Namara Marketplace

2016 QHP Landscape NV Individual Market Dental

State Code

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County Name

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Metal Level

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Issuer Name

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Plan Id (Standard Component)

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Plan Marketing Name

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Plan Type

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Rating Area

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Child Only Offering

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Source

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Customer Service Phone Number Local

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Customer Service Phone Number Toll Free

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Customer Service Phone Number Tty

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Network Url

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Plan Brochure Url

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Summary Of Benefits Url

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Drug Formulary Url

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Routine Dental Services Adult 1

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Basic Dental Care Adult 1

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Major Dental Care Adult 1

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Orthodontia Adult 1

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Dental Check-Up For Children

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Basic Dental Care Child 1

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Major Dental Care Child 1

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Orthodontia Child 1

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Premium Rates

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Premium Child

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Premium Adult Individual Age 21

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Premium Adult Individual Age 27

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Premium Adult Individual Age 30

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Premium Adult Individual Age 40

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Premium Adult Individual Age 50

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Premium Adult Individual Age 60

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Premium Couple 21

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Premium Couple 30

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Premium Couple 40

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Premium Couple 50

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Premium Couple 60

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Couple+1 Child, Age 21

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Couple+1 Child, Age 30

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Couple+1 Child, Age 40

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Couple+1 Child, Age 50

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Couple+2 Children, Age 21

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Couple+2 Children, Age 30

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Couple+2 Children, Age 40

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Couple+2 Children, Age 50

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Couple+3 Or More Children, Age 21

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Couple+3 Or More Children, Age 30

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Couple+3 Or More Children, Age 40

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Couple+3 Or More Children, Age 50

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Individual+1 Child, Age 21

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Individual+1 Child, Age 30

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Individual+1 Child, Age 40

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Individual+1 Child, Age 50

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Individual+2 Children, Age 21

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Individual+2 Children, Age 30

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Individual+2 Children, Age 40

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Individual+2 Children, Age 50

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Individual+3 Or More Children, Age 21

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Individual+3 Or More Children, Age 30

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Individual+3 Or More Children, Age 40

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Individual+3 Or More Children, Age 50

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Standard On Exchange

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Dental Deductible - Individual - Standard

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Dental Deductible - Family - Standard

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Dental Deductible - Family (Per Person) - Standard

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Dental Maximum Out Of Pocket - Individual - Standard

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Dental Maximum Out Of Pocket - Family - Standard

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Dental Maximum Out Of Pocket - Family (Per Person) - Standard

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Routine Dental Services Adult

