Namara Marketplace

QHP Landscape NM Individual Market Dental

State

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County

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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

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Major Dental Care - Adult

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Orthodontia Adult 1

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Dental Check-Up For Children

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Basic Dental Care - Child

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Major Dental Care - Child

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Orthodontia Child 1

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Premium Scenarios

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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 Plan Cost Sharing

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Dental Deductible -Individual

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Dental Deductible - Family

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Maximum Out Of Pocket -Individual

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Maximum Out Of Pocket - Family

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Routine Dental Services Adult

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Basic Dental Adult

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Major Dental Adult

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Orthodontia Adult

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Dental Check-Up Child

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Basic Dental Child

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Major Dental Child

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Orthodontia Child

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NM
BERNALILLO
High
BEST Life
26075NM0020001
BESTOne Child Dental Plus
PPO
Rating Area 1
Allows Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Child_Denta_Plus_Plan.pdf
X
X
X
X
26.11
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
BERNALILLO
High
Blue Cross Blue Shield of New Mexico
75605NM0430003
BlueCare Dental 4 Kids 1A
PPO
Rating Area 1
Allows Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
41.62
25
$75
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
BERNALILLO
High
Renaissance Dental
17911NM0090001
Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)
PPO
Rating Area 1
Allows Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_Ped_High
X
X
X
X
37.15
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
10% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
BERNALILLO
Low
BEST Life
26075NM0020005
BESTOne Dental 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://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
32.65
32.65
32.65
32.65
32.65
32.65
32.65
65.29
65.29
65.29
65.29
65.29
86.97
86.97
86.97
86.97
108.65
108.65
108.65
108.65
139.01
139.01
139.01
139.01
54.33
54.33
54.33
54.33
76.01
76.01
76.01
76.01
106.36
106.36
106.36
106.36
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
BERNALILLO
Low
BEST Life
26075NM0020006
BESTOne Dental 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://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
25.4
25.4
25.4
25.4
25.4
25.4
25.4
50.8
50.8
50.8
50.8
50.8
71.13
71.13
71.13
71.13
91.45
91.45
91.45
91.45
119.91
119.91
119.91
119.91
45.73
45.73
45.73
45.73
66.05
66.05
66.05
66.05
94.5
94.5
94.5
94.5
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
BERNALILLO
Low
Blue Cross Blue Shield of New Mexico
75605NM0430002
BlueCare Dental 1B
PPO
Rating Area 1
Allows Adult and Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
X
X
X
33.07
24.85
24.85
24.85
24.85
24.85
24.85
49.7
49.7
49.7
49.7
49.7
82.77
82.77
82.77
82.77
115.84
115.84
115.84
115.84
148.91
148.91
148.91
148.91
57.92
57.92
57.92
57.92
90.99
