Summary of Benefits SUNRUN, INC.
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- Luke Singleton
- 5 years ago
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1 Summary of Benefits SUNRUN, INC. US Active Full Time Employees Basic Term Life, Basic Accidental Death & Dismemberment, Optional Term Life, Dependent Term Life, Optional Accidental Death & Dismemberment, Short Term Disability and Long Term Disability Issued by The Prudential Insurance Company of America Effective: 01/01/2018 Basic Term Life 100% Employer Paid n Basic Term Life: You are automatically enrolled for 1.0 times your covered annual earnings to $250,000. The minimum amount is $10,000. n If you are terminally ill, you can get a partial payment of your group life insurance benefit. You can use this payment as you see fit. The payment to your beneficiary will be reduced by the amount you receive with the Accelerated Benefit Option.* Refer to the plan booklet for details. n Coverage will be reduced as you age - by 35% at age 65 and 50% at age 70. n Coverage will end on your termination of employment or as specified in the plan booklet. You may convert your insurance to an individual life insurance policy issued by the Prudential Insurance Company of America. Basic Accidental Death & Dismemberment 100% Employer Paid n Basic AD&D pays you and your beneficiary a benefit for the loss of life or other injuries resulting from a covered accident % for loss of life and a lesser percentage for other injuries. Injuries covered may include loss of sight or speech, paralysis, and dismemberment of hands or feet. Basic AD&D benefits are paid regardless of other coverages you may have. n Basic AD&D: You are automatically enrolled for 1.0 times your covered annual earnings to $250,
2 Optional Term Life 100% Employee Paid n Purchase coverage in increments of $10,000 up to a maximum of $2,000,000. n n n New Hires: If you are newly eligible, you can elect a coverage amount up to the Guaranteed Issue amount of $250,000, without providing evidence of insurability to The Prudential Insurance Company of America. Current Employees, Current Employees who waived coverage in the past or Late Entrants (did not enroll when first eligible): During the open enrollment period, you can elect a coverage amount up to 250,000, without providing evidence of insurability to Prudential. Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts over the Guaranteed Issue amount or if enrolling after the open enrollment period. Current Employees who were denied coverage in the past: Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts. n If terminally ill, you can get a partial payment of your group term life insurance benefit. You can use this payment as you see fit. In the event of your death, your beneficiary will receive a benefit payout which has been reduced by the amount you receive. n Coverage will be reduced as you age - by 35% at age 65 and 50% at age 70. n Upon termination of employment, you (if eligible to port) may choose to continue a coverage amount equal to or lower than your current benefit amount. Coverage amounts will be subject to maximum of five times your annual earnings or $1 million, whichever is less. Spouse / Domestic Partner - Dependent Term Life 5 100% Employee Paid n Purchase coverage for your spouse in increments of $10,000 up to a maximum of $500,000. Please note: The Dependent Term Life Insurance coverage amount on your spouse may not exceed 100% of your Optional Term Life coverage amount. n n n New Hires: If your spouse is newly eligible, you can elect a coverage amount for your spouse up to the Guaranteed Issue amount of $100,000, without providing evidence of insurability to The Prudential Insurance Company of America. Current Spouse Participants: Your spouses current coverage amount will be continued. Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all increases in coverage amounts. Current Employees whose spouse has been denied coverage in the past, Current Employees who waived spouse coverage in the past or Late Entrants (did not enroll when first eligible): Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts. 5 California Residents: Coverage is extended to include California Registered Domestic Partners. n Upon termination of employment, your spouse (if eligible to port) may choose to continue a coverage amount equal to or lower than your current benefit amount. Coverage amounts for you and your spouse will be subject to a maximum of five times your annual earnings or $1 million, whichever is less.
