Page 15 - Revelations Group 2 - 2021 Greenbrier Benefit Guide (R2)

Life / AD&D Insurance:

Mutual of Omaha

Employee Life / AD&D Spouse Life / AD&D Child Life / AD&D
AGE Per Pay Period Cost per Per Pay Period Cost per $1,000 Per Pay Period Cost for
$1,000 of Face Amount of Face Amount $10,000 Benefit on ALL

Spouse Age Based
24 Pay Periods 24 Pay Periods 24 Pay Periods
on Employees Age
0-19 $0.100 $0.100 $.200

20-24 $0.100 $0.100 $.200

25 - 29 $0.100 $0.100 $.200

30 - 34 $0.110 $0.110 N/A

35 - 39 $0.120 $0.120 N/A

40 - 44 $0.180 $0.180 N/A

45 - 49 $0.300 $0.300 N/A

50 - 54 $0.480 $0.480 N/A

55 - 59 $0.730 $0.730 N/A

60 - 64 $1.130 $1.130 N/A

65 - 69 $2.020 $2.020 N/A

70 - 74 $3.600 N/A N/A

75 - 79 $11.980 N/A N/A

80 + $11.980 N/A N/A

Your rate will be calculated when you go through the online enrollment process.
Employees are responsible for paying the cost of voluntary life coverage through payroll deduction. Calculate the cost by dividing the amount of voluntary life
insurance by 1,000 and multiply by the appropriate rate above. Follow the example for a 35 year old below to determine your monthly cost. This example
provides $100,000 of Basic Life and additional $100,000 AD&D for Total of $200,000. Rates are the same for smokers or non-smokers, males or females and
employees or spouses.

Example amount
Divided by 1,000 Multiplied by rate of 35 year old Example Cost
of Insurance

$100,000 / 1000 = 100 X $0.055 $5.54

Example amount Multiplied by rate of 45 year
Divided by 1,000 Example Cost
of Insurance old
$100,000 / 1000 = 100 X $0.138 $13.85

15