2016 QHP Landscape NM Individual Market Dental

State Code Want total control? Request access to start using the data.	County Name Want total control? Request access to start using the data.	Metal Level Want total control? Request access to start using the data.	Issuer Name Want total control? Request access to start using the data.	Plan Id (Standard Component) Want total control? Request access to start using the data.	Plan Marketing Name Want total control? Request access to start using the data.	Plan Type Want total control? Request access to start using the data.	Rating Area Want total control? Request access to start using the data.	Child Only Offering Want total control? Request access to start using the data.	Source Want total control? Request access to start using the data.	Customer Service Phone Number Local Want total control? Request access to start using the data.	Customer Service Phone Number Toll Free Want total control? Request access to start using the data.	Customer Service Phone Number Tty Want total control? Request access to start using the data.	Network Url Want total control? Request access to start using the data.	Plan Brochure Url Want total control? Request access to start using the data.	Summary Of Benefits Url Want total control? Request access to start using the data.	Routine Dental Services Adult 1 Want total control? Request access to start using the data.	Basic Dental Care Adult 1 Want total control? Request access to start using the data.	Major Dental Care Adult 1 Want total control? Request access to start using the data.	Dental Check-Up For Children Want total control? Request access to start using the data.	Basic Dental Care Child 1 Want total control? Request access to start using the data.	Major Dental Care Child 1 Want total control? Request access to start using the data.	Orthodontia Child 1 Want total control? Request access to start using the data.	Premium Child Want total control? Request access to start using the data.	Premium Adult Individual Age 21 Want total control? Request access to start using the data.	Premium Adult Individual Age 27 Want total control? Request access to start using the data.	Premium Adult Individual Age 30 Want total control? Request access to start using the data.	Premium Adult Individual Age 40 Want total control? Request access to start using the data.	Premium Adult Individual Age 50 Want total control? Request access to start using the data.	Premium Adult Individual Age 60 Want total control? Request access to start using the data.	Premium Couple 21 Want total control? Request access to start using the data.	Premium Couple 30 Want total control? Request access to start using the data.	Premium Couple 40 Want total control? Request access to start using the data.	Premium Couple 50 Want total control? Request access to start using the data.	Premium Couple 60 Want total control? Request access to start using the data.	Couple+1 Child, Age 21 Want total control? Request access to start using the data.	Couple+1 Child, Age 30 Want total control? Request access to start using the data.	Couple+1 Child, Age 40 Want total control? Request access to start using the data.	Couple+1 Child, Age 50 Want total control? Request access to start using the data.	Couple+2 Children, Age 21 Want total control? Request access to start using the data.	Couple+2 Children, Age 30 Want total control? Request access to start using the data.	Couple+2 Children, Age 40 Want total control? Request access to start using the data.	Couple+2 Children, Age 50 Want total control? Request access to start using the data.	Couple+3 Or More Children, Age 21 Want total control? Request access to start using the data.	Couple+3 Or More Children, Age 30 Want total control? Request access to start using the data.	Couple+3 Or More Children, Age 40 Want total control? Request access to start using the data.	Couple+3 Or More Children, Age 50 Want total control? Request access to start using the data.	Individual+1 Child, Age 21 Want total control? Request access to start using the data.	Individual+1 Child, Age 30 Want total control? Request access to start using the data.	Individual+1 Child, Age 40 Want total control? Request access to start using the data.	Individual+1 Child, Age 50 Want total control? Request access to start using the data.	Individual+2 Children, Age 21 Want total control? Request access to start using the data.	Individual+2 Children, Age 30 Want total control? Request access to start using the data.	Individual+2 Children, Age 40 Want total control? Request access to start using the data.	Individual+2 Children, Age 50 Want total control? Request access to start using the data.	Individual+3 Or More Children, Age 21 Want total control? Request access to start using the data.	Individual+3 Or More Children, Age 30 Want total control? Request access to start using the data.	Individual+3 Or More Children, Age 40 Want total control? Request access to start using the data.	Individual+3 Or More Children, Age 50 Want total control? Request access to start using the data.	Dental Deductible - Individual - Standard Want total control? Request access to start using the data.	Dental Deductible - Family - Standard Want total control? Request access to start using the data.	Dental Deductible - Family (Per Person) - Standard Want total control? Request access to start using the data.	Dental Maximum Out Of Pocket - Individual - Standard Want total control? Request access to start using the data.	Dental Maximum Out Of Pocket - Family - Standard Want total control? Request access to start using the data.	Dental Maximum Out Of Pocket - Family (Per Person) - Standard Want total control? Request access to start using the data.	Routine Dental Services Adult Want total control? Request access to start using the data.	Basic Dental Care Adult Want total control? Request access to start using the data.	Major Dental Care Adult Want total control? Request access to start using the data.	Orthodontia Adult Want total control? Request access to start using the data.	Dental Checkup For Children Want total control? Request access to start using the data.	Basic Dental Care Child Want total control? Request access to start using the data.	Major Dental Care Child Want total control? Request access to start using the data.	Orthodontia Child Want total control? Request access to start using the data.
