PREMIUMS
Initial Monthly Premium Rates
The initial monthly premium rates to be charged for employee Coverage and/or child/spouse coverage, if applicable,
will be:
Basic Life Insurance $.113 for each $1,000 of Group Life Insurance
Supplemental Life Insurance
$ for each $1,000 of Supplemental Life Insurance
the monthly premium rate shall be determined in
accordance with the Insured Person’s Age as follows:
Employee Age Rate
Less than 30 $.065
30-35 $.07
35-40 $.082
40-45 $.135
45-50 $.165
50-55 $.386
55-60 $.61
60-65 $.937
65-70 $1.436
70-75 $3.007
75 or over $4.192
Accidental Death, Dismemberment
And Loss of Sight Insurance
The Initial Monthly Premium Rates may be converted as follows:
To Convert Rates to: Use a Conversion Factor of:
-- annual rates 11.8227
-- semi-annual rates 5.9557
-- quarterly rates 2.9852
$.03 for each $1,000 of Maximum Benefit
GR-11383-HLA(4)
PI-4.04
