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Solera Dental Health Insurance in TENNESSEE – 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 — Open Access 1000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% after deductible is fulfilled	CIGNA pays 60% after deductible is fulfilled
Office Visit	Primary Care Physician - $25 copay (deductible waived), Specialist - $50 copay (deductible waived)	CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician - $25, Specialist - $50	CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $1,000, Family: $3,000	Individual: $2,000, Family: $6,000

Solera Dental — Open Access 2000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician - $25 copay (deductible waived), Specialist - $50 copay (deductible waived)	CIGNA pays 60% (once the annual deductible amount is fulfilled by the member)
Copay	Primary Care Physician - $25, Specialist - $50	CIGNA pays 60%
Deductible	Individual: $2,000, Family: $4,000	Individual: $4,000, Family: $8,000

Solera Dental — Open Access 3000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician: $40 copay, deductible waived, Specialist: $60 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician: $40 copay, deductible waived, Specialist: $60 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — Open Access 5000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician - $30 copay (deductible waived), Specialist - $60 copay (deductible waived)	CIGNA pays 60% (once the annual deductible amount is fulfilled by the member)
Copay	Primary Care Physician - $30, Specialist - $60	CIGNA pays 60%
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Health Savings 1500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% after plan deductible	CIGNA pays 60% after plan deductible
Office Visit	Primary Care Physician/Specialist- CIGNA pays 80% after plan deductible	Primary Care Physician/Specialist- CIGNA pays 60% after plan deductible
Copay	N/A	N/A
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — Health Savings 3000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Office Visit	Primary Care Physician - CIGNA pays 100% after deductible is fulfilled; Specialist - CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family; $12,000

Solera Dental — Health Savings 5000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Office Visit	Primary Care Physician - CIGNA pays 100% after deductible is fulfilled, Specialist – CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — 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 — PPO 1500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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: $25 copay deductible waived (unlimited visits), Specialist Visit: $35 copay deductible waived (unlimited visits)	N/A
Copay	Non-Specialist Office Visit: $25 copay deductible waived (unlimited visits), Specialist Visit: $35 copay deductible waived (unlimited visits)	N/A
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

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 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 Value 5000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $5,000, Family: $10,000	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 — Preventative and Hospital Care 1250

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

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

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

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Not Covered	Not Covered
Copay	Not Covered	Not Covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — PPO 1500 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	50% after deductible
Office Visit	Non-Specialist Office Visit: $20, Specialist Visit: $30.	N/A
Copay	Non-Specialist Office Visit: $20, Specialist Visit: $30.	N/A
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

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 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 Value 5000 with Dental

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

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

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 — Preventative and Hospital Care 1250 with Dental

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

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

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

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

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

Solera Dental — PremierBlue A01S

A comparison of the PremierBlue A01S 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Solera Dental — PremierBlue A02S

A comparison of the PremierBlue A02S 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A04S

A comparison of the PremierBlue A04S 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A12S

A comparison of the PremierBlue A12S 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	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A14S

A comparison of the PremierBlue A14S 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	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A18S

A comparison of the PremierBlue A18S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — PremierBlue A22S

A comparison of the PremierBlue A22S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A24S

A comparison of the PremierBlue A24S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A25S

A comparison of the PremierBlue A25S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A28S

A comparison of the PremierBlue A28S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — PremierBlue A31S

A comparison of the PremierBlue A31S 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Solera Dental — PremierBlue A32S

A comparison of the PremierBlue A32S 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A34S

A comparison of the PremierBlue A34S 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A42S

A comparison of the PremierBlue A42S 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	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A44S

A comparison of the PremierBlue A44S 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	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A48S

A comparison of the PremierBlue A48S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — PremierBlue A52S

A comparison of the PremierBlue A52S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A54S

A comparison of the PremierBlue A54S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A55S

A comparison of the PremierBlue A55S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A58S

A comparison of the PremierBlue A58S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — PremierBlue A01P

A comparison of the PremierBlue A01P 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Solera Dental — PremierBlue A02P

A comparison of the PremierBlue A02P 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A04P

A comparison of the PremierBlue A04P 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A12P

A comparison of the PremierBlue A12P 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	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A14P

A comparison of the PremierBlue A14P 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	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A18P

A comparison of the PremierBlue A18P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — PremierBlue A22P

A comparison of the PremierBlue A22P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A24P

A comparison of the PremierBlue A24P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A25P

A comparison of the PremierBlue A25P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A28P

A comparison of the PremierBlue A28P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — PremierBlue A31P

