| Zip Code | 91303 |
| Age | 57 |
| # Children | 1 |
| Bronze Dental PPO | 50.40 | Brochure | |
| Silver Dental PPO | 79.50 | Brochure | |
| Gold Dental PPO | 101.50 | Brochure | |
| Platinum Dental PPO | 121.00 | Brochure | |
| Incentive Dental PPO | 115.50 | 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 | 47.70 | Brochure | |
| Dental Standard HMO | 26.90 | Brochure | |
| Duo Dental & Vision | 91.60 | Brochure | |
| Ultimate Vision 15/25/120 | 13.80 | Brochure | |
| Ultimate Vision 15/25/150 | 25.80 | Brochure | |