Page 95 - Aflac Flipbook 2023

Rate sheet prepared by Web User on 3/3/2023 3:03:24 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.

AFLAC HOSPITAL CHOICE - Option 1 Benefit Amount 3000 - Series B40100
Premium EBR HSSCR Total
18-49 INDIVIDUAL $20.58 $3.09 $4.86 $28.53
50-59 $20.73 $3.48 $6.24 $30.45
60-75 $22.11 $3.54 $8.13 $33.78
18-49 INSURED/SPOUSE $31.23 $6.48 $8.91 $46.62
50-59 $32.82 $7.26 $12.39 $52.47
60-75 $36.42 $7.35 $15.54 $59.31
18-49 ONE-PARENT FAMILY $24.99 $6.15 $6.75 $37.89
50-59 $25.14 $6.27 $7.68 $39.09
60-75 $25.29 $6.42 $10.05 $41.76
18-49 TWO-PARENT FAMILY $31.35 $7.86 $9.09 $48.30
50-59 $32.97 $8.01 $14.61 $55.59
60-75 $36.57 $8.34 $16.59 $61.50
EBR*: Extended Benefit Rider Premium (Available for ages 18-75)
HSSCR*: Hospital Stay and Surgical Care Rider Premium (Available for ages 18-75)
The field force must obtain approval prior to selling the $3,000, $4,000, $5,000 Benefit Amount.
*Note – The Extended Benefit Rider and Hospital Stay and Surgical Care Rider are not available with Option H.

AFLAC HOSPITAL CHOICE - Option 1 Benefit Amount 4000 - Series B40100
Premium EBR HSSCR Total
18-49 INDIVIDUAL $28.47 $3.09 $4.86 $36.42
50-59 $28.62 $3.48 $6.24 $38.34
60-75 $30.72 $3.54 $8.13 $42.39
18-49 INSURED/SPOUSE $43.62 $6.48 $8.91 $59.01
50-59 $45.81 $7.26 $12.39 $65.46
60-75 $51.15 $7.35 $15.54 $74.04
18-49 ONE-PARENT FAMILY $34.35 $6.15 $6.75 $47.25
50-59 $34.50 $6.27 $7.68 $48.45
60-75 $34.65 $6.42 $10.05 $51.12
18-49 TWO-PARENT FAMILY $43.74 $7.86 $9.09 $60.69
50-59 $45.96 $8.01 $14.61 $68.58
60-75 $51.30 $8.34 $16.59 $76.23
EBR*: Extended Benefit Rider Premium (Available for ages 18-75)
HSSCR*: Hospital Stay and Surgical Care Rider Premium (Available for ages 18-75)
The field force must obtain approval prior to selling the $3,000, $4,000, $5,000 Benefit Amount.
*Note – The Extended Benefit Rider and Hospital Stay and Surgical Care Rider are not available with Option H.

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