| Zip Code | 92804 |
| Age | 33 |
| Spouse age | 33 |
| Blue Basic Dental PPO | 47.00 | Brochure | |
| Blue Enhanced Dental PPO | 104.00 | Brochure | |
| Prime Dental PPO Plan A | 56.30 | Brochure | |
| Prime Dental PPO Plan B | 86.70 | Brochure | |
| Prime Dental PPO Plan C | 109.55 | Brochure | |
| Dental Net 3000D DHMO | 32.12 | Brochure | |
| Blue View Vision Plan | 13.79 | Brochure | |
| Dental PPO | 89.00 | Brochure | |
| Dental PPO 50/1250 | 83.80 | Brochure | |
| Dental PPO 25/500 | 1,100.00 | Brochure | |
| Enhanced Dental PPO 50/2000 | 131.80 | Brochure | |
| Dental HMO | 49.80 | Brochure | |
| Dental Standard HMO | 29.80 | Brochure | |
| Duo Dental & Vision | 99.00 | Brochure | |
| Ultimate Vision 15/25/120 | 13.80 | Brochure | |
| Ultimate Vision 15/25/150 | 25.80 | Brochure | |