| Zip Code | 92028 |
| Age | 68 |
| # Children | 1 |
| Blue Basic Dental PPO | 53.00 | Brochure | |
| Blue Enhanced Dental PPO | 99.00 | Brochure | |
| Prime Dental PPO Plan A | 58.55 | Brochure | |
| Prime Dental PPO Plan B | 92.80 | Brochure | |
| Prime Dental PPO Plan C | 124.85 | Brochure | |
| Dental Net 3000D DHMO | 32.12 | Brochure | |
| Blue View Vision Plan | 13.79 | Brochure | |
| Dental PPO | 75.80 | Brochure | |
| Dental PPO 50/1250 | 68.00 | Brochure | |
| Dental PPO 25/500 | 56.10 | Brochure | |
| Dental HMO | 44.70 | Brochure | |
| Dental Standard HMO | 23.90 | Brochure | |
| Duo Dental & Vision | 88.00 | Brochure | |
| Ultimate Vision 15/25/120 | 13.00 | Brochure | |
| Ultimate Vision 15/25/150 | 24.00 | Brochure | |