3 100% Employee Paid Child - Dependent Term Life n Purchase coverage for your children in increments of $10,000 up to a maximum of $20,000. Please note: The Optional Dependent Term Life Insurance coverage amount on your children may not exceed 100% of your Optional Term Life coverage amount. There are no health requirements for this coverage. n Coverage begins from live birth, and continues to age 26. n The death benefit for babies from live birth to 14 days old is $1,000. n Upon termination of employment, you (if eligible to port) may choose to continue a dependent child coverage amount equal to or lower than your current benefit amount. Employee - Optional Accidental Death & Dismemberment 100% Employee Paid n Purchase coverage in increments of $10,000 up to a maximum of $2,000,000. n You must be enrolled in Optional Term Life Insurance in order to elect to enroll for Optional AD&D Insurance. n Coverage will be reduced as you age - by 35% at age 65 and 50% at age 70. Spouse - Optional Accidental Death & Dismemberment 100% Employee Paid n Purchase coverage for your spouse in increments of $10,000 up to a maximum of $500,000. n Your spouse must be enrolled in Dependent Term Life Insurance in order to elect to enroll your spouse for Optional AD&D Insurance. n You must be enrolled in Optional AD&D Insurance in order to elect to enroll your spouse for Optional AD&D Insurance. Child - Optional Accidental Death & Dismemberment 100% Employee Paid n Purchase coverage in increments of $10,000 up to a maximum of $20,000. n Coverage begins from live birth, and continues to age 26. n The benefit for babies from live birth to 14 days old is $1,000. n Your child(ren) must be enrolled in Dependent Term Life Insurance in order to elect to enroll your child(ren) for Optional AD&D Insurance. n You must be enrolled in Optional AD&D Insurance in order to elect to enroll your child(ren) for Optional AD&D Insurance.
4 Short Term Disability 100% Employer Paid n Your weekly Short Term Disability benefit will be 66 2/3% of your weekly pre-disability earnings, up to a maximum of $2,500, less deductible sources of income. The minimum weekly benefit is $25. n Deductible sources of income may include from statutory plans, unemployment income and salary continuation. n If you meet the definition of disability, your benefits will begin on the 8th day following a non-occupational injury or the 8th day following a non-occupational sickness. The benefit duration is 12 weeks. You are considered totally disabled when you are not working at your usual occupation and, as a result of your sickness or injury, you are unable to perform with reasonable continuity the substantial and material acts necessary to pursue your usual occupation. You are partially disabled when while working in your usual occupation and as a result of your sickness or injury, you are unable to earn 80% of your weekly earnings. n If you work while disabled, you can receive full benefits as long as your combined income and disability benefits do not exceed your weekly pre-disability earnings. n You are not covered for a disability caused by war or any act of war, declared or undeclared, an intentionally self-inflicted injury, active participation in a riot, and commission of a felony for which you have been convicted. Benefits are not payable for any period of incarceration as a result of a conviction. Long Term Disability 100% Employer Paid n Your monthly Long Term Disability benefit will be 60% of your monthly pre-disability earnings, up to the maximum of $10,000, less deductible sources of income. The minimum monthly benefit is $100. n Deductible sources of income may include benefits from statutory plans, Social Security to you and your dependents, workers compensation, unemployment income and other income. n If you meet the definition of disability, your benefits will begin 90 days following an accidental injury or sickness. The benefit duration is up to your normal retirement age under the Social Security Act. However, if you become disabled at or after age 65 benefits are payable according to an age-based schedule. Refer to the Booklet-Certificate for details. n You are considered totally disabled when you are not working at your usual occupation and, as a result of your sickness or injury you are unable to perform with reasonable continuity the substantial and material acts necessary to pursue your usual occupation. You are considered partially disabled while actually working in your usual occupation and as a result of your sickness or injury, you are unable to earn 80% or more of your indexed monthly earnings. n After receiving benefits for 24 months, you are considered totally disabled when, as a result of the same sickness or injury, you are unable to engage with reasonable continuity in any occupation in which you could reasonably be expected to perform satisfactorily in light of your age, education, training, experience, station in life, and physical and mental capacity. You are considered partially disabled after 24 months of payments while actually working in an occupation, and as a result of the same sickness or injury, you are unable to engage with reasonable continuity in that or any other occupation in which you could reasonably be expected to perform satisfactorily in light of your age, education, training, experience, station in life and physical and mental capacity. n Disabilities primarily due to mental illness are limited to 24 months of benefits during your lifetime. Examples of mental illness include schizophrenia, depression, manic depressive or bipolar illness, anxiety, somatization, substance related disorders (including drug and alcohol abuse), and/or adjustment disorders. Disabilities due to mental illness have a combined limited pay period during your lifetime. n LTD benefits will not be paid for a disability that begins during the first 12 months of coverage and is caused by or substantially contributed to by a pre-existing condition. A pre-existing condition is a diagnosed condition for which you received medical treatment, care or services or took prescribed medication in the 12 months just prior to your effective date. This provision also applies to undiagnosed conditions under very limited circumstances as outlined in your Booklet-Certificate.
