| Zip Code | 90211 |
| Age | 64 |
| Spouse age | 61 |
| # Children | 1 |
| Bronze Dental PPO | 75.60 | Brochure | |
| Silver Dental PPO | 119.25 | Brochure | |
| Gold Dental PPO | 152.25 | Brochure | |
| Platinum Dental PPO | 181.50 | Brochure | |
| Incentive Dental PPO | 173.25 | Brochure | |
| Dental Net 3000D DHMO | 52.20 | Brochure | |
| Blue View Vision Plan | 22.30 | Brochure | |
| Dental PPO | 126.60 | Brochure | |
| Dental PPO 50/1250 | 116.40 | Brochure | |
| Enhanced Dental PPO 50/2000 | 182.90 | Brochure | |
| Enhanced Dental PPO 50/2000 | 198.50 | Brochure | |
| Dental HMO | 72.60 | Brochure | |
| Dental Standard HMO | 41.80 | Brochure | |
| Duo Dental & Vision | 141.10 | Brochure | |
| Ultimate Vision 15/25/120 | 20.70 | Brochure | |
| Ultimate Vision 15/25/150 | 38.70 | Brochure | |