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PPO Dental

This program is described in the chart below and similar to the POS II medical plan, as you may go to any provider for a covered procedure. However there is network of providers that offers a discount. A provider list can be obtained by visiting the Solstice website or by calling 877-SCG-9922 (877-724-9922). There is a deductible (separate from the medical deductible) for Type II, III and IV benefits.

ff you use a network dentist for services benefit level will be increased to 90 percent of UCR for tier II services and 60 percent of UCR for tier III services (see chart below for tiers and services).

Note: Your dental coverage is completely independent from your medical plan selection.

Member Satisfaction Survey

Take the Sarasota County Member Satisfaction Survey

Summary of Benefits

Type of benefit		Procedures	In-Network	Out of Network
I	Preventative	Cleaning, sealants (for dependents under age 19) Fluoride treatments Exams Surgical removal of impacted teeth X-rays Emergency pain treatment	100 percent No deductible	100 percent of usual customary and reasonable allowance (UCR) No deductible
II	Routine restorative	Amalgram Acrylic Plastic fillings	90 percent	80 percent of UCR
	Oral surgery	Single or multiple extractions	90 percent	80 percent of UCR
	Endodontics	Root canal therapy	90 percent	80 percent of UCR
	Periodontics	Treatment of gums gingivectomy	90 percent	80 percent of UCR
III	Repairs	Adjustment or repairs to dentures and bridges	60 percent	50 percent of UCR
	Major restorative	Gold inlay restoration	60 percent	50 percent of UCR
	Prothodontics	Dentures Bridges Crowns	60 percent	50 percent of UCR
IV	Orthodontics	Straightening of teeth	60 percent	50 percent of UCR

Maximum Benefit:

Type I, II, III: $1,750 per calendar year
Type IV: $1,500 lifetime benefit

Maximum Deductible:

Per Person $50 per calendar year
Per Family $150 per calendar year

(S700)

The S700 plan provides dental coverage using a specific network of providers for procedures with fixed co-payments. There is no coverage for out-of-network providers. Refer to the schedule of benefits for specific details on coverage and co-payment amounts. This plan does not require the selection of a primary care dentist (PCD).

Member Satisfaction Survey

Take the Sarasota County Member Satisfaction Survey

S700 brochure (includes co-pays for procedures)
Solstice website
Provider Search