| MONTHLY DEDUCTIONS |
AD&D |
|
| |
|
|
| Principal Sum |
Employee Only Plan |
Family Plan |
| $10,000 |
0.34 |
0.5 |
| 20,000 |
0.68 |
1 |
| 30,000 |
1.02 |
1.5 |
| 40,000 |
1.36 |
2 |
| 50,000 |
1.7 |
2.5 |
| 60,000 |
2.04 |
3 |
| 70,000 |
2.38 |
3.5 |
| 80,000 |
2.72 |
4 |
| 90,000 |
3.06 |
4.5 |
| 100,000 |
3.4 |
5 |
| 110,000 |
3.74 |
5.5 |
| 120,000 |
4.08 |
6 |
| 130,000 |
4.42 |
6.5 |
| 140,000 |
4.76 |
7 |
| 150,000 |
5.1 |
7.5 |
| 160,000 |
5.44 |
8 |
| 170,000 |
5.78 |
8.5 |
| 180,000 |
6.12 |
9 |
| 190,000 |
6.46 |
9.5 |
| 200,000 |
6.8 |
10 |
| 210,000 |
7.14 |
10.5 |
| 220,000 |
7.48 |
11 |
| 230,000 |
7.82 |
11.5 |
| 240,000 |
8.16 |
12 |
| 250,000 |
8.5 |
12.5 |
| |
|
|
| Rate: Employee- $.034 per $1,000 of covered benefit, Family-$.050 per $1,000 of covered benefit |
| For amounts above $150,000, the Principal Sum requested cannot exceed the lesser of 10 times |
| Your Earnings or the maximum above. |