90.99
90.99
90.99
124.06
124.06
124.06
124.06
75
$225
700
1400
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
BERNALILLO
Low
Renaissance Dental
17911NM0060002
Delta Dental Individual PPO, EHB Certified (Exchange)
PPO
Rating Area 1
Allows Adult and Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_EHB_Low
X
X
X
X
X
X
X
30.53
30.53
21.72
21.72
23.41
29.15
35.15
61.06
43.44
46.82
58.3
70.31
91.59
73.97
77.34
88.83
122.12
104.5
107.88
119.36
152.65
135.03
138.41
149.88
61.06
52.25
53.94
59.68
91.59
82.78
84.47
90.21
122.12
113.31
115
120.74
50
See Plan Brochure
700
1400
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CATRON
High
BEST Life
26075NM0020001
BESTOne Child Dental Plus
PPO
Rating Area 5
Allows Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Child_Denta_Plus_Plan.pdf
X
X
X
X
24.34
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CATRON
High
Blue Cross Blue Shield of New Mexico
75605NM0430003
BlueCare Dental 4 Kids 1A
PPO
Rating Area 5
Allows Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
41.62
25
$75
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CATRON
High
Renaissance Dental
17911NM0090001
Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_Ped_High
X
X
X
X
29.17
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
10% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CATRON
Low
BEST Life
26075NM0020005
BESTOne Dental Plus - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
30.43
30.43
30.43
30.43
30.43
30.43
30.43
60.86
60.86
60.86
60.86
60.86
81.06
81.06
81.06
81.06
101.28
101.28
101.28
101.28
129.58
129.58
129.58
129.58
50.64
50.64
50.64
50.64
70.84
70.84
70.84
70.84
99.14
99.14
99.14
99.14
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CATRON
Low
BEST Life
26075NM0020006
BESTOne Dental Basic - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
23.68
23.68
23.68
23.68
23.68
23.68
23.68
47.36
47.36
47.36
47.36
47.36
66.3
66.3
66.3
66.3
85.25
85.25
85.25
85.25
111.77
111.77
111.77
111.77
42.62
42.62
42.62
42.62
61.57
61.57
61.57
61.57
88.09
88.09
88.09
88.09
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CATRON
Low
Blue Cross Blue Shield of New Mexico
75605NM0430002
BlueCare Dental 1B
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
X
X
X
33.07
24.85
24.85
24.85
24.85
24.85
24.85
49.7
49.7
49.7
49.7
49.7
82.77
82.77
82.77
82.77
115.84
115.84
115.84
115.84
148.91
148.91
148.91
148.91
57.92
57.92
57.92
57.92
90.99
90.99
90.99
90.99
124.06
124.06
124.06
124.06
75
$225
700
1400
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CATRON
Low
Renaissance Dental
17911NM0060002
Delta Dental Individual PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_EHB_Low
X
X
X
X
X
X
X
23.96
23.96
17.05
17.05
18.38
22.88
27.6
47.92
34.1
36.76
45.76
55.2
71.88
58.06
60.72
69.72
95.84
82.02
84.68
93.68
119.8
105.97
108.63
117.63
47.92
41.01
42.34
46.84
71.88
64.97
66.3
70.8
95.84
88.92
90.25
94.75
50
See Plan Brochure
700
1400
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CHAVES
High
BEST Life
26075NM0020001
BESTOne Child Dental Plus
PPO
Rating Area 5
Allows Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Child_Denta_Plus_Plan.pdf
X
X
X
X
24.34
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CHAVES
High
Blue Cross Blue Shield of New Mexico
75605NM0430003
BlueCare Dental 4 Kids 1A
PPO
Rating Area 5
Allows Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
41.62
25
$75
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CHAVES
High
Renaissance Dental
17911NM0090001
Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_Ped_High
X
X
X
X
29.17
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
10% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CHAVES
Low
BEST Life
26075NM0020005
BESTOne Dental Plus - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
30.43
30.43
30.43
30.43
30.43
30.43
30.43
60.86
60.86
60.86
60.86
60.86
81.06
81.06
81.06
81.06
101.28
101.28
101.28
101.28
129.58
