SOLSTICE DENTAL EPO S700B

SOLSTICE DENTAL EPO S700B

With Solstice Dental EPO, all covered services are based on a list of fixed patient charges so there are never any claim forms to complete and the member can switch dentists at any time.A referral is not required to see a specialist and the member will pay a 25% reduction of the provider’s usual and customary fee. If a Solstice pre-authorization to see a specialist is acquired, the member will pay the related listed copays which offers more cost-savings. If you use a dentist who does not participate with the Solstice S700B network, your procedures will not be covered.

SOLSTICE DENTAL EPO S700B

Rates are for new and renewing groups effective 7/1/2022 — 9/1/2022

PLAN RATES (MONTHLY)

Employee
$17.37
Employee/Spouse (DP)
$33.99
Employee/Child(ren)
$38.32
Family (DP)
$53.50

PLAN HIGHLIGHTS

  • $0 copay for primary care office visit (includes a cleaning, 1 set of x-rays, checkup and 2nd visit includes cleaning only)
  • Open access and no specialist referrals
  • No deductible, no calendar year maximum
  • Cosmetic and orthodontia treatment covered
  • Implant benefit

Dental coverage can only be elected by a group enrolling in HealthPass medical coverage.
The following billing and administrative fees apply to the Solstice Dental EPO S700B: EE $1.50, EE/Spouse $2.25, EE+Child(ren) $2.25, Family $3.00.
Rates are subject to final verification at the time of enrollment.