5 n During the first 12 months of part-time work while disabled, you can receive full benefits as long as your combined income and disability benefits do not exceed your monthly pre-disability earnings. n If you die while collecting disability benefits, a lump sum payment may be paid to your eligible survivors. n You are not covered for a disability caused by war or any act of war, declared or undeclared, an intentionally self-inflicted injury, active participation in a riot, and commission of a felony for which you have been convicted. Benefits are not payable for any period of incarceration as a result of a conviction. Benefits, exclusions and provisions may vary by state. Refer to the plan booklet for details. For your coverage to become effective, you must be actively at work on the effective date of the plan. If you apply for an amount that requires satisfactory evidence of insurability to The Prudential Insurance Company of America, you must be actively at work on the date of approval for the amount requiring satisfactory evidence of insurability. *Accelerated Death Benefit option is a feature that is made available to group life insurance participants. It is not a health, nursing home, or long-term care insurance benefit and is not designed to eliminate the need for those types of insurance coverage. The death benefit is reduced by the amount of the accelerated death benefit paid. There is no administrative fee to accelerate benefits. Receipt of accelerated death benefits may affect eligibility for public assistance and may be taxable. The federal income tax treatment of payments made under this rider depends upon whether the insured is the recipient of the benefits and is considered "terminally ill" or "chronically ill." You may wish to seek professional tax advice before exercising this option. This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services. IMPORTANT NOTICE - THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS. This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services. Optional Term Life, Dependent Term Life, Long Term Disability, Short Term Disability, Accidental Death & Dismemberment Insurance coverages are issued by The Prudential Insurance Company of America, a Prudential Financial company, Newark, NJ The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. Contract Series: Prudential Financial, Inc. and its related entities. Prudential, the Prudential logo, and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide.
6 How much it will cost Rate Sheet SUNRUN, INC. US Active Full Time Employees Issued by The Prudential Insurance Company of America Effective: 01/01/2018 Monthly Non-Smoker Cost per Coverage Amount $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 < 30 $0.70 $1.40 $2.10 $2.80 $3.50 $4.20 $4.90 $5.60 $6.30 $7.00 $7.70 $8.40 $ $0.90 $1.80 $2.70 $3.60 $4.50 $5.40 $6.30 $7.20 $8.10 $9.00 $9.90 $10.80 $ $1.10 $2.20 $3.30 $4.40 $5.50 $6.60 $7.70 $8.80 $9.90 $11.00 $12.10 $13.20 $ $1.70 $3.40 $5.10 $6.80 $8.50 $10.20 $11.90 $13.60 $15.30 $17.00 $18.70 $20.40 $ $2.70 $5.40 $8.10 $10.80 $13.50 $16.20 $18.90 $21.60 $24.30 $27.00 $29.70 $32.40 $ $4.30 $8.60 $12.90 $17.20 $21.50 $25.80 $30.10 $34.40 $38.70 $43.00 $47.30 $51.60 $ $7.50 $15.00 $22.50 $30.00 $37.50 $45.00 $52.50 $60.00 $67.50 $75.00 $82.50 $90.00 $ $11.60 $23.20 $34.80 $46.40 $58.00 $69.60 $81.20 $92.80 $ $ $ $ $ $21.30 $42.60 $63.90 $85.20 $ $ $ $ $ $ $ $ $ $44.10 $88.20 $ $ $ $ $ $ $ $ $ $ $ $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 $210,000 $220,000 $230,000 $240,000 $250,000 $260,000 < 30 $9.80 $10.50 $11.20 $11.90 $12.60 $13.30 $14.00 $14.70 $15.40 $16.10 $16.80 $17.50 $ $12.60 $13.50 $14.40 $15.30 $16.20 $17.10 $18.00 $18.90 $19.80 $20.70 $21.60 $22.50 $ $15.40 $16.50 $17.60 $18.70 $19.80 $20.90 $22.00 $23.10 $24.20 $25.30 $26.40 $27.50 $ $23.80 $25.50 $27.20 $28.90 $30.60 $32.30 $34.00 $35.70 $37.40 $39.10 $40.80 $42.50 $ $37.80 $40.50 $43.20 $45.90 $48.60 $51.30 $54.00 $56.70 $59.40 $62.10 $64.80 $67.50 $ $60.20 $64.50 $68.80 $73.10 $77.40 $81.70 $86.00 $90.30 $94.60 $98.90 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, Implementation of the insurance plan(s) will depend on having a specific percentage of all eligible employees enrolling in the plan(s). If this percentage of enrollment level is not met, these coverage(s) may not be effective
7 Monthly Non-Smoker Cost per Coverage Amount $270,000 $280,000 $290,000 $300,000 $310,000 $320,000 $330,000 $340,000 $350,000 $360,000 $370,000 $380,000 $390,000 < 30 $18.90 $19.60 $20.30 $21.00 $21.70 $22.40 $23.10 $23.80 $24.50 $25.20 $25.90 $26.60 $ $24.30 $25.20 $26.10 $27.00 $27.90 $28.80 $29.70 $30.60 $31.50 $32.40 $33.30 $34.20 $ $29.70 $30.80 $31.90 $33.00 $34.10 $35.20 $36.30 $37.40 $38.50 $39.60 $40.70 $41.80 $ $45.90 $47.60 $49.30 $51.00 $52.70 $54.40 $56.10 $57.80 $59.50 $61.20 $62.90 $64.60 $ $72.90 $75.60 $78.30 $81.00 $83.70 $86.40 $89.10 $91.80 $94.50 $97.20 $99.90 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $400,000 $410,000 $420,000 $430,000 $440,000 $450,000 $460,000 $470,000 $480,000 $490,000 $500,000 $510,000 $520,000 < 30 $28.00 $28.70 $29.40 $30.10 $30.80 $31.50 $32.20 $32.90 $33.60 $34.30 $35.00 $35.70 $ $36.00 $36.90 $37.80 $38.70 $39.60 $40.50 $41.40 $42.30 $43.20 $44.10 $45.00 $45.90 $ $44.00 $45.10 $46.20 $47.30 $48.40 $49.50 $50.60 $51.70 $52.80 $53.90 $55.00 $56.10 $ $68.00 $69.70 $71.40 $73.10 $74.80 $76.50 $78.20 $79.90 $81.60 $83.30 $85.00 $86.70 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $530,000 $540,000 $550,000 $560,000 $570,000 $580,000 $590,000 $600,000 $610,000 $620,000 $630,000 $640,000 $650,000 < 30 $37.10 $37.80 $38.50 $39.20 $39.90 $40.60 $41.30 $42.00 $42.70 $43.40 $44.10 $44.80 $ $47.70 $48.60 $49.50 $50.40 $51.30 $52.20 $53.10 $54.00 $54.90 $55.80 $56.70 $57.60 $ $58.30 $59.40 $60.50 $61.60 $62.70 $63.80 $64.90 $66.00 $67.10 $68.20 $69.30 $70.40 $ $90.10 $91.80 $93.50 $95.20 $96.90 $98.60 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $660,000 $670,000 $680,000 $690,000 $700,000 $710,000 $720,000 $730,000 $740,000 $750,000 $760,000 $770,000 $780,000 < 30 $46.20 $46.90 $47.60 $48.30 $49.00 $49.70 $50.40 $51.10 $51.80 $52.50 $53.20 $53.90 $ $59.40 $60.30 $61.20 $62.10 $63.00 $63.90 $64.80 $65.70 $66.60 $67.50 $68.40 $69.30 $ $72.60 $73.70 $74.80 $75.90 $77.00 $78.10 $79.20 $80.30 $81.40 $82.50 $83.60 $84.70 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3,439.80