129.58
129.58
129.58
50.64
50.64
50.64
50.64
70.84
70.84
70.84
70.84
99.14
99.14
99.14
99.14
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CHAVES
Low
BEST Life
26075NM0020006
BESTOne Dental Basic - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
23.68
23.68
23.68
23.68
23.68
23.68
23.68
47.36
47.36
47.36
47.36
47.36
66.3
66.3
66.3
66.3
85.25
85.25
85.25
85.25
111.77
111.77
111.77
111.77
42.62
42.62
42.62
42.62
61.57
61.57
61.57
61.57
88.09
88.09
88.09
88.09
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CHAVES
Low
Blue Cross Blue Shield of New Mexico
75605NM0430002
BlueCare Dental 1B
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
X
X
X
33.07
24.85
24.85
24.85
24.85
24.85
24.85
49.7
49.7
49.7
49.7
49.7
82.77
82.77
82.77
82.77
115.84
115.84
115.84
115.84
148.91
148.91
148.91
148.91
57.92
57.92
57.92
57.92
90.99
90.99
90.99
90.99
124.06
124.06
124.06
124.06
75
$225
700
1400
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CHAVES
Low
Renaissance Dental
17911NM0060002
Delta Dental Individual PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_EHB_Low
X
X
X
X
X
X
X
23.96
23.96
17.05
17.05
18.38
22.88
27.6
47.92
34.1
36.76
45.76
55.2
71.88
58.06
60.72
69.72
95.84
82.02
84.68
93.68
119.8
105.97
108.63
117.63
47.92
41.01
42.34
46.84
71.88
64.97
66.3
70.8
95.84
88.92
90.25
94.75
50
See Plan Brochure
700
1400
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CIBOLA
High
BEST Life
26075NM0020001
BESTOne Child Dental Plus
PPO
Rating Area 5
Allows Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Child_Denta_Plus_Plan.pdf
X
X
X
X
24.34
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CIBOLA
High
Blue Cross Blue Shield of New Mexico
75605NM0430003
BlueCare Dental 4 Kids 1A
PPO
Rating Area 5
Allows Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
41.62
25
$75
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CIBOLA
High
Renaissance Dental
17911NM0090001
Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_Ped_High
X
X
X
X
29.17
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
10% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CIBOLA
Low
BEST Life
26075NM0020005
BESTOne Dental Plus - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
30.43
30.43
30.43
30.43
30.43
30.43
30.43
60.86
60.86
60.86
60.86
60.86
81.06
81.06
81.06
81.06
101.28
101.28
101.28
101.28
129.58
129.58
129.58
129.58
50.64
50.64
50.64
50.64
70.84
70.84
70.84
70.84
99.14
99.14
99.14
99.14
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CIBOLA
Low
BEST Life
26075NM0020006
BESTOne Dental Basic - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
23.68
23.68
23.68
23.68
23.68
23.68
23.68
47.36
47.36
47.36
47.36
47.36
66.3
66.3
66.3
66.3
85.25
85.25
85.25
85.25
111.77
111.77
111.77
111.77
42.62
42.62
42.62
42.62
61.57
61.57
61.57
61.57
88.09
88.09
88.09
88.09
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CIBOLA
Low
Blue Cross Blue Shield of New Mexico
75605NM0430002
BlueCare Dental 1B
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
X
X
X
33.07
24.85
24.85
24.85
24.85
24.85
24.85
49.7
49.7
49.7
49.7
49.7
82.77
82.77
82.77
82.77
115.84
115.84
115.84
115.84
148.91
148.91
148.91
148.91
57.92
57.92
57.92
57.92
90.99
90.99
90.99
90.99
124.06
124.06
124.06
124.06
75
$225
700
1400
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CIBOLA
Low
Renaissance Dental
17911NM0060002
Delta Dental Individual PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_EHB_Low
X
X
X
X
X
X
X
23.96
23.96
17.05
17.05
18.38
22.88
27.6
47.92
34.1
36.76
45.76
55.2
71.88
58.06
60.72
69.72
95.84
82.02
84.68
93.68
119.8
105.97
108.63
117.63
47.92
41.01
42.34
46.84
71.88
64.97
66.3
70.8
95.84
88.92
90.25
94.75
50
See Plan Brochure
700
1400
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
COLFAX
High
BEST Life
26075NM0020001
BESTOne Child Dental Plus
PPO
Rating Area 5
Allows Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Child_Denta_Plus_Plan.pdf