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Bernalillo	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 1	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	37.53																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Bernalillo	Low	BEST Life and Health Insurance Company	26075NM0020005	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/NM/2016/NM_BESTOne_Dental_Plus-Silver_Plan.pdf		X	X	X	X	X	X	X	20.76	27.32	29.19	29.19	29.19	29.19	29.19	54.64	58.38	58.38	58.38	58.38	75.4	79.14	79.14	79.14	96.16	99.9	99.9	99.9	116.92	120.66	120.66	120.66	48.08	49.95	49.95	49.95	68.84	70.71	70.71	70.71	89.6	91.47	91.47	91.47	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%
NM	Bernalillo	Low	BEST Life and Health Insurance Company	26075NM0020006	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/NM/2016/NM_BESTOne_Dental_Basic-Silver_Plan.pdf		X	X	X	X	X	X	X	20.76	19.98	21.34	21.34	21.34	21.34	21.34	39.96	42.68	42.68	42.68	42.68	60.72	63.44	63.44	63.44	81.48	84.2	84.2	84.2	102.24	104.96	104.96	104.96	40.74	42.1	42.1	42.1	61.5	62.86	62.86	62.86	82.26	83.62	83.62	83.62	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%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	X	X	X	X	X	X	X	26.86	22.02	22.02	22.02	22.02	22.02	22.02	44.04	44.04	44.04	44.04	44.04	70.9	70.9	70.9	70.9	97.76	97.76	97.76	97.76	124.62	124.62	124.62	124.62	48.88	48.88	48.88	48.88	75.74	75.74	75.74	75.74	102.6	102.6	102.6	102.6	75	$225	$75	350	700	350	10%	30% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	50% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Bernalillo	Low	Renaissance Life & Health Insurance Company of America	17911NM0060002	Delta Dental Individual PPO, EHB Certified (Exchange)	PPO	Rating Area 1	Allows Adult and Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_EHB_Low_2016	http://www.deltadentalnm.com/NM_EHB_Low_2016	X	X	X	X	X	X	X	31.11	31.11	18.23	18.23	19.83	25.45	31.26	62.22	36.46	39.66	50.9	62.52	93.33	67.57	70.77	82.01	124.44	98.68	101.88	113.12	155.55	129.79	132.99	144.23	62.22	49.34	50.94	56.56	93.33	80.45	82.05	87.67	124.44	111.56	113.16	118.78	50	$150	$50	350	700	350	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	50%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Catron	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	29.46																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Catron	Low	BEST Life and Health Insurance Company	26075NM0020005	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Plus-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	24.44	26.11	26.11	26.11	26.11	26.11	48.88	52.22	52.22	52.22	52.22	67.45	70.79	70.79	70.79	86.02	89.36	89.36	89.36	104.59	107.93	107.93	107.93	43.01	44.68	44.68	44.68	61.58	63.25	63.25	63.25	80.15	81.82	81.82	81.82	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%
NM	Catron	Low	BEST Life and Health Insurance Company	26075NM0020006	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Basic-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	17.87	19.09	19.09	19.09	19.09	19.09	35.74	38.18	38.18	38.18	38.18	54.31	56.75	56.75	56.75	72.88	75.32	75.32	75.32	91.45	93.89	93.89	93.89	36.44	37.66	37.66	37.66	55.01	56.23	56.23	56.23	73.58	74.8	74.8	74.8	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%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	X	X	X	X	X	X	X	26.86	22.02	22.02	22.02	22.02	22.02	22.02	44.04	44.04	44.04	44.04	44.04	70.9	70.9	70.9	70.9	97.76	97.76	97.76	97.76	124.62	124.62	124.62	124.62	48.88	48.88	48.88	48.88	75.74	75.74	75.74	75.74	102.6	102.6	102.6	102.6	75	$225	$75	350	700	350	10%	30% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	50% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Catron	