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Solera Dental Health Insurance in TEXAS – 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 plan deductible	CIGNA pays 60% after plan deductible
Office Visit	Primary Care Physician - $25 copay (deductible waived), Specialist - $50 copay (deductible waived)	CIGNA pays 60% after plan deductible
Copay	Primary Care Physician - $25, Specialist - $50	CIGNA pays 60% after plan deductible
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

Solera Dental — Open Access 2000

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

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

Solera Dental — Open Access 3000

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

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

Solera Dental — Open Access 5000

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

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

Solera Dental — Health Savings 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% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician or Specialist CIGNA pays 80% after deductible is fulfilled	Primary Care Physician or Specialist CIGNA pays 60% after deductible is fulfilled
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 plan deductible	CIGNA pays 60% after plan deductible
Office Visit	Primary Care Physician/Specialist- CIGNA pays 100% after plan deductible	Primary Care Physician/Specialist- CIGNA pays 60% after plan deductible
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 — Open Access 7500

A comparison of the Open Access 7500 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% of eligible charges	CIGNA pays 70% of eligible charges
Office Visit	Primary Care Physician: $30 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled, Specialist: CIGNA pays 70% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $7,500, Family: $15,000	Individual: $15,000, Family: $30,000

Solera Dental — Open Access 10000

A comparison of the Open Access 10000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% of eligible charges	CIGNA pays 70% of eligible charges
Office Visit	Primary Care Physician: $30 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled, Specialist: CIGNA pays 70% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $10,000, Family: $20,000	Individual: $15,000, Family: $30,000

Solera Dental — Open Access Value 1500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $40 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — Open Access Value 2500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $40 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — Open Access Value 5000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $40 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Open Access Value 7500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $40 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $7,500, Family: $15,000	Individual: $15,000, Family: $30,000

Solera Dental — Open Access Value 10000

A comparison of the Open Access Value 10000 offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled, Specialist: CIGNA pays 70% after deductible is fulfilled	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled; Specialist: CIGNA pays 70% after deductible is fulfilled	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled; Specialist: CIGNA pays 70% after deductible is fulfilled
Deductible	Individual: $10,000, Family: $20,000	Individual: $15,000, Family: $40,000

Solera Dental — MedOne Plus- PPO Benefit Plan

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Solera Dental — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Solera Dental — MedOne Plus- PPO Benefit Plan

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Solera Dental — MedOne- HSAvings Individual

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible, then coinsurance.	Subject to deductible, then coinsurance.
Copay	N/A	N/A
Deductible	$2,800	$5,600

Solera Dental — MedOne- HSAvings Individual with Wellness

A comparison of the MedOne- HSAvings Individual with Wellness offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 100%	Plan pays 70%
Office Visit	Subject to deductible, then coinsurance.	Subject to deductible, then coinsurance.
Copay	N/A	N/A
Deductible	$2,600	$5,200

Solera Dental — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Solera Dental — MedOne Security- PPO Facility Copay Plan

A comparison of the MedOne Security- PPO Facility Copay Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$30 Copay then 100%	Subject to deductible, then 70% coinsurance.
Copay	$30	N/A
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Solera Dental — MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Solera Dental — MedOne Security- PPO Facility Copay Plan

A comparison of the MedOne Security- PPO Facility Copay Plan offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$30 Copay then 100%	Subject to deductible, then 70% coinsurance.
Copay	$30	N/A
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Solera Dental — MedOne Plus- PPO Benefit Plan

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Solera Dental — MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Solera Dental — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — Short Term Medical

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

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

Solera Dental — HealthSaver Limited-Benefit

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

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

Solera Dental — HealthSaver Limited-Benefit

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

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

Solera Dental — HealthSaver Limited-Benefit

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

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

Solera Dental — HealthSaver Limited-Benefit

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

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

Solera Dental — HealthSaver Limited-Benefit

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

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

Solera Dental — HealthSaver Limited-Benefit

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

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

Solera Dental — HealthSaver Limited-Benefit

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

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

Solera Dental — HealthSaver Limited-Benefit

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

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

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$7,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$7,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$5,000	$5,000

