| Zip Code | 92804 |
| Age | 55 |
| Spouse age | 44 |
| # Children | 2 |
| Bronze Dental PPO | 100.8 | Brochure | |
| Blue Enhanced Dental PPO | 202.00 | Brochure | |
| Prime Dental PPO Plan A | 90.10 | Brochure | |
| Prime Dental PPO Plan B | 138.75 | Brochure | |
| Prime Dental PPO Plan C | 175.25 | Brochure | |
| Dental Net 3000D DHMO | 52.20 | Brochure | |
| Blue View Vision Plan | 22.30 | Brochure | |
| Dental PPO | 164.20 | Brochure | |
| Dental PPO 50/1250 | 149.00 | Brochure | |
| Enhanced Dental PPO 50/2000 | 234.00 | Brochure | |
| Enhanced Dental PPO 50/2000 | 254.00 | Brochure | |
| Dental HMO | 95.40 | Brochure | |
| Dental Standard HMO | 53.80 | Brochure | |
| Duo Dental & Vision | 183.20 | Brochure | |
| Ultimate Vision 15/25/120 | 27.60 | Brochure | |
| Ultimate Vision 15/25/150 | 51.60 | Brochure | |