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Basic Dental Care Adult

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Major Dental Care Adult

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Orthodontia Adult

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Dental Checkup For Children

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Basic Dental Care Child

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Major Dental Care Child

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Orthodontia Child

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NV
Carson City
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
31.77
30.6
32.7
32.7
32.7
32.7
32.7
61.2
65.4
65.4
65.4
65.4
92.97
97.17
97.17
97.17
124.74
128.94
128.94
128.94
156.51
160.71
160.71
160.71
62.37
64.47
64.47
64.47
94.14
96.24
96.24
96.24
125.91
128.01
128.01
128.01
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Carson City
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
31.77
22
23.5
23.5
23.5
23.5
23.5
44
47
47
47
47
75.77
78.77
78.77
78.77
107.54
110.54
110.54
110.54
139.31
142.31
142.31
142.31
53.77
55.27
55.27
55.27
85.54
87.04
87.04
87.04
117.31
118.81
118.81
118.81
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Carson City
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Churchill
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Churchill
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Churchill
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Clark
High
Nevada Dental Benefits, Ltd.
43126NV0110001
NDB Nevada Kids Gold
HMO
Rating Area 1
Allows Child-Only
SERFF
http://nevadadentalbenefits.com/find_dentist.php
http://www.nevadadentalbenefits.com/nevada_health_link.php
http://www.nevadadentalbenefits.com/nevada_health_link.php
X
X
X
X
20.13
Not Applicable
Not Applicable
Not Applicable
350
700
350
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
$35
$53
$350
NV
Clark
Low
Alpha Dental of Nevada, Inc.
34962NV0010006
DeltaCare USA Basic Plan for Families
HMO
Rating Area 1
Allows Adult and Child-Only
SERFF
https://www.deltadentalins.com/find-a-dentist
https://deltadentalins.com/hcx/nv/34962nv0010006-16
X
X
X
X
X
X
X
X
17.84
22.53
22.53
22.53
22.53
22.53
22.53
45.06
45.06
45.06
45.06
45.06
62.9
62.9
62.9
62.9
80.74
80.74
80.74
80.74
98.58
98.58
98.58
98.58
40.37
40.37
40.37
40.37
58.21
58.21
58.21
58.21
76.05
76.05
76.05
76.05
Not Applicable
Not Applicable
Not Applicable
350
700
350
$5
$45
$350
$3,250
$5
$45
$350
$350
NV
Clark
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 1
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
27.44
26.43
28.24
28.24
28.24
28.24
28.24
52.86
56.48
56.48
56.48
56.48
80.3
83.92
83.92
83.92
107.74
111.36
111.36
111.36
135.18
138.8
138.8
138.8
53.87
55.68
55.68
55.68
81.31
83.12
83.12
83.12
108.75
110.56
110.56
110.56
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Clark
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 1
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
27.44
19
20.3
20.3
20.3
20.3
20.3
38
40.6
40.6
40.6
40.6
65.44
68.04
68.04
68.04
92.88
95.48
95.48
95.48
120.32
122.92
122.92
122.92
46.44
47.74
47.74
47.74
73.88
75.18
75.18
75.18
101.32
102.62
102.62
102.62
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Clark
Low
Nevada Dental Benefits, Ltd.
43126NV0150001
NDB Nevada Kids + Adult
HMO
Rating Area 1
Allows Adult and Child-Only
SERFF
http://nevadadentalbenefits.com/find_dentist.php
http://www.nevadadentalbenefits.com/nevada_health_link.php
http://www.nevadadentalbenefits.com/nevada_health_link.php
X
X
X
X
X
X
X
16.9
16.9
16.9
16.9
16.9
16.9
16.9
33.8
33.8
33.8
33.8
33.8
50.7
50.7
50.7
50.7
67.6
67.6
67.6
67.6
84.5
84.5
84.5
84.5
33.8
33.8
33.8
33.8
50.7
50.7
50.7
50.7
67.6
67.6
67.6
67.6
Not Applicable
Not Applicable
Not Applicable
350
700
350
No Charge
$50
$400
Not Covered
No Charge
$50
$75
$350
NV
Clark
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 1
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
25.73
28.42
28.42
28.42
28.42
28.42
28.42
56.84
56.84
56.84
56.84
56.84
82.57
82.57
82.57
82.57
108.3
108.3
108.3
108.3
134.03
134.03
134.03
134.03
54.15
