| Zip Code | |
| Age |
| Bronze Dental PPO | Brochure | | |
| Blue Enhanced Dental PPO | Brochure | | |
| Prime Dental PPO Plan A | 28.85 | Brochure | |
| Prime Dental PPO Plan B | 44.60 | Brochure | |
| Prime Dental PPO Plan C | 56.35 | Brochure | |
| Blue View Vision Plan | 7.81 | Brochure | |
| Dental PPO | 0.00 | Brochure | |
| Dental PPO 50/1250 | 0.00 | Brochure | |
| Enhanced Dental PPO 50/2000 | 0.00 | Brochure | |
| Enhanced Dental PPO 50/2000 | 0.00 | Brochure | |
| Dental HMO | 22.80 | Brochure | |
| Dental Standard HMO | 12.00 | Brochure | |
| Duo Dental & Vision | 42.10 | Brochure | |
| Ultimate Vision 15/25/120 | 6.90 | Brochure | |
| Ultimate Vision 15/25/150 | 12.90 | Brochure | |