| Zip Code | 90025 |
| Age | 61 |
| Spouse age | 49 |
| # Children | 2 |
| Blue Basic Dental PPO | 124.00 | Brochure | |
| Blue Enhanced Dental PPO | 224.00 | 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 | 22.06 | Brochure | |
| Dental PPO | 151.60 | Brochure | |
| Dental PPO 50/1250 | 136.00 | Brochure | |
| Dental PPO 25/500 | 112.20 | Brochure | |
| Dental HMO | 89.40 | Brochure | |
| Dental Standard HMO | 47.80 | Brochure | |
| Duo Dental & Vision | 176.00 | Brochure | |
| Ultimate Vision 15/25/120 | 26.00 | Brochure | |
| Ultimate Vision 15/25/150 | 48.00 | Brochure | |