54.15
54.15
54.15
79.88
79.88
79.88
79.88
105.61
105.61
105.61
105.61
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Douglas
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
31.77
30.6
32.7
32.7
32.7
32.7
32.7
61.2
65.4
65.4
65.4
65.4
92.97
97.17
97.17
97.17
124.74
128.94
128.94
128.94
156.51
160.71
160.71
160.71
62.37
64.47
64.47
64.47
94.14
96.24
96.24
96.24
125.91
128.01
128.01
128.01
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Douglas
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
31.77
22
23.5
23.5
23.5
23.5
23.5
44
47
47
47
47
75.77
78.77
78.77
78.77
107.54
110.54
110.54
110.54
139.31
142.31
142.31
142.31
53.77
55.27
55.27
55.27
85.54
87.04
87.04
87.04
117.31
118.81
118.81
118.81
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Douglas
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Elko
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Elko
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Elko
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Esmeralda
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Esmeralda
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Esmeralda
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Eureka
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Eureka
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Eureka
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Humboldt
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Humboldt
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Humboldt
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Lander
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Lander
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Lander
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Lincoln
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Lincoln
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Lincoln
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Lyon
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
31.77
30.6
32.7
32.7
32.7
32.7
32.7
61.2
65.4
65.4
65.4
65.4
92.97
97.17
97.17
97.17
124.74
128.94
128.94
128.94
156.51
160.71
160.71
160.71
62.37
64.47
64.47
64.47
94.14
96.24
96.24
96.24
125.91
128.01
128.01
128.01
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Lyon
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
31.77
22
23.5
23.5
23.5
23.5
23.5
44
47
47
47
47
75.77
78.77
78.77
78.77
107.54
110.54
110.54
110.54
139.31
142.31
142.31
142.31
53.77
55.27
55.27
55.27
85.54
87.04
87.04
87.04
117.31
118.81
118.81
118.81
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Lyon
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Mineral
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Mineral
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Mineral
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Nye
High
Nevada Dental Benefits, Ltd.
43126NV0110001
NDB Nevada Kids Gold
HMO
Rating Area 1
Allows Child-Only
SERFF
http://nevadadentalbenefits.com/find_dentist.php
http://www.nevadadentalbenefits.com/nevada_health_link.php
http://www.nevadadentalbenefits.com/nevada_health_link.php
X
X
X
X
20.13
Not Applicable
Not Applicable
Not Applicable
350
700
350
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
$35
$53
$350
NV
Nye
Low
Alpha Dental of Nevada, Inc.
34962NV0010006
DeltaCare USA Basic Plan for Families
HMO
Rating Area 1
Allows Adult and Child-Only
SERFF
https://www.deltadentalins.com/find-a-dentist
https://deltadentalins.com/hcx/nv/34962nv0010006-16
X
X
X
X
X
X
X
X
17.84
22.53
22.53
22.53
22.53
22.53
22.53
45.06
45.06
45.06
45.06
45.06
62.9
62.9
62.9
62.9
80.74
80.74
80.74
80.74
98.58
98.58
98.58
98.58
40.37
40.37
40.37
40.37
58.21
58.21
58.21
58.21
76.05
76.05
76.05
76.05
Not Applicable
Not Applicable
Not Applicable
350
700
350
$5
$45
$350
$3,250
$5
$45
$350
$350
NV
Nye
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 1
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
27.44
26.43
28.24
28.24
28.24
28.24
28.24
52.86
56.48
56.48
56.48
56.48
80.3
83.92
83.92
83.92
107.74
111.36
111.36
111.36
135.18
138.8
138.8
138.8
53.87
55.68
55.68
55.68
81.31
83.12
83.12
83.12
108.75
110.56
110.56
110.56
