| Zip Code | 91311 |
| Age | 59 |
| Spouse age | 52 |
| # Children | 2 |
| Bronze Dental PPO | 100.80 | Brochure | |
| Silver Dental PPO | 159.00 | Brochure | |
| Gold Dental PPO | 203.00 | Brochure | |
| Platinum Dental PPO | 242.00 | Brochure | |
| Incentive Dental PPO | 231.00 | Brochure | |
| Dental Net 3000D DHMO | 52.20 | Brochure | |
| Blue View Vision Plan | 21.30 | Brochure | |
| Dental PPO | 170.60 | Brochure | |
| Dental PPO 50/1250 | 154.80 | Brochure | |
| Enhanced Dental PPO 50/2000 | 243.20 | Brochure | |
| Enhanced Dental PPO 50/2000 | 264.00 | Brochure | |
| Dental HMO | 99.20 | Brochure | |
| Dental Standard HMO | 56.00 | Brochure | |
| Duo Dental & Vision | 189.40 | Brochure | |
| Ultimate Vision 15/25/120 | 27.60 | Brochure | |
| Ultimate Vision 15/25/150 | 51.60 | Brochure | |