SOLSTICE DENTAL VALUE PPO MAC

SOLSTICE DENTAL VALUE PPO MAC

Solstice dental offers members more than just basic care. With Solstice Dental Value PPO MAC, all covered services In-Network are based on a percentage of the fixed charges and varies whether the procedure is preventive, basic or major service. Specialist referrals are not necessary for In and Out-of-Network. If you choose to go Out-of-Network, most dentists will submit your claims directly to Solstice.

SOLSTICE DENTAL VALUE PPO MAC

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

PLAN RATES (MONTHLY)

Employee
$34.25
Employee/Spouse (DP)
$68.24
Employee/Child(ren)
$73.31
Family (DP)
$106.03

PLAN HIGHLIGHTS

  • Includes 2 cleanings in any 12 consecutive months
  • No referrals needed to see a specialist
  • Out-of-Network reimbursement is MAC (Maximum Allowable Charge)
  • $50 deductible for In-Network services/$50 deductible for Out-of-Network services
  • Annual maximum of $1,000

Dental coverage can only be elected by a group enrolling in HealthPass medical coverage.
The following billing and administrative fees apply to the Solstice PPO plan: EE $9.25, EE/Spouse $18.25, EE+Child(ren) $16.50, Family $26.50.
Rates are subject to final verification at the time of enrollment.