| Zip Code | 94558 |
| Age | 65 |
| Spouse age | 67 |
| Bronze Dental PPO | 56.50 | Brochure | |
| Silver Dental PPO | 89.10 | Brochure | |
| Gold Dental PPO | 113.70 | Brochure | |
| Platinum Dental PPO | 135.60 | Brochure | |
| Incentive Dental PPO | 129.40 | Brochure | |
| Blue View Vision Plan | 13.31 | Brochure | |
| Dental PPO | 92.40 | Brochure | |
| Dental PPO 50/1250 | 87.00 | Brochure | |
| Enhanced Dental PPO 50/2000 | 137.00 | Brochure | |
| Enhanced Dental PPO 50/2000 | 148.60 | Brochure | |
| Duo Dental & Vision | 102.40 | Brochure | |
| Ultimate Vision 15/25/120 | 13.80 | Brochure | |
| Ultimate Vision 15/25/150 | 25.80 | Brochure | |