| Zip Code | 92804 |
| Age | 33 |
| # Children | 2 |
| Blue Basic Dental PPO | 89.00 | Brochure | |
| Blue Enhanced Dental PPO | 160.00 | 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 | 119.70 | Brochure | |
| Dental PPO 50/1250 | 107.10 | Brochure | |
| Dental PPO 25/500 | 1,550.00 | Brochure | |
| Dental HMO | 70.50 | Brochure | |
| Dental Standard HMO | 38.90 | Brochure | |
| Duo Dental & Vision | 133.70 | Brochure | |
| Ultimate Vision 15/25/120 | 20.70 | Brochure | |
| Ultimate Vision 15/25/150 | 38.70 | Brochure | |