Solera Dental — The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$2,000	see brochure

Solera Dental — The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$2,850	see brochure

Solera Dental — The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$5,500	$11,000

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$7,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$5,000	$5,000

Solera Dental — The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$5,500	$11,000

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	ubject to deductible and coinsurance	ubject to deductible and coinsurance
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	ubject to deductible and coinsurance	ubject to deductible and coinsurance
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	ubject to deductible and coinsurance	ubject to deductible and coinsurance
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,000	$5,000

Solera Dental — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,700	$2,850

Solera Dental — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Solera Dental — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Solera Dental — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,700	$2,850

Solera Dental — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Solera Dental — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Solera Dental — HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,500	$11,000

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,000	$5,000

Solera Dental — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	30% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Solera Dental — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Solera Dental — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Solera Dental — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	30% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Solera Dental — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Solera Dental — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Solera Dental — HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,500	$11,000

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,000	$5,000

Solera Dental — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,000	$4,000

Solera Dental — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	None	None
Deductible	$2,000	see brochure

Solera Dental — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,000	$4,000

Solera Dental — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,850	$5,700

Solera Dental — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	None	None
Deductible	$2,850	see brochure

Solera Dental — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,850	$5,700

Solera Dental — HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,500	$11,000

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Solera Dental — HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,000	$5,000

Solera Dental — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	None	None
Deductible	$2,000	$4,000

Solera Dental — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,000	see brochure

Solera Dental — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,000	$4,000

Solera Dental — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million 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% after deductible	70% after deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	None	None
Deductible	$2,850	$5,700

Solera Dental — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,850	see brochure

Solera Dental — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,850	$5,700

Solera Dental — HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,500	$11,000

Solera Dental — PPO Select Value Care - Plan I

A comparison of the PPO Select Value Care - Plan I 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% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Solera Dental — PPO Select Value Care - Plan II

A comparison of the PPO Select Value Care - Plan II 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% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Solera Dental — PPO Select Value Care - Plan III

A comparison of the PPO Select Value Care - Plan III 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% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Solera Dental — Foundation Hospital Care

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	BCBSTX pays 80%, insured pays 20%	BCBSTX pays 60%, insured pays 40%
Office Visit	Not Covered	Not Covered
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000	Individual: $10,000, Family: $30,000

Solera Dental — Select Blue Advantage - Plan I

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$250 Individual/$750 Family	$500 Individual/$1,500 Family

Solera Dental — Select Blue Advantage - Plan II

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Solera Dental — Select Blue Advantage - Plan III

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — Select Blue Advantage - Plan IV

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Solera Dental — Select Blue Advantage - Plan V

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — Select Blue Advantage - Plan VI

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Solera Dental — Select Blue Advantage - Plan VII

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — Select Blue Advantage - Plan VIII

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Solera Dental — PPO Select Choice - Plan I

A comparison of the PPO Select Choice - Plan I 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$250 Individual/$750 Family	$500 Individual/$1,500 Family

Solera Dental — PPO Select Choice - Plan II

A comparison of the PPO Select Choice - Plan II 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Solera Dental — PPO Select Choice - Plan III

A comparison of the PPO Select Choice - Plan III 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Solera Dental — PPO Select Choice - Plan IV

A comparison of the PPO Select Choice - Plan IV 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Solera Dental — PPO Select Choice - Plan V

A comparison of the PPO Select Choice - Plan V 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Solera Dental — PPO Select Choice - Plan VI

A comparison of the PPO Select Choice - Plan VI 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Solera Dental — PPO Select Choice - Plan VII

A comparison of the PPO Select Choice - Plan VII 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Solera Dental — PPO Select Choice - Plan VIII

A comparison of the PPO Select Choice - Plan VIII 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Solera Dental — PPO Select Saver - Plan I

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Solera Dental — PPO Select Saver - Plan II

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be 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 — PPO Select Saver - Plan III

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Solera Dental — PPO Select Saver - Plan IV

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be 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 — PPO Select Saver - Plan V

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Solera Dental — PPO Select Saver - Plan VI