Low	Renaissance Life & Health Insurance Company of America	17911NM0060002	Delta Dental Individual PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Adult and Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_EHB_Low_2016	http://www.deltadentalnm.com/NM_EHB_Low_2016	X	X	X	X	X	X	X	24.42	24.42	14.31	14.31	15.56	19.97	24.54	48.84	28.62	31.12	39.94	49.08	73.26	53.04	55.54	64.36	97.68	77.46	79.96	88.78	122.1	101.88	104.38	113.2	48.84	38.73	39.98	44.39	73.26	63.15	64.4	68.81	97.68	87.57	88.82	93.23	50	$150	$50	350	700	350	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	50%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Chaves	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	29.46																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Chaves	Low	BEST Life and Health Insurance Company	26075NM0020005	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Plus-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	24.44	26.11	26.11	26.11	26.11	26.11	48.88	52.22	52.22	52.22	52.22	67.45	70.79	70.79	70.79	86.02	89.36	89.36	89.36	104.59	107.93	107.93	107.93	43.01	44.68	44.68	44.68	61.58	63.25	63.25	63.25	80.15	81.82	81.82	81.82	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%
NM	Chaves	Low	BEST Life and Health Insurance Company	26075NM0020006	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Basic-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	17.87	19.09	19.09	19.09	19.09	19.09	35.74	38.18	38.18	38.18	38.18	54.31	56.75	56.75	56.75	72.88	75.32	75.32	75.32	91.45	93.89	93.89	93.89	36.44	37.66	37.66	37.66	55.01	56.23	56.23	56.23	73.58	74.8	74.8	74.8	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%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	X	X	X	X	X	X	X	26.86	22.02	22.02	22.02	22.02	22.02	22.02	44.04	44.04	44.04	44.04	44.04	70.9	70.9	70.9	70.9	97.76	97.76	97.76	97.76	124.62	124.62	124.62	124.62	48.88	48.88	48.88	48.88	75.74	75.74	75.74	75.74	102.6	102.6	102.6	102.6	75	$225	$75	350	700	350	10%	30% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	50% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Chaves	Low	Renaissance Life & Health Insurance Company of America	17911NM0060002	Delta Dental Individual PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Adult and Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_EHB_Low_2016	http://www.deltadentalnm.com/NM_EHB_Low_2016	X	X	X	X	X	X	X	24.42	24.42	14.31	14.31	15.56	19.97	24.54	48.84	28.62	31.12	39.94	49.08	73.26	53.04	55.54	64.36	97.68	77.46	79.96	88.78	122.1	101.88	104.38	113.2	48.84	38.73	39.98	44.39	73.26	63.15	64.4	68.81	97.68	87.57	88.82	93.23	50	$150	$50	350	700	350	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	50%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Cibola	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	29.46																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Cibola	Low	BEST Life and Health Insurance Company	26075NM0020005	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Plus-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	24.44	26.11	26.11	26.11	26.11	26.11	48.88	52.22	52.22	52.22	52.22	67.45	70.79	70.79	70.79	86.02	89.36	89.36	89.36	104.59	107.93	107.93	107.93	43.01	44.68	44.68	44.68	61.58	63.25	63.25	63.25	80.15	81.82	81.82	81.82	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%
