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SCHEDULE OF BENEFITS
$12 VOLUNTARY LIFE PLAN
| SCHEDULE OF BENEFITS - $12 MONTHLY CONTRIBUTION |
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MEMBER |
DEPENDENT |
| Member's Age at Time of Claim |
Group Term Life Insurance 1 |
Group Accidental Death & Dismemberment Insurance |
Total Benefit for Accidental Death |
Group Term Life Insurance |
| Spouse |
Child(ren) |
| Less than 25 |
$165,000 |
$75,000 |
$240,000 |
$15,000 |
$3,000 |
| 25 - 29 |
$142,500 |
$75,000 |
$217,500 |
$15,000 |
(Age 14 days, but less than 21 years) |
| 30 - 39 |
$84,000 |
$45,000 |
$129,000 |
$15,000 |
| 40 - 44 |
$54,000 |
$38,000 |
$92,000 |
$13,000 |
| 45 - 49 |
$33,000 |
$30,000 |
$63,000 |
$12,000 |
| 50 - 54 |
$24,200 |
$25,000 |
$49,200 |
$8,000 |
| 55 - 59 |
$16,500 |
$21,000 |
$37,500 |
$5,000 |
| 60 - 64 |
$11,000 |
$20,000 |
$31,000 |
$4,000 |
| 65 and over |
$6,600 |
$3,000 |
$9,600 |
$3,000 |
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The total cost of coverage for the Member, their Spouse and eligible Children is $12 per month. Payment is made by payroll deduction.
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1 Total coverage purchased by premiums plus Accumulated Dividends
Example: If an insured member age 38 dies of natural causes, the beneficiary would receive $84,000. If death was due to an accident, an additional $45,000 would be payable. If the spouse of a 42 year-old member died, the member would receive $13,000. If a child less than age 21 died, the payment to the member would be $3,000
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