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be 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 — PPO Select Saver - Plan VII

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Solera Dental — BlueEdge Individual HSA - Plan I

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — BlueEdge Individual HSA - Plan II

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,750, Family: $3,500	Individual: $3,500, Family: $7,000

Solera Dental — BlueEdge Individual HSA - Plan III

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — BlueEdge Individual HSA - Plan IV

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of Allowable Amount after Calendar Year Deductible	60% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	see brochure	see brochure

Solera Dental — BlueEdge Individual HSA - Plan V

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of Allowable Amount after Calendar Year Deductible	60% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,750, Family: $3,500	Individual: $3,500, Family: $7,000

Solera Dental — BlueEdge Individual HSA - Plan VI

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of Allowable Amount after Calendar Year Deductible	60% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — BlueEdge Individual HSA - Plan VII

A comparison of the BlueEdge Individual HSA - Plan VII 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% of Allowable Amount after Calendar Year Deductible	100% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Solera Dental — BlueEdge Individual HSA - Plan VIII

A comparison of the BlueEdge Individual HSA - Plan VIII 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% of Allowable Amount after Calendar Year Deductible	100% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — SelecTemp PPO - Plan I

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$1,000, Individual, $3,000 Family

Solera Dental — SelecTemp PPO - Plan II

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$1,000, Individual, $3,000 Family	$2,000, Individual, $6,000 Family

Solera Dental — SelecTemp PPO - Plan III

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$1,500, Individual, $4,500 Family	$3,000, Individual, $9,000 Family

Solera Dental — SelecTemp PPO - Plan IV

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$2,000, Individual, $6,000 Family	$4,000, Individual, $12,000 Family

Solera Dental — SelecTemp PPO - Plan V

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$2,500, Individual, $7,500 Family	$5,000, Individual, $15,000 Family

Solera Dental — PPO First Dollar 30

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

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

Solera Dental — PPO First Dollar 40

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

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

Solera Dental — PPO 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 (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — 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: $40 copay deductible waived (unlimited visits), Specialist Visit: $50 copay deductible waived (unlimited visits).	50% after deductible (unlimited visits)
Copay	Non-Specialist Office Visit: $40 copay deductible waived (unlimited visits), Specialist Visit: $50 copay deductible waived (unlimited visits).	50% after deductible (unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — PPO Value 1500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible, up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible, up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max(Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max(Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — PPO Value 2500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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 Visits 1-5 $30 copay, deductible waived; Specialist Visits 1-5 $50 copay, deductible waived.	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist Office Visits 1-5 $30 copay, deductible waived; Specialist Visits 1-5 $50 copay, deductible waived.	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $2,500, Family: $5,000	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	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	65% 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): Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)
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)	50% 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 (Includes Chiropractic Care 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 (Includes Chiropractic Care 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: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Solera Dental — PPO High Deductible 5000 (HSA Compatible)

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

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

Solera Dental — Preventive and Hospital Care 1250

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

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

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

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

Solera Dental — PPO 3500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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): $35 copay (Unlimited visits); Specialist Visit: $45 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $35 copay, deductible waived (Unlimited visits); Specialist Visit: $45 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Solera Dental — PPO 7500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible. $0 once out-of-pocket max. is satisfied	50% after deductible. $0 once out-of-pocket max. is satisfied
Office Visit	Non-Specialist Office Visit: $45 Copay deductible waived (Unlimited visits), Specialist Visit: $50 Copay deductible waived (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit: $45 Copay deductible waived (Unlimited visits), Specialist Visit: $50 Copay deductible waived (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $7,500, Family: $15,000	Individual: $10,000, Family: $20,000

Solera Dental — PPO 750 with Medical $50K CYM

A comparison of the PPO 750 with Medical $50K CYM offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible ($0 once out-of-pocket max. is satisfied)	50% after deductible ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist):50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited Visits); Specialist Visit: $50 copay (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: $750, Family: $1,500	Individual: $1,500, Family: $3,000