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Nye
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 1
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
27.44
19
20.3
20.3
20.3
20.3
20.3
38
40.6
40.6
40.6
40.6
65.44
68.04
68.04
68.04
92.88
95.48
95.48
95.48
120.32
122.92
122.92
122.92
46.44
47.74
47.74
47.74
73.88
75.18
75.18
75.18
101.32
102.62
102.62
102.62
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Nye
Low
Nevada Dental Benefits, Ltd.
43126NV0150001
NDB Nevada Kids + Adult
HMO
Rating Area 1
Allows Adult and Child-Only
SERFF
http://nevadadentalbenefits.com/find_dentist.php
http://www.nevadadentalbenefits.com/nevada_health_link.php
http://www.nevadadentalbenefits.com/nevada_health_link.php
X
X
X
X
X
X
X
16.9
16.9
16.9
16.9
16.9
16.9
16.9
33.8
33.8
33.8
33.8
33.8
50.7
50.7
50.7
50.7
67.6
67.6
67.6
67.6
84.5
84.5
84.5
84.5
33.8
33.8
33.8
33.8
50.7
50.7
50.7
50.7
67.6
67.6
67.6
67.6
Not Applicable
Not Applicable
Not Applicable
350
700
350
No Charge
$50
$400
Not Covered
No Charge
$50
$75
$350
NV
Nye
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 1
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
25.73
28.42
28.42
28.42
28.42
28.42
28.42
56.84
56.84
56.84
56.84
56.84
82.57
82.57
82.57
82.57
108.3
108.3
108.3
108.3
134.03
134.03
134.03
134.03
54.15
54.15
54.15
54.15
79.88
79.88
79.88
79.88
105.61
105.61
105.61
105.61
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Pershing
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
29.77
31.81
31.81
31.81
31.81
31.81
59.54
63.62
63.62
63.62
63.62
90.44
94.52
94.52
94.52
121.34
125.42
125.42
125.42
152.24
156.32
156.32
156.32
60.67
62.71
62.71
62.71
91.57
93.61
93.61
93.61
122.47
124.51
124.51
124.51
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Pershing
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
30.9
21.4
22.86
22.86
22.86
22.86
22.86
42.8
45.72
45.72
45.72
45.72
73.7
76.62
76.62
76.62
104.6
107.52
107.52
107.52
135.5
138.42
138.42
138.42
52.3
53.76
53.76
53.76
83.2
84.66
84.66
84.66
114.1
115.56
115.56
115.56
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Pershing
Low
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
33670NV0980003
Anthem Dental Family
PPO
Rating Area 4
Allows Adult and Child-Only
SERFF
1-855-711-8949
1-855-711-8949
http://www.geoaccess.com/awp/Dental/PO/begin.asp?Gateway=False&st=DV&Company=Anthem-BCBS&netcode=DVP
http://www.anthem.com/agent/nv/f0/s0/t0/pw_e214670.pdf
X
X
X
X
X
X
X
34.44
39.7
39.7
39.7
39.7
39.7
39.7
79.4
79.4
79.4
79.4
79.4
113.84
113.84
113.84
113.84
148.28
148.28
148.28
148.28
182.72
182.72
182.72
182.72
74.14
74.14
74.14
74.14
108.58
108.58
108.58
108.58
143.02
143.02
143.02
143.02
$100
See Plan Brochure
$100
350
700
350
No Charge after Deductible
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
10%
50% Coinsurance after deductible
50% Coinsurance after deductible
50% Coinsurance after deductible
NV
Storey
Low
BEST Life and Health Insurance Company
75719NV0020005
BESTOne Plus Silver
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Plus-Silver_Plan.pdf
X
X
X
X
X
X
X
31.77
30.6
32.7
32.7
32.7
32.7
32.7
61.2
65.4
65.4
65.4
65.4
92.97
97.17
97.17
97.17
124.74
128.94
128.94
128.94
156.51
160.71
160.71
160.71
62.37
64.47
64.47
64.47
94.14
96.24
96.24
96.24
125.91
128.01
128.01
128.01
$75
See Plan Brochure
$75
350
700
350
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%
NV
Storey
Low
BEST Life and Health Insurance Company
75719NV0020006
BESTOne Basic Silver
PPO
Rating Area 3
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www.bestlife.com/exchange/dentemax.html
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
https://www.bestlife.com/nv/2015/NV_BESTOne_Dental_Basic-Silver_Plan.pdf
X
X
X
X
X
X
X
31.77
22
23.5
23.5
23.5
23.5
23.5
44
47
47
47
47
75.77
78.77
78.77
78.77
107.54
110.54
110.54
110.54
139.31
142.31
142.31
142.31
53.77
55.27
55.27
55.27
85.54
87.04
87.04
87.04
117.31
118.81
118.81
118.81
$75
See Plan Brochure
$75
350
700
350
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge
40% Coinsurance after deductible
50% Coinsurance after deductible
50%

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