Page 21 - 2019 Benefit Guide Non-CA

CHILD
CRITICAL
ILLNESS Option 1 Option 2 Option 3 Option 4
BENEFITS
(TO AGE 26)
Heart Attack (100%) $1,250 $2,500 $5,000 $7,500
Stroke (100%) $1,250 $2,500 $5,000 $7,500
Coronary Artery Disease $312 $625 $1,250 $1,875
(25%)
Major Organ Failure $1,250 $2,500 $5,000 $7,500
(100%)
End Stage Renal Failure $1,250 $2,500 $5,000 $7,500
(100%)
Cancer Critical Illness Benefits
Invasive Cancer (100%) $1,250 $2,500 $5,000 $7,500
Carcinoma in Situ (25%) $312 $625 $1,250 $1,875
Additional Benefits
Wellness Benefit $50 $50 $50 $50
(per year)

GROUP CRITICAL ILLNESS INSURANCE COVERAGE - EMPLOYEE MONTHLY RATES

$5,000 $10,000 $20,000 $30,000
0-24 $1.92 $3.84 $7.68 $11.52
25-29 $2.37 $4.74 $9.48 $14.22
30-34 $3.15 $6.30 $12.60 $18.90
35-39 $4.32 $8.64 $17.28 $25.92
40-44 $6.33 $12.66 $25.32 $37.98
45-49 $9.39 $18.78 $37.56 $56.34
50-54 $13.26 $26.52 $53.04 $79.56
55-59 $18.42 $36.82 $73.68 $110.52
60+ $27.00 $54.00 $108.00 $162.00

GROUP CRITICAL ILLNESS INSURANCE COVERAGE - SPOUSE MONTHLY RATES
$2,500 $5,000 $10,000 $15,000
0-24 $0.77 $1.53 $3.06 $4.59
25-29 $0.90 $1.80 $3.60 $5.40
30-34 $1.20 $2.40 $4.80 $7.20
35-39 $1.71 $3.42 $6.84 $10.26
40-44 $2.63 $5.25 $10.50 $15.75
45-49 $3.99 $7.98 $15.96 $23.94
50-54 $5.76 $11.52 $23.04 $34.56
55-59 $8.03 $16.05 $32.10 $48.15
60+ $11.57 $23.13 $46.26 $69.39
Children (age 0-26) are eligible to be enrolled at no charge if Employee is enrolled.

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