Solera Dental — PPO 1500 with Medical $50K CYM

A comparison of the PPO 1500 with Medical $50K CYM offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible. $0 once out of pocket max. is satisfied	50% after deductible. $0 once out of pocket max. is satisfied
Office Visit	Non-Specialist Office Visit: $25 Copay (Unlimited visits), Specialist Visit: $50 Copay (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited visits), Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit: $25 Copay (Unlimited visits), Specialist Visit: $50 Copay (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited visits), Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — PPO 2500 with Medical $50K CYM

A comparison of the PPO 2500 with Medical $50K CYM offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible ($0 once out-of-pocket max. is satisfied)	50% after deductible ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — PPO First Dollar 30 with Dental

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

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

Solera Dental — PPO First Dollar 40 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 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 (Unlimited visits); Specialist Visit: $50 copay (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: $0, Family: $0	Individual: $7,000, Family: $14,000

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 (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — 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 (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 Value 1500 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible, up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible, up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max(Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max(Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — PPO Value 2500 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible 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): Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	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)	70% 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): $0 copay after deductible (Unlimited visits); Specialist Visit: $0 copay 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): $0 copay after deductible (Unlimited visits); Specialist Visit: $0 copay 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: $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): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Solera Dental — Preventive and Hospital Care 1250 with Dental

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

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

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

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

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

Solera Dental — PPO 3500 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	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: $35 copay deductible waived, Specialist: $45 copay deductible waived	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist: $35 copay deductible waived, Specialist: $45 copay deductible waived	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Solera Dental — PPO 750 with Medical $50K CYM with Dental

A comparison of the PPO 750 with Medical $50K CYM with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible ($0 once out-of-pocket max. is satisfied)	50% after deductible ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist):50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited Visits); Specialist Visit: $50 copay (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: $750, Family: $1,500	Individual: $1,500, Family: $3,000

Solera Dental — PPO 1500 with Medical $50K CYM with Dental

A comparison of the PPO 1500 with Medical $50K CYM with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible ($0 once out-of-pocket max. is satisfied)	50% after deductible ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit: $25 Copay (Unlimited visits), Specialist Visit: $50 Copay (Unlimited visits) Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited Visits); Specialist Visit: $50 copay (Unlimited Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited Visits); Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited Visits); Specialist Visit: $50 copay (Unlimited Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited Visits); Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Solera Dental — PPO 2500 with Medical $50K CYM with Dental

A comparison of the PPO 2500 with Medical $50K CYM with Dental offered by Solera Dental is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible $0 once out-of-pocket max is satisfied.	50% after deductible $0 once out-of-pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $25 copay (Unlimited visits), Specialist Office Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist: 50% after deductible (unlimited visits)
Copay	Non-Specialist Office Visit: $25 copay (Unlimited visits), Specialist Office Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited visits), Specialist Office Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Solera Dental — PPO 7500 with Dental

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible. $0 once out-of-pocket max. is satisfied	50% after deductible. $0 once out-of-pocket max. is satisfied
Office Visit	Non-Specialist Office Visit: $45 Copay deductible waived (Unlimited visits), Specialist Visit: $50 Copay deductible waived (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit: $45 Copay deductible waived (Unlimited visits), Specialist Visit: $50 Copay deductible waived (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $7,500, Family: $15,000	Individual: $10,000, Family: $20,000

Solera Dental — Copay Saver

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

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

Solera Dental — Copay Saver

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

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

Solera Dental — Copay Saver

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

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

Solera Dental — Copay Saver

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

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

Solera Dental — Copay Saver

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

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

Solera Dental — Single HSA 100

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

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

Solera Dental — Single HSA 100

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

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

Solera Dental — Single HSA 100

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

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

Solera Dental — Single HSA 100

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

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

Solera Dental — Single HSA 100

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

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

Solera Dental — Single HSA 70

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

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

Solera Dental — Single HSA 70

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

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

Solera Dental — Single HSA 70

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

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

Solera Dental — Single HSA 70

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

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

Solera Dental — Single HSA 70

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

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

Solera Dental — Plan 100

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Solera Dental — Plan 100

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

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

Solera Dental — Plan 100

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

	Network	Non-Network
Network	See Provider	See Provider