NM	Cibola	Low	BEST Life and Health Insurance Company	26075NM0020006	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Basic-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	17.87	19.09	19.09	19.09	19.09	19.09	35.74	38.18	38.18	38.18	38.18	54.31	56.75	56.75	56.75	72.88	75.32	75.32	75.32	91.45	93.89	93.89	93.89	36.44	37.66	37.66	37.66	55.01	56.23	56.23	56.23	73.58	74.8	74.8	74.8	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%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	X	X	X	X	X	X	X	26.86	22.02	22.02	22.02	22.02	22.02	22.02	44.04	44.04	44.04	44.04	44.04	70.9	70.9	70.9	70.9	97.76	97.76	97.76	97.76	124.62	124.62	124.62	124.62	48.88	48.88	48.88	48.88	75.74	75.74	75.74	75.74	102.6	102.6	102.6	102.6	75	$225	$75	350	700	350	10%	30% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	50% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Cibola	Low	Renaissance Life & Health Insurance Company of America	17911NM0060002	Delta Dental Individual PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Adult and Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_EHB_Low_2016	http://www.deltadentalnm.com/NM_EHB_Low_2016	X	X	X	X	X	X	X	24.42	24.42	14.31	14.31	15.56	19.97	24.54	48.84	28.62	31.12	39.94	49.08	73.26	53.04	55.54	64.36	97.68	77.46	79.96	88.78	122.1	101.88	104.38	113.2	48.84	38.73	39.98	44.39	73.26	63.15	64.4	68.81	97.68	87.57	88.82	93.23	50	$150	$50	350	700	350	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	50%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Colfax	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	29.46																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Colfax	Low	BEST Life and Health Insurance Company	26075NM0020005	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Plus-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	24.44	26.11	26.11	26.11	26.11	26.11	48.88	52.22	52.22	52.22	52.22	67.45	70.79	70.79	70.79	86.02	89.36	89.36	89.36	104.59	107.93	107.93	107.93	43.01	44.68	44.68	44.68	61.58	63.25	63.25	63.25	80.15	81.82	81.82	81.82	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%
NM	Colfax	Low	BEST Life and Health Insurance Company	26075NM0020006	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Basic-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	17.87	19.09	19.09	19.09	19.09	19.09	35.74	38.18	38.18	38.18	38.18	54.31	56.75	56.75	56.75	72.88	75.32	75.32	75.32	91.45	93.89	93.89	93.89	36.44	37.66	37.66	37.66	55.01	56.23	56.23	56.23	73.58	74.8	74.8	74.8	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%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	X	X	X	X	X	X	X	26.86	22.02	22.02	22.02	22.02	22.02	22.02	44.04	44.04	44.04	44.04	44.04	70.9	70.9	70.9	70.9	97.76	97.76	97.76	97.76	124.62	124.62	124.62	124.62	48.88	48.88	48.88	48.88	75.74	75.74	75.74	75.74	102.6	102.6	102.6	102.6	75	$225	$75	350	700	350	10%	30% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	50% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Colfax	Low	Renaissance Life & Health Insurance Company of America	17911NM0060002	Delta Dental Individual PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Adult and Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_EHB_Low_2016	http://www.deltadentalnm.com/NM_EHB_Low_2016	X	X	X	X	X	X	X	24.42	24.42	14.31	14.31	15.56	19.97	24.54	48.84	28.62	31.12	39.94	49.08	73.26	53.04	55.54	64.36	97.68	77.46	79.96	88.78	122.1	101.88	104.38	113.2	48.84	38.73	39.98	44.39	73.26	63.15	64.4	68.81	97.68	87.57	88.82	93.23	50	$150	$50	350	700	350	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	50%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Curry	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	29.46																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Curry	Low	BEST Life and Health Insurance Company	26075NM0020005	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Plus-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	24.44	26.11	26.11	26.11	26.11	26.11	48.88	52.22	52.22	52.22	52.22	67.45	70.79	70.79	70.79	86.02	89.36	89.36	89.36	104.59	107.93	107.93	107.93	43.01	44.68	44.68	44.68	61.58	63.25	63.25	63.25	80.15	81.82	81.82	81.82	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%
