Page 6 - MN Group Critical Illness Cricital Illness with Rates 24 PP.PDF

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Applicable to policy forms GCI6000-P, GCI6000-C,
Group Critical Illness (GCI6000) for MN R-GCI6000-CB, R-GCI6000-BB, R-GCI6000-HB,
R-GCI6000-INF, R-GCI6000-PD
l Plan 2 - Critical Illness & Cancer, Without Wellbeing Assistance, Heart Benefits, Infectious Diseases Benefit, Progressive
Diseases Benefit

Tobacco Rates
ISSUE AGE NAMED INSURED NAMED INSURED AND NAMED INSURED AND NAMED INSURED, SPOUSE
SPOUSE DEPENDENT CHILD(REN) AND DEPENDENT CHILD(REN)
$5,000 17-24 $2.01 $2.93 $2.01 $2.93
25-29 $2.60 $3.83 $2.60 $3.83
30-34 $3.20 $4.70 $3.20 $4.70
35-39 $4.58 $6.80 $4.58 $6.80
40-44 $5.98 $8.88 $5.98 $8.88
45-49 $8.23 $12.40 $8.23 $12.40
50-54 $10.50 $15.90 $10.50 $15.90
55-59 $13.63 $20.68 $13.63 $20.68
60-64 $18.08 $27.43 $18.08 $27.43
65-69 $21.33 $32.38 $21.36 $32.38
70-74 $21.33 $32.38 $21.36 $32.38
$10,000 17-24 $4.00 $5.85 $4.00 $5.85
25-29 $5.20 $7.65 $5.20 $7.65
30-34 $6.40 $9.40 $6.40 $9.40
35-39 $9.15 $13.60 $9.15 $13.60
40-44 $11.95 $17.75 $11.95 $17.75
45-49 $16.45 $24.80 $16.45 $24.80
50-54 $21.00 $31.80 $21.00 $31.80
55-59 $27.25 $41.35 $27.25 $41.35
60-64 $36.15 $54.85 $36.15 $54.85
65-69 $42.65 $64.75 $42.70 $64.75
70-74 $42.65 $64.75 $42.70 $64.75
$20,000 17-24 $8.00 $11.70 $8.00 $11.70
25-29 $10.40 $15.30 $10.40 $15.30
30-34 $12.80 $18.80 $12.80 $18.80
35-39 $18.30 $27.20 $18.30 $27.20
40-44 $23.90 $35.50 $23.90 $35.50
45-49 $32.90 $49.60 $32.90 $49.60
50-54 $42.00 $63.60 $42.00 $63.60
55-59 $54.50 $82.70 $54.50 $82.70
60-64 $72.30 $109.70 $72.30 $109.70
65-69 $85.30 $129.50 $85.40 $129.50
70-74 $85.30 $129.50 $85.40 $129.50

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.
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"Colonial Life," and the Colonial Life logo, separately and in combination, are service marks of Colonial Life & Accident Insurance Company. All rights reserved.

Underwritten by Colonial Life & Accident Insurance Company
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