8 Monthly Non-Smoker Cost per Coverage Amount $790,000 $800,000 $810,000 $820,000 $830,000 $840,000 $850,000 $860,000 $870,000 $880,000 $890,000 $900,000 $910,000 < 30 $55.30 $56.00 $56.70 $57.40 $58.10 $58.80 $59.50 $60.20 $60.90 $61.60 $62.30 $63.00 $ $71.10 $72.00 $72.90 $73.80 $74.70 $75.60 $76.50 $77.40 $78.30 $79.20 $80.10 $81.00 $ $86.90 $88.00 $89.10 $90.20 $91.30 $92.40 $93.50 $94.60 $95.70 $96.80 $97.90 $99.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $4, $920,000 $930,000 $940,000 $950,000 $960,000 $970,000 $980,000 $990,000 $1,000,000 $1,010,000 $1,020,000 $1,030,000 $1,040,000 < 30 $64.40 $65.10 $65.80 $66.50 $67.20 $67.90 $68.60 $69.30 $70.00 $70.70 $71.40 $72.10 $ $82.80 $83.70 $84.60 $85.50 $86.40 $87.30 $88.20 $89.10 $90.00 $90.90 $91.80 $92.70 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $1,050,000 $1,060,000 $1,070,000 $1,080,000 $1,090,000 $1,100,000 $1,110,000 $1,120,000 $1,130,000 $1,140,000 $1,150,000 $1,160,000 < 30 $73.50 $74.20 $74.90 $75.60 $76.30 $77.00 $77.70 $78.40 $79.10 $79.80 $80.50 $ $94.50 $95.40 $96.30 $97.20 $98.10 $99.00 $99.90 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $4, $4, $4, $4, $4, $4, $4, $4, $4, $5, $5, $5, $1,170,000 $1,180,000 $1,190,000 $1,200,000 $1,210,000 $1,220,000 $1,230,000 $1,240,000 $1,250,000 $1,260,000 $1,270,000 $1,280,000 < 30 $81.90 $82.60 $83.30 $84.00 $84.70 $85.40 $86.10 $86.80 $87.50 $88.20 $88.90 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $5, $5, $5, $5, $5, $5, $5, $5, $5, $5, $5, $5,644.80
9 Monthly Non-Smoker Cost per Coverage Amount $1,290,000 $1,300,000 $1,310,000 $1,320,000 $1,330,000 $1,340,000 $1,350,000 $1,360,000 $1,370,000 $1,380,000 $1,390,000 $1,400,000 < 30 $90.30 $91.00 $91.70 $92.40 $93.10 $93.80 $94.50 $95.20 $95.90 $96.60 $97.30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $5, $5, $5, $5, $5, $5, $5, $5, $6, $6, $6, $6, $1,410,000 $1,420,000 $1,430,000 $1,440,000 $1,450,000 $1,460,000 $1,470,000 $1,480,000 $1,490,000 $1,500,000 $1,510,000 $1,520,000 < 30 $98.70 $99.40 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $6, $6, $6, $6, $6, $6, $6, $6, $6, $6, $6, $6, $1,530,000 $1,540,000 $1,550,000 $1,560,000 $1,570,000 $1,580,000 $1,590,000 $1,600,000 $1,610,000 $1,620,000 $1,630,000 $1,640,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $6, $6, $6, $6, $6, $6, $7, $7, $7, $7, $7, $7, $1,650,000 $1,660,000 $1,670,000 $1,680,000 $1,690,000 $1,700,000 $1,710,000 $1,720,000 $1,730,000 $1,740,000 $1,750,000 $1,760,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $7, $7, $7, $7, $7, $7, $7, $7, $7, $7, $7, $7,761.60
10 Monthly Non-Smoker Cost per Coverage Amount $1,770,000 $1,780,000 $1,790,000 $1,800,000 $1,810,000 $1,820,000 $1,830,000 $1,840,000 $1,850,000 $1,860,000 $1,870,000 $1,880,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $4, $7, $7, $7, $7, $7, $8, $8, $8, $8, $8, $8, $8, $1,890,000 $1,900,000 $1,910,000 $1,920,000 $1,930,000 $1,940,000 $1,950,000 $1,960,000 $1,970,000 $1,980,000 $1,990,000 $2,000,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $8, $8, $8, $8, $8, $8, $8, $8, $8, $8, $8, $8, Monthly Smoker Cost