Page 119 - Aflac Flipbook 2023

Rate sheet prepared by Web User on 3/3/2023 2:54:11 PM.
Maryland Payroll Premium rates are Weekly for industry Class C.
The rates shown on this insert page are for illustration purposes only; they do not imply coverage.
For more information about policy/plan benefits and limitations, please refer to the accompanying
product brochure for each insurance policy/plan listed below.

DENTAL ESSENTIALS - Series A-82100R
Premium Total
18-70 INDIVIDUAL $5.73 $5.73
18-70 ONE-PARENT FAMILY $9.99 $9.99
18-70 INSURED/SPOUSE $10.08 $10.08
18-70 TWO-PARENT FAMILY $14.40 $14.40

DENTAL LEVEL 1 - Series A-82200R
Premium Total
18-70 INDIVIDUAL $7.44 $7.44
18-70 ONE-PARENT FAMILY $14.28 $14.28
18-70 INSURED/SPOUSE $14.49 $14.49
18-70 TWO-PARENT FAMILY $21.60 $21.60

DENTAL LEVEL 2 - Series A-82300R
Premium Total
18-70 INDIVIDUAL $9.09 $9.09
18-70 ONE-PARENT FAMILY $17.70 $17.70
18-70 INSURED/SPOUSE $17.82 $17.82
18-70 TWO-PARENT FAMILY $26.64 $26.64

DENTAL LEVEL 3 - Series A-82400R
Premium Total
18-70 INDIVIDUAL $13.17 $13.17
18-70 ONE-PARENT FAMILY $25.98 $25.98
18-70 INSURED/SPOUSE $26.25 $26.25
18-70 TWO-PARENT FAMILY $39.03 $39.03

Page 1 of 1