| Zip Code | 94558 |
| Age | 43 |
| Spouse age | 44 |
| # Children | 7 |
| Bronze Dental PPO | 126.00 | Brochure | |
| Silver Dental PPO | 198.75 | Brochure | |
| Gold Dental PPO | 253.75 | Brochure | |
| Platinum Dental PPO | 302.50 | Brochure | |
| Incentive Dental PPO | 288.75 | Brochure | |
| Blue View Vision Plan | 21.30 | Brochure | |