Page 41 - Applied Plastics - Post Enrollment Binder

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Critical Illness 1.0 for WI Applicable to policy form CI-1.0

l with Subsequent Diagnosis Coverage, Cancer Benefit
Tobacco Rates
ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
$20,000 17-24 $2.68 $4.11 $3.46 $4.89
25-29 $4.20 $6.46 $4.98 $7.20
30-34 $6.09 $9.37 $6.88 $10.15
35-39 $8.35 $12.83 $9.14 $13.62
40-44 $10.71 $16.48 $11.49 $17.26
45-49 $14.03 $21.60 $14.82 $22.34
50-54 $19.43 $29.86 $20.22 $30.65
55-59 $24.97 $38.35 $25.71 $39.09
60-64 $32.12 $49.34 $32.91 $50.12
65-70 $36.00 $55.34 $36.78 $56.08

Important Notice
Insurance coverage has exclusions and limitations that may affect benefits payable. For a complete description of benefits, limitations and exclusions, please refer to an
outline of coverage, sample policy/certificate, proposal description or see your Colonial Life benefits counselor. Coverage type, benefits and rates vary by state. Coverage may
not be available in all states. Rates provided are illustrative and your actual premium may be different depending on your particular situation and plan choices.
Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.
© 2021 Colonial Life & Accident Insurance Company
"Colonial Life," and the Colonial Life logo, separately and in combination, are service marks of Colonial Life & Accident Insurance Company. All rights reserved.
Mary Roemer | mary.roemer@coloniallifesales.com | (262) 617-5633

Underwritten by Colonial Life & Accident Insurance Company
Page 3 of 3 See page 3 for Important Notice