Page 13 - Citizens Bank Benefit Guide 2020

Voluntary Life / AD&D Insurance:

Mutual of Omaha

Spouse Life / AD&D Child Life / AD&D
Employee Life / AD&D
AGE Per Pay Period Cost per Per Pay Period Cost per Per Pay Period Cost for
$1,000 of Face Amount $1,000 of Face Amount $10,000 Benefit on ALL
Use Employees Age Eligible Children to age 26

$1.37 For $10,000 Basic Life
Under 25 $0.0380 $0.0655 and $10,000 AD&D

25 - 29 $0.0435 $0.0755 Above Rates is for ALL Children

30 - 34 $0.0545 $0.1320 N/A

35 - 39 $0.0600 $0.1060 N/A

40 - 44 $0.0655 $0.1160 N/A

45 - 49 $0.0935 $0.1525 N/A

50 - 54 $0.1380 $0.2480 N/A

55 - 59 $0.2495 $0.4515 N/A

60 - 64 $0.3730 $0.6850 N/A

65 - 69 $0.7175 $1.3050 N/A

70 - 74 $1.1580 N/A N/A

75 - 99 $1.1580 N/A N/A

As a New Hire you can enroll up to $100,000 without health questions and cannot be turned down. Your spouse can enroll up to
100% of your amount based on your age. Up to $30,000 are without health questions. No health questions for Children coverage.
At open Enrollment employees can increase coverage $10,000 and add Children coverage without medical questions.

Example amount Divided by 1,000 Multiplied by the rate of a Example Per Pay Period Cost
of Insurance 30 year old
$100,000 / 1000 = 100 X $0.0545 $5.45

Example amount Divided by 1,000 Multiplied by the rate of a Example Per Pay Period Cost
of Insurance 40 year old

$100,000 / 1000 = 100 X $0.0655 $11.60
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