A comparison of the PremierBlue A31P 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Solera Dental — PremierBlue A32P

A comparison of the PremierBlue A32P 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A34P

A comparison of the PremierBlue A34P 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	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A42P

A comparison of the PremierBlue A42P 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	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A44P

A comparison of the PremierBlue A44P 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	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A48P

A comparison of the PremierBlue A48P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — PremierBlue A52P

A comparison of the PremierBlue A52P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PremierBlue A54P

A comparison of the PremierBlue A54P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A55P

A comparison of the PremierBlue A55P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PremierBlue A58P

A comparison of the PremierBlue A58P offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — SimplyBlue S1S

A comparison of the SimplyBlue S1S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

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

Solera Dental — SimplyBlue S2S

A comparison of the SimplyBlue S2S 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	N/A	N/A
Copay	N/A	N/A
Deductible	$1,500 Individual/ $3,000 Family	$3,000 Individual/ $6,000 Family

Solera Dental — SimplyBlue S3S

A comparison of the SimplyBlue S3S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible	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 — SimplyBlue S4S

A comparison of the SimplyBlue S4S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,500 Individual/ $7,000 Family	$7,000 Individual/ $14,000 Family

Solera Dental — SimplyBlue S5S

A comparison of the SimplyBlue S5S 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	N/A	N/A
Copay	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Deductible	$1,000 Individual/ $2,000 Family	$2,000 Individual/ $4,000 Family

Solera Dental — SimplyBlue S6S

A comparison of the SimplyBlue S6S 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	N/A	N/A
Copay	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Deductible	$1,500 Individual/ $3,000 Family	$3,000 Individual/ $6,000 Family

Solera Dental — SimplyBlue S7S

A comparison of the SimplyBlue S7S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Copay	$30	$30
Deductible	$2,500 Individual/ $5,000 Family	$5,000 Individual/ $10,000 Family

Solera Dental — SimplyBlue S8S

A comparison of the SimplyBlue S8S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Copay	$30	$30
Deductible	$3,500 Individual/ $7,000 Family	$7,000 Individual/ $14,000 Family

Solera Dental — BluePartner D1S

A comparison of the BluePartner D1S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,200 Individual/ $2,400 Family	$2,400 Individual/ $4,800 Family

Solera Dental — BluePartner D2S

A comparison of the BluePartner D2S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,800 Individual/ $2,400 Family	$3,600 Individual/ $7,200 Family

Solera Dental — BluePartner D3S

A comparison of the BluePartner D3S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$2,850 Individual/ $5,650 Family	$5,700 Individual/ $11,400 Family

Solera Dental — BluePartner D4S

A comparison of the BluePartner D4S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$5,500 Individual/ $11,000 Family	$11,000 Individual/ $22,000 Family

Solera Dental — BluePartner D1S

A comparison of the BluePartner D1S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,200 Individual/ $2,400 Family	$2,400 Individual/ $4,800 Family

Solera Dental — BluePartner D2S

A comparison of the BluePartner D2S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,800 Individual/ $2,400 Family	$3,600 Individual/ $7,200 Family

Solera Dental — BluePartner D3S

A comparison of the BluePartner D3S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$2,850 Individual/ $5,650 Family	$5,700 Individual/ $11,400 Family

Solera Dental — BluePartner D4S

A comparison of the BluePartner D4S offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$5,500 Individual/ $11,000 Family	$11,000 Individual/ $22,000 Family

Solera Dental — Copay Saver

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Saver

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$1,250 (one per family, per calendar year)	$1,250 (one per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$2,500 (one per family, per calendar year)	$2,500 (one per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$3,000 (one per family, per calendar year)	$3,000 (one per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Solera Dental — Single HSA 100

A comparison of the Single HSA 100 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Solera Dental — Single HSA 70

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$1,250 (one per family, per calendar year)	$1,250 (one per family, per calendar year)

Solera Dental — Single HSA 70

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$2,500 (one per family, per calendar year)	$2,500 (one per family, per calendar year)

Solera Dental — Single HSA 70

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$3,000 (one per family, per calendar year)	$3,000 (one per family, per calendar year)

Solera Dental — Single HSA 70

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Solera Dental — Single HSA 70

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Solera Dental — Plan 100

A comparison of the Plan 100 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$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 — 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 — Saver 80

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

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

Solera Dental — Saver 80

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

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

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Solera Dental — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

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 — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Solera Dental — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Solera Dental — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Solera Dental — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Solera Dental — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000