NM	Curry	Low	BEST Life and Health Insurance Company	26075NM0020006	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Basic-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	17.87	19.09	19.09	19.09	19.09	19.09	35.74	38.18	38.18	38.18	38.18	54.31	56.75	56.75	56.75	72.88	75.32	75.32	75.32	91.45	93.89	93.89	93.89	36.44	37.66	37.66	37.66	55.01	56.23	56.23	56.23	73.58	74.8	74.8	74.8	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%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	X	X	X	X	X	X	X	26.86	22.02	22.02	22.02	22.02	22.02	22.02	44.04	44.04	44.04	44.04	44.04	70.9	70.9	70.9	70.9	97.76	97.76	97.76	97.76	124.62	124.62	124.62	124.62	48.88	48.88	48.88	48.88	75.74	75.74	75.74	75.74	102.6	102.6	102.6	102.6	75	$225	$75	350	700	350	10%	30% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	50% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Curry	Low	Renaissance Life & Health Insurance Company of America	17911NM0060002	Delta Dental Individual PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Adult and Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_EHB_Low_2016	http://www.deltadentalnm.com/NM_EHB_Low_2016	X	X	X	X	X	X	X	24.42	24.42	14.31	14.31	15.56	19.97	24.54	48.84	28.62	31.12	39.94	49.08	73.26	53.04	55.54	64.36	97.68	77.46	79.96	88.78	122.1	101.88	104.38	113.2	48.84	38.73	39.98	44.39	73.26	63.15	64.4	68.81	97.68	87.57	88.82	93.23	50	$150	$50	350	700	350	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	50%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	De Baca	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	29.46																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	De Baca	Low	BEST Life and Health Insurance Company	26075NM0020005	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Plus-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	24.44	26.11	26.11	26.11	26.11	26.11	48.88	52.22	52.22	52.22	52.22	67.45	70.79	70.79	70.79	86.02	89.36	89.36	89.36	104.59	107.93	107.93	107.93	43.01	44.68	44.68	44.68	61.58	63.25	63.25	63.25	80.15	81.82	81.82	81.82	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%
NM	De Baca	Low	BEST Life and Health Insurance Company	26075NM0020006	BESTOne 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://www.bestlife.com/exchange/dentemax.html	https://www.bestlife.com/NM/2016/NM_BESTOne_Dental_Basic-Silver_Plan.pdf		X	X	X	X	X	X	X	18.57	17.87	19.09	19.09	19.09	19.09	19.09	35.74	38.18	38.18	38.18	38.18	54.31	56.75	56.75	56.75	72.88	75.32	75.32	75.32	91.45	93.89	93.89	93.89	36.44	37.66	37.66	37.66	55.01	56.23	56.23	56.23	73.58	74.8	74.8	74.8	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%
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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	X	X	X	X	X	X	X	26.86	22.02	22.02	22.02	22.02	22.02	22.02	44.04	44.04	44.04	44.04	44.04	70.9	70.9	70.9	70.9	97.76	97.76	97.76	97.76	124.62	124.62	124.62	124.62	48.88	48.88	48.88	48.88	75.74	75.74	75.74	75.74	102.6	102.6	102.6	102.6	75	$225	$75	350	700	350	10%	30% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	50% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	De Baca	Low	Renaissance Life & Health Insurance Company of America	17911NM0060002	Delta Dental Individual PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Adult and Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_EHB_Low_2016	http://www.deltadentalnm.com/NM_EHB_Low_2016	X	X	X	X	X	X	X	24.42	24.42	14.31	14.31	15.56	19.97	24.54	48.84	28.62	31.12	39.94	49.08	73.26	53.04	55.54	64.36	97.68	77.46	79.96	88.78	122.1	101.88	104.38	113.2	48.84	38.73	39.98	44.39	73.26	