and Exam: You pay: $30 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: You pay: $30 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 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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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	see brochure	see brochure
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 — 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	$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	$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	$1,250 (one per family, per calendar year)	$1,250 (one per family, per calendar year)

Solera Dental — PPO First Dollar 30

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Non-specialist Office Visit: $30 Copay, Specialist Visit: $40 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: $30 Copay, Specialist Visit: $40 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

Solera Dental — PPO First Dollar 40

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

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

Solera Dental — PPO 1000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $20 Copay deductible waived, Specialist Visit: $30 Copay deductible waived	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-Specialist Office Visit: $20 Copay deductible waived, Specialist Visit: $30 Copay deductible waived	Non-Specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

Solera Dental — PPO 2500

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

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

Solera Dental — PPO 5000

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

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

Solera Dental — PPO 7500 with Unlimited Primary Care Visits plus Dental

A comparison of the PPO 7500 with Unlimited Primary Care Visits plus Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible, up to out-of-pocket max. $0 once out-of-pocket max. is satisfied.	50% after deductible, up to out-of-pocket max. $0 once out-of-pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $30 copay deductible waived (unlimited visits), Specialist Visit: 80% after deductible (unlimited visits).	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist Office Visit: $30 copay deductible waived (unlimited visits), Specialist Visit: 80% after deductible (unlimited visits).	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $7,500, Family: $15,000	Individual: $10,000, Family: $20,000

Solera Dental — PPO High Deductible 3000 (HSA Compatible)

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	see brochure	see brochure
Copay	Not Covered	Not Covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — PPO High Deductible 5000 (HSA Compatible)

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

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

Solera Dental — Preventive and Hospital Care 1250

A comparison of the Preventive and Hospital Care 1250 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

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

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

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered (Unlimited visits); Specialist Visit: Not covered (Includes Chiropractic Care Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered (Unlimited visits); Specialist Visit: Not covered (Includes Chiropractic Care Visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered (Unlimited visits); Specialist Visit: Not covered (Includes Chiropractic Care Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered (Unlimited visits); Specialist Visit: Not covered (Includes Chiropractic Care Visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — PPO First Dollar 30 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Non-specialist Office Visit: $30 Copay, Specialist Visit: $40 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: $30 Copay, Specialist Visit: $40 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

Solera Dental — PPO First Dollar 40 with Dental

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

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

Solera Dental — PPO 1000 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $20 copay, deductible waived (Unlimited visits); Specialist Visit: $30 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $20 copay, deductible waived (Unlimited visits); Specialist Visit: $30 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

Solera Dental — PPO 2500 with Dental

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

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

Solera Dental — PPO 5000 with Dental

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

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

Solera Dental — PPO Value 2500 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	Visit 1-2: $30.	N/A
Copay	Visit 1-2: $30.	N/A
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — PPO High Deductible 3000 (HSA Compatible) with Dental

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

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

Solera Dental — PPO High Deductible 5000 (HSA Compatible) with Dental

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

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

Solera Dental — Preventive and Hospital Care 1250 with Dental

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

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

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

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — PPO Value 2500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible. Specialist and Non Specialist share visit max. (Unlimited visits); Specialist Visit: Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible. Specialist and Non Specialist share visit max. (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible. Specialist and Non Specialist share visit max. (Unlimited visits); Specialist Visit: Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible. Specialist and Non Specialist share visit max. (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — 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:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $5,000	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $5,000	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $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:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $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: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Solera Dental — Plan 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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	$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	$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	$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	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Saver 80

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

	Network	Non-Network
Network