per Coverage Amount $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 < 30 $0.84 $1.67 $2.51 $3.34 $4.18 $5.02 $5.85 $6.69 $7.52 $8.36 $9.20 $10.03 $ $1.03 $2.07 $3.10 $4.14 $5.17 $6.20 $7.24 $8.27 $9.31 $10.34 $11.37 $12.41 $ $1.40 $2.81 $4.21 $5.61 $7.02 $8.42 $9.82 $11.22 $12.63 $14.03 $15.43 $16.84 $ $2.14 $4.27 $6.41 $8.54 $10.68 $12.82 $14.95 $17.09 $19.22 $21.36 $23.50 $25.63 $ $3.49 $6.98 $10.48 $13.97 $17.46 $20.95 $24.44 $27.94 $31.43 $34.92 $38.41 $41.90 $ $5.56 $11.11 $16.67 $22.22 $27.78 $33.34 $38.89 $44.45 $50.00 $55.56 $61.12 $66.67 $ $9.67 $19.34 $29.02 $38.69 $48.36 $58.03 $67.70 $77.38 $87.05 $96.72 $ $ $ $14.28 $28.57 $42.85 $57.13 $71.42 $85.70 $99.98 $ $ $ $ $ $ $25.14 $50.27 $75.41 $ $ $ $ $ $ $ $ $ $ $52.11 $ $ $ $ $ $ $ $ $ $ $ $677.39
11 Monthly Smoker Cost per Coverage Amount $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 $210,000 $220,000 $230,000 $240,000 $250,000 $260,000 < 30 $11.70 $12.54 $13.38 $14.21 $15.05 $15.88 $16.72 $17.56 $18.39 $19.23 $20.06 $20.90 $ $14.48 $15.51 $16.54 $17.58 $18.61 $19.65 $20.68 $21.71 $22.75 $23.78 $24.82 $25.85 $ $19.64 $21.05 $22.45 $23.85 $25.25 $26.66 $28.06 $29.46 $30.87 $32.27 $33.67 $35.08 $ $29.90 $32.04 $34.18 $36.31 $38.45 $40.58 $42.72 $44.86 $46.99 $49.13 $51.26 $53.40 $ $48.89 $52.38 $55.87 $59.36 $62.86 $66.35 $69.84 $73.33 $76.82 $80.32 $83.81 $87.30 $ $77.78 $83.34 $88.90 $94.45 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $270,000 $280,000 $290,000 $300,000 $310,000 $320,000 $330,000 $340,000 $350,000 $360,000 $370,000 $380,000 $390,000 < 30 $22.57 $23.41 $24.24 $25.08 $25.92 $26.75 $27.59 $28.42 $29.26 $30.10 $30.93 $31.77 $ $27.92 $28.95 $29.99 $31.02 $32.05 $33.09 $34.12 $35.16 $36.19 $37.22 $38.26 $39.29 $ $37.88 $39.28 $40.69 $42.09 $43.49 $44.90 $46.30 $47.70 $49.11 $50.51 $51.91 $53.31 $ $57.67 $59.81 $61.94 $64.08 $66.22 $68.35 $70.49 $72.62 $74.76 $76.90 $79.03 $81.17 $ $94.28 $97.78 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $400,000 $410,000 $420,000 $430,000 $440,000 $450,000 $460,000 $470,000 $480,000 $490,000 $500,000 $510,000 $520,000 < 30 $33.44 $34.28 $35.11 $35.95 $36.78 $37.62 $38.46 $39.29 $40.13 $40.96 $41.80 $42.64 $ $41.36 $42.39 $43.43 $44.46 $45.50 $46.53 $47.56 $48.60 $49.63 $50.67 $51.70 $52.73 $ $56.12 $57.52 $58.93 $60.33 $61.73 $63.14 $64.54 $65.94 $67.34 $68.75 $70.15 $71.55 $ $85.44 $87.58 $89.71 $91.85 $93.98 $96.12 $98.26 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $530,000 $540,000 $550,000 $560,000 $570,000 $580,000 $590,000 $600,000 $610,000 $620,000 $630,000 $640,000 $650,000 < 30 $44.31 $45.14 $45.98 $46.82 $47.65 $48.49 $49.32 $50.16 $51.00 $51.83 $52.67 $53.50 $ $54.80 $55.84 $56.87 $57.90 $58.94 $59.97 $61.01 $62.04 $63.07 $64.11 $65.14 $66.18 $ $74.36 $75.76 $77.17 $78.57 $79.97 $81.37 $82.78 $84.18 $85.58 $86.99 $88.39 $89.79 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $3, $3, $3, $3, $3, $3, $3, $3,386.96
