Page 43 - ABC Company 2018 Open Enrollment Guide

Critical Illness Rate Schedule
Below is a schedule of semi-monthly payroll contributions for the following benefit: $30,000 Critical Illness
Critical Illness / Semi-Monthly Rates
$30,000 Employee & Spouse — $7,500 Children to age 26
Rate Calc
per1000
EE
EE+SP
EE+CH
FAM
Ages 0-29
0.25
$3.75
$7.50
$4.04
$7.79
Ages 30-34
0.404
$6.06
$12.12
$6.35
$12.41
Ages 35-39
0.59
$8.85
$17.70
$9.14
$17.99
Ages 40-44
0.904
$13.56
$27.12
$13.85
$27.41
Ages 45-49
1.39
$20.85
$41.70
$21.14
$41.99
Ages 50-54
2.089
$31.34
$62.67
$31.62
$62.96
Ages 55-59
3.005
$45.08
$90.15
$45.36
$90.44
Ages 60-64
4.375
$65.63
$131.25
$65.91
$131.54
Ages 65-69
6.681
$100.22
$200.43
$100.50
$200.72
Ages 70-74
9
$135.00
$270.00
$135.29
$270.29
Ages 75-79
14.3
$214.50
$429.00
$214.79
$429.29
Ages 80-84
17.81
$267.15
$534.30
$267.44
$534.59
Ages 85+
26.29
$394.35
$788.70
$394.64
$788.99
Hospital Indemnity Rate Schedule
Below is a schedule of semi-monthly payroll contributions for the following benefit: Hospital Indemnity Insurance MetLife/ MetLaw
Hospital Indemnity Insurance
Tiers
Semi-Monthly
Employee
$11.035
Employee + Spouse
$23.28
Employee + Child(ren)
$16.55
Employee + Family
$28.795
Semi-Monthly Rate
$11.25
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