| Zip Code | 91362 |
| Age | 39 |
| Spouse age | 0 |
| # Children | 0 |
| Bronze Dental PPO | 25.20 | Brochure | |
| Silver Dental PPO | 39.75 | Brochure | |
| Gold Dental PPO | 50.75 | Brochure | |
| Platinum Dental PPO | 60.50 | Brochure | |
| Incentive Dental PPO | 57.75 | Brochure | |
| Dental Net 3000D DHMO | 32.12 | Brochure | |
| Blue View Vision Plan | 13.31 | Brochure | |
| Dental PPO | 82.10 | Brochure | |
| Dental PPO 50/1250 | 74.50 | Brochure | |
| Enhanced Dental PPO 50/2000 | 117.00 | Brochure | |
| Enhanced Dental PPO 50/2000 | 127.00 | Brochure | |
| Dental HMO | 61.60 | Brochure | |
| Dental Standard HMO | 34.50 | Brochure | |
| Duo Dental & Vision | 99.00 | Brochure | |
| Ultimate Vision 15/25/120 | 13.80 | Brochure | |
| Ultimate Vision 15/25/150 | 25.80 | Brochure | |