12 Monthly Smoker Cost per Coverage Amount $660,000 $670,000 $680,000 $690,000 $700,000 $710,000 $720,000 $730,000 $740,000 $750,000 $760,000 $770,000 $780,000 < 30 $55.18 $56.01 $56.85 $57.68 $58.52 $59.36 $60.19 $61.03 $61.86 $62.70 $63.54 $64.37 $ $68.24 $69.28 $70.31 $71.35 $72.38 $73.41 $74.45 $75.48 $76.52 $77.55 $78.58 $79.62 $ $92.60 $94.00 $95.40 $96.81 $98.21 $99.61 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $4, $4, $790,000 $800,000 $810,000 $820,000 $830,000 $840,000 $850,000 $860,000 $870,000 $880,000 $890,000 $900,000 $910,000 < 30 $66.04 $66.88 $67.72 $68.55 $69.39 $70.22 $71.06 $71.90 $72.73 $73.57 $74.40 $75.24 $ $81.69 $82.72 $83.75 $84.79 $85.82 $86.86 $87.89 $88.92 $89.96 $90.99 $92.03 $93.06 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $920,000 $930,000 $940,000 $950,000 $960,000 $970,000 $980,000 $990,000 $1,000,000 $1,010,000 $1,020,000 $1,030,000 $1,040,000 < 30 $76.91 $77.75 $78.58 $79.42 $80.26 $81.09 $81.93 $82.76 $83.60 $84.44 $85.27 $86.11 $ $95.13 $96.16 $97.20 $98.23 $99.26 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $4, $4, $4, $4, $5, $5, $5, $5, $5, $5, $5, $5, $5, $1,050,000 $1,060,000 $1,070,000 $1,080,000 $1,090,000 $1,100,000 $1,110,000 $1,120,000 $1,130,000 $1,140,000 $1,150,000 $1,160,000 < 30 $87.78 $88.62 $89.45 $90.29 $91.12 $91.96 $92.80 $93.63 $94.47 $95.30 $96.14 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $5, $5, $5, $5, $5, $5, $5, $5, $5, $5, $5, $6,044.41
13 Monthly Smoker Cost per Coverage Amount $1,170,000 $1,180,000 $1,190,000 $1,200,000 $1,210,000 $1,220,000 $1,230,000 $1,240,000 $1,250,000 $1,260,000 $1,270,000 $1,280,000 < 30 $97.81 $98.65 $99.48 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $3, $3, $3, $3, $3, $3, $3, $3, $3, $6, $6, $6, $6, $6, $6, $6, $6, $6, $6, $6, $6, $1,290,000 $1,300,000 $1,310,000 $1,320,000 $1,330,000 $1,340,000 $1,350,000 $1,360,000 $1,370,000 $1,380,000 $1,390,000 $1,400,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $6, $6, $6, $6, $6, $6, $7, $7, $7, $7, $7, $7, $1,410,000 $1,420,000 $1,430,000 $1,440,000 $1,450,000 $1,460,000 $1,470,000 $1,480,000 $1,490,000 $1,500,000 $1,510,000 $1,520,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $3, $7, $7, $7, $7, $7, $7, $7, $7, $7, $7, $7, $7, $1,530,000 $1,540,000 $1,550,000 $1,560,000 $1,570,000 $1,580,000 $1,590,000 $1,600,000 $1,610,000 $1,620,000 $1,630,000 $1,640,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $3, $3, $3, $3, $3, $3, $3, $4, $4, $4, $4, $4, $7, $8, $8, $8, $8, $8, $8, $8, $8, $8, $8, $8,545.55
14 Monthly Smoker Cost per Coverage Amount $1,650,000 $1,660,000 $1,670,000 $1,680,000 $1,690,000 $1,700,000 $1,710,000 $1,720,000 $1,730,000 $1,740,000 $1,750,000 $1,760,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $8, $8, $8, $8, $8, $8, $8, $8, $9, $9, $9, $9, $1,770,000 $1,780,000 $1,790,000 $1,800,000 $1,810,000 $1,820,000 $1,830,000 $1,840,000 $1,850,000 $1,860,000 $1,870,000 $1,880,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $9, $9, $9, $9, $9, $9, $9, $9, $9, $9, $9, $9, $1,890,000 $1,900,000 $1,910,000 $1,920,000 $1,930,000 $1,940,000 $1,950,000 $1,960,000 $1,970,000 $1,980,000 $1,990,000 $2,000,000 < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $2, $4, $4, $4, $4, $4, $4, $4, $4, $4, $4, $5, $5, $9, $9, $9, $10, $10, $10, $10, $10, $10, $10, $10, $10, Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all
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