63.15	64.4	68.81	97.68	87.57	88.82	93.23	50	$150	$50	350	700	350	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Dona Ana	High	Blue Cross Blue Shield of New Mexico	75605NM0430003	BlueCare Dental 4 Kids? 1A	PPO	Rating Area 3	Allows Child-Only	SERFF	1-866-236-1702	1-866-236-1702	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Dona Ana	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 3	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	29																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Dona Ana	Low	BEST Life and Health Insurance Company	26075NM0020005	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/NM/2016/NM_BESTOne_Dental_Plus-Silver_Plan.pdf		X	X	X	X	X	X	X	17.72	23.31	24.91	24.91	24.91	24.91	24.91	46.62	49.82	49.82	49.82	49.82	64.34	67.54	67.54	67.54	82.06	85.26	85.26	85.26	99.78	102.98	102.98	102.98	41.03	42.63	42.63	42.63	58.75	60.35	60.35	60.35	76.47	78.07	78.07	78.07	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%
NM	Dona Ana	Low	BEST Life and Health Insurance Company	26075NM0020006	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/NM/2016/NM_BESTOne_Dental_Basic-Silver_Plan.pdf		X	X	X	X	X	X	X	17.72	17.05	18.21	18.21	18.21	18.21	18.21	34.1	36.42	36.42	36.42	36.42	51.82	54.14	54.14	54.14	69.54	71.86	71.86	71.86	87.26	89.58	89.58	89.58	34.77	35.93	35.93	35.93	52.49	53.65	53.65	53.65	70.21	71.37	71.37	71.37	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%
NM	Dona Ana	Low	Blue Cross Blue Shield of New Mexico	75605NM0430002	BlueCare Dental? 1B	PPO	Rating Area 3	Allows Adult and Child-Only	SERFF	1-866-236-1702	1-866-236-1702	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	X	X	X	X	X	X	X	26.86	22.02	22.02	22.02	22.02	22.02	22.02	44.04	44.04	44.04	44.04	44.04	70.9	70.9	70.9	70.9	97.76	97.76	97.76	97.76	124.62	124.62	124.62	124.62	48.88	48.88	48.88	48.88	75.74	75.74	75.74	75.74	102.6	102.6	102.6	102.6	75	$225	$75	350	700	350	10%	30% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	50% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Dona Ana	Low	Renaissance Life & Health Insurance Company of America	17911NM0060002	Delta Dental Individual PPO, EHB Certified (Exchange)	PPO	Rating Area 3	Allows Adult and Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_EHB_Low_2016	http://www.deltadentalnm.com/NM_EHB_Low_2016	X	X	X	X	X	X	X	24.04	24.04	14.08	14.08	15.32	19.66	24.15	48.08	28.16	30.64	39.32	48.3	72.12	52.2	54.68	63.36	96.16	76.24	78.72	87.4	120.2	100.28	102.76	111.44	48.08	38.12	39.36	43.7	72.12	62.16	63.4	67.74	96.16	86.2	87.44	91.78	50	$150	$50	350	700	350	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	Not Covered	20%	40% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Eddy	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	1-800-659-8331	http://www.bcbsnm.com/provider_finder/important_info_dental.html	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf	http://www.bcbsnm.com/pdf/bluecare-dental-individuals-and-families-nm.pdf				X	X	X	X	33.02																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%
NM	Eddy	High	Renaissance Life & Health Insurance Company of America	17911NM0090001	Delta Dental Individual Pediatric-Only PPO, EHB Certified (Exchange)	PPO	Rating Area 5	Allows Child-Only	SERFF	1-800-971-4108	1-800-971-4108		http://www.deltadental.com/DentistSearch/DentistSearchController.ccl	http://www.deltadentalnm.com/NM_Ped_High_2016	http://www.deltadentalnm.com/NM_Ped_High_2016				X	X	X	X	29.46																																				50	$150	$50	350	700	350	Not Covered	Not Covered	Not Covered	Not Covered	No Charge	20% Coinsurance after deductible	50% Coinsurance after deductible	50%

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