| Zip Code | 90027 |
| Age | 54 |
| Spouse age | 50 |
| # Children | 3 |
| Bronze Dental PPO | 126.00 | Brochure | |
| Silver Dental PPO | 198.75 | Brochure | |
| Gold Dental PPO | 253.75 | Brochure | |
| Platinum Dental PPO | 302.50 | Brochure | |
| Incentive Dental PPO | 288.75 | Brochure | |
| Dental Net 3000D DHMO | 52.20 | Brochure | |
| Blue View Vision Plan | 21.30 | Brochure | |
| Dental PPO | 209.70 | Brochure | |
| Dental PPO 50/1250 | 188.70 | Brochure | |
| Enhanced Dental PPO 50/2000 | 296.30 | Brochure | |
| Enhanced Dental PPO 50/2000 | 321.70 | Brochure | |
| Dental HMO | 122.90 | Brochure | |
| Dental Standard HMO | 68.50 | Brochure | |
| Duo Dental & Vision | 232.90 | Brochure | |
| Ultimate Vision 15/25/120 | 34.50 | Brochure | |
| Ultimate Vision 15/25/150 | 64.50 | Brochure | |