X
X
X
X
24.34
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
COLFAX
High
Blue Cross Blue Shield of New Mexico
75605NM0430003
BlueCare Dental 4 Kids 1A
PPO
Rating Area 5
Allows Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
41.62
25
$75
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
COLFAX
High
Renaissance Dental
17911NM0090001
Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_Ped_High
X
X
X
X
29.17
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
10% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
COLFAX
Low
BEST Life
26075NM0020005
BESTOne Dental Plus - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
30.43
30.43
30.43
30.43
30.43
30.43
30.43
60.86
60.86
60.86
60.86
60.86
81.06
81.06
81.06
81.06
101.28
101.28
101.28
101.28
129.58
129.58
129.58
129.58
50.64
50.64
50.64
50.64
70.84
70.84
70.84
70.84
99.14
99.14
99.14
99.14
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
COLFAX
Low
BEST Life
26075NM0020006
BESTOne Dental Basic - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
23.68
23.68
23.68
23.68
23.68
23.68
23.68
47.36
47.36
47.36
47.36
47.36
66.3
66.3
66.3
66.3
85.25
85.25
85.25
85.25
111.77
111.77
111.77
111.77
42.62
42.62
42.62
42.62
61.57
61.57
61.57
61.57
88.09
88.09
88.09
88.09
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
COLFAX
Low
Blue Cross Blue Shield of New Mexico
75605NM0430002
BlueCare Dental 1B
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
X
X
X
33.07
24.85
24.85
24.85
24.85
24.85
24.85
49.7
49.7
49.7
49.7
49.7
82.77
82.77
82.77
82.77
115.84
115.84
115.84
115.84
148.91
148.91
148.91
148.91
57.92
57.92
57.92
57.92
90.99
90.99
90.99
90.99
124.06
124.06
124.06
124.06
75
$225
700
1400
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
COLFAX
Low
Renaissance Dental
17911NM0060002
Delta Dental Individual PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_EHB_Low
X
X
X
X
X
X
X
23.96
23.96
17.05
17.05
18.38
22.88
27.6
47.92
34.1
36.76
45.76
55.2
71.88
58.06
60.72
69.72
95.84
82.02
84.68
93.68
119.8
105.97
108.63
117.63
47.92
41.01
42.34
46.84
71.88
64.97
66.3
70.8
95.84
88.92
90.25
94.75
50
See Plan Brochure
700
1400
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CURRY
High
BEST Life
26075NM0020001
BESTOne Child Dental Plus
PPO
Rating Area 5
Allows Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Child_Denta_Plus_Plan.pdf
X
X
X
X
24.34
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CURRY
High
Blue Cross Blue Shield of New Mexico
75605NM0430003
BlueCare Dental 4 Kids 1A
PPO
Rating Area 5
Allows Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
41.62
25
$75
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CURRY
High
Renaissance Dental
17911NM0090001
Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_Ped_High
X
X
X
X
29.17
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
10% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CURRY
Low
BEST Life
26075NM0020005
BESTOne Dental Plus - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
30.43
30.43
30.43
30.43
30.43
30.43
30.43
60.86
60.86
60.86
60.86
60.86
81.06
81.06
81.06
81.06
101.28
101.28
101.28
101.28
129.58
129.58
129.58
129.58
50.64
50.64
50.64
50.64
70.84
70.84
70.84
70.84
99.14
99.14
99.14
99.14
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CURRY
Low
BEST Life
26075NM0020006
BESTOne Dental Basic - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
23.68
23.68
23.68
23.68
23.68
23.68
23.68
47.36
47.36
47.36
47.36
47.36
66.3
66.3
66.3
66.3
85.25
85.25
85.25
85.25
111.77
111.77
111.77
111.77
42.62
42.62
42.62
42.62
61.57
61.57
61.57
61.57
88.09
88.09
88.09
88.09
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CURRY
Low
Blue Cross Blue Shield of New Mexico
75605NM0430002
BlueCare Dental 1B
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
X
X
X
33.07
24.85
24.85
24.85
24.85
24.85
24.85
49.7
49.7
49.7
49.7
49.7
82.77
82.77
82.77
82.77
115.84
115.84
115.84
115.84
148.91
