Smile Now Florida - No Waiting Period PPO - 43274FL0010002 Health Insurance Plan

Solstice Benefits, Inc. health insurance plan with the Plan ID 43274FL0010002. The plan is called Smile Now Florida - No Waiting Period PPO.

Health Insurance Plan ID 43274FL0010002
Health Insurance Plan Year 2025
State Florida
Health Insurance Issuer Solstice Benefits, Inc.
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 43274FL0010002-00
Provider Network(s) PREFERRED
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 10 Dec 2024 06:32 GMT).

Providers Florida All US States
All 5418 5800
PCP 4 5
Allergy N/A N/A
OB/GYN N/A N/A
Dentists 3324 3536
Available Variants of the Health Plan

Standard Off Exchange Plan - 43274FL0010002-00

Standard On Exchange Plan - 43274FL0010002-01

Last Plan Update Date Tue, 11 Jun 2024 00:00 GMT
Last Import Date Tue, 10 Dec 2024 06:32 GMT

Benefits of Smile Now Florida - No Waiting Period PPO Health Insurance Plan, 43274FL0010002-00

Benefit Covered In Network Out Of Network
Accidental Dental
NO
Basic Dental Care - Adult

Limit: 1000.0 Dollars per Year

YES

30.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Basic Dental Care - Child
YES

30.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Dental Check-Up for Children
YES

No Charge after deductible

50.00% Coinsurance after deductible
Major Dental Care - Adult

Limit: 1000.0 Dollars per Year

YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Major Dental Care - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Routine Dental Services (Adult)

Limit: 1000.0 Dollars per Year

YES

No Charge after deductible

50.00% Coinsurance after deductible

Smile Now Florida - No Waiting Period PPO Health Insurance Plan Variant 43274FL0010002-00 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2025
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low Off Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1.0
First Tier Utilization 100%
HIOS Product ID 43274FL001
Import Date 2024-06-11 12:13:38
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 43274
Issuer Marketplace Marketing Name Solstice Benefits
Market Coverage Individual
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Not Applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $60 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $60
Medical EHB Deductible, In Network (Tier 1), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person $60 per person
Medical EHB Deductible, In Network (Tier 1), Individual $60
Medical EHB Deductible, Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person $60 per person
Medical EHB Deductible, Out of Network, Individual $60
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group $800 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $400 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $400
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual Not Applicable
Metal Level Low
Multiple In Network Tiers No
National Network Yes
Network ID FLN001
Out of Country Coverage Yes
Out of Country Coverage Description Available only for emergency services to treat an Emergency Condition.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description National Network of providers is available and members may also receive services at out of network providers.
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan Expiration Date 2025-12-31
Plan ID (Standard Component ID with Variant) 43274FL0010002-00
Plan Marketing Name Smile Now Florida - No Waiting Period PPO
Plan Type PPO
Plan Variant Marketing Name Smile Now Florida - No Waiting Period PPO
QHP/Non QHP Both
Service Area ID FLS001
Source Name HIOS
Plan ID 43274FL0010002
State Code FL
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL

Copay & Coinsurance of Smile Now Florida - No Waiting Period PPO Health Insurance Plan, 43274FL0010002

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about Smile Now Florida - No Waiting Period PPO, 43274FL0010002 Health Insurance Plan, 43274FL0010002

  • Does Smile Now Florida - No Waiting Period PPO Health Insurance Plan, 43274FL0010002 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (43274FL0010002) Health Insurance Plan, Variant (43274FL0010002-00) have Out Of Country Coverage?

    Yes. Details: Available only for emergency services to treat an Emergency Condition.

    Does (43274FL0010002) Health Insurance Plan, Variant (43274FL0010002-00) have Out of Service Area Coverage?

    Yes. Details: National Network of providers is available and members may also receive services at out of network providers.

 

Disclaimer: This is based on the import(Date: Tue, 10 Dec 2024 06:32 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API