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Monthly Optional Life Insurance Premium
        Calculate Your Premium.




        Group Life Rates for You                 Group Life Rates for Your Spouse        Group Life Rates for your

                                                                                         Dependent Child(ren)
           Employee    Life                        Employee     Life
             Age     Premium                          Age     Premium
            Range      Rate                          Range     Rate                            Child(ren) Life
             0 - 24    $0.05                         0 - 24    $0.05                         Premium Rate, per
            25 - 29    $0.06                        25 - 29    $0.06                             $1,000
            30 - 34    $0.08                        30 - 34    $0.08                              $0.20
            35 - 39    $0.09                        35 - 39    $0.09                     One affordable monthly
            40 - 44    $0.10                        40 - 44    $0.10                     premium covers all of your
            45 - 49    $0.17                        45 - 49    $0.15                     eligible dependent children.
            50 - 54    $0.35                        50 - 54    $0.23
            55 - 59    $0.54                        55 - 59    $0.43                     Note: To be eligible for coverage,
            60 - 64    $0.67                        60 - 64    $0.66                     a spouse or dependent child
                                                                                         cannot be confined on the date
            65 - 69    $1.27                        65 - 69    $1.27                     the increase or addition is to take
             70 +      $2.06                         70 +      $2.06                     effect, it will take effect when
                                                                                         the confinement ends.




        Calculate Your Cost
        Use the appropriate rate provided in the tables above to calculate your cost based on the amount of coverage you
        select. The following example calculates the monthly cost for a 36-year-old employee who would like to purchase
        $100,000 in employee optional term life insurance coverage.

                                    Calculation Example                          Example    You
                                           Using the table above, enter the rate that
                                    Step 1                                        $0.09
                                           corresponds with your age.
                                           Enter the desired coverage amount in
                                    Step 2                                       $100,000
                                           dollars.
                                           Enter the desired coverage amount in
                                    Step 3   increments of $1,000. To calculate, divide   100
                                           the coverage amount by $1,000.
                                           Calculate the monthly cost. Multiply Step
                                    Step 4                                        $9.00
                                           1 by Step 3.

                                         Note: Rates are subject to change and can vary over time.















                                          Please see prior page for product information.
                                              Life Insurance Premium Calculation

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