148.91
148.91
148.91
57.92
57.92
57.92
57.92
90.99
90.99
90.99
90.99
124.06
124.06
124.06
124.06
75
$225
700
1400
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
CURRY
Low
Renaissance Dental
17911NM0060002
Delta Dental Individual PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_EHB_Low
X
X
X
X
X
X
X
23.96
23.96
17.05
17.05
18.38
22.88
27.6
47.92
34.1
36.76
45.76
55.2
71.88
58.06
60.72
69.72
95.84
82.02
84.68
93.68
119.8
105.97
108.63
117.63
47.92
41.01
42.34
46.84
71.88
64.97
66.3
70.8
95.84
88.92
90.25
94.75
50
See Plan Brochure
700
1400
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
DE BACA
High
BEST Life
26075NM0020001
BESTOne Child Dental Plus
PPO
Rating Area 5
Allows Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Child_Denta_Plus_Plan.pdf
X
X
X
X
24.34
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
DE BACA
High
Blue Cross Blue Shield of New Mexico
75605NM0430003
BlueCare Dental 4 Kids 1A
PPO
Rating Area 5
Allows Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
41.62
25
$75
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
DE BACA
High
Renaissance Dental
17911NM0090001
Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_Ped_High
X
X
X
X
29.17
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
10% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
DE BACA
Low
BEST Life
26075NM0020005
BESTOne Dental Plus - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
30.43
30.43
30.43
30.43
30.43
30.43
30.43
60.86
60.86
60.86
60.86
60.86
81.06
81.06
81.06
81.06
101.28
101.28
101.28
101.28
129.58
129.58
129.58
129.58
50.64
50.64
50.64
50.64
70.84
70.84
70.84
70.84
99.14
99.14
99.14
99.14
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
DE BACA
Low
BEST Life
26075NM0020006
BESTOne Dental Basic - Silver
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
23.68
23.68
23.68
23.68
23.68
23.68
23.68
47.36
47.36
47.36
47.36
47.36
66.3
66.3
66.3
66.3
85.25
85.25
85.25
85.25
111.77
111.77
111.77
111.77
42.62
42.62
42.62
42.62
61.57
61.57
61.57
61.57
88.09
88.09
88.09
88.09
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
DE BACA
Low
Blue Cross Blue Shield of New Mexico
75605NM0430002
BlueCare Dental 1B
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-866-236-1702
1-866-236-1702
1-855-543-4921
https://public.hcsc.net/providerfinder/home.do?corpEntCd=NM1
http://www.bcbsnm.com/coverage/individual/on-exchange/dental/
X
X
X
X
X
X
X
33.07
24.85
24.85
24.85
24.85
24.85
24.85
49.7
49.7
49.7
49.7
49.7
82.77
82.77
82.77
82.77
115.84
115.84
115.84
115.84
148.91
148.91
148.91
148.91
57.92
57.92
57.92
57.92
90.99
90.99
90.99
90.99
124.06
124.06
124.06
124.06
75
$225
700
1400
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
30% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
DE BACA
Low
Renaissance Dental
17911NM0060002
Delta Dental Individual PPO, EHB Certified (Exchange)
PPO
Rating Area 5
Allows Adult and Child-Only
SERFF
1-800-971-4108
http://www.deltadental.com/DentistSearch/DentistSearchController.ccl
http://www.deltadentalnm.com/NM_EHB_Plan_Brochure
http://www.deltadentalnm.com/NM_EHB_Low
X
X
X
X
X
X
X
23.96
23.96
17.05
17.05
18.38
22.88
27.6
47.92
34.1
36.76
45.76
55.2
71.88
58.06
60.72
69.72
95.84
82.02
84.68
93.68
119.8
105.97
108.63
117.63
47.92
41.01
42.34
46.84
71.88
64.97
66.3
70.8
95.84
88.92
90.25
94.75
50
See Plan Brochure
700
1400
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
Not Covered
10%
40% Coinsurance after deductible
50% Coinsurance after deductible
0.5
NM
DONA ANA
High
BEST Life
26075NM0020001
BESTOne Child Dental Plus
PPO
Rating Area 3
Allows Child-Only
SERFF
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/NM/pdf/NM_BESTOne_Child_Denta_Plus_Plan.pdf
X
X
X
X
23.56
50
See Plan Brochure
700
1400
Not Covered
Not Covered
Not Covered
Not Covered
No Charge
20% Coinsurance after deductible
50% Coinsurance after deductible
0.5

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