Exhibit A - City of Madison Premium Rate Report.xlsx

This is a Premium Rate Report for the City of Madison's life and disability insurance program, detailing billing records and premium calculations across multiple billing periods from September 2021 through July 2025. The report covers self-administered life insurance coverage including Additional Life, All Other (Life) coverage with dependent life options, and Supplemental Life insurance organized by employee age bands. The City maintains multiple bill groups and invoice records documenting monthly billing segments with coverage periods. Premium rates are calculated on a per-$1,000-of-coverage basis for salary-based coverage and per-dependent-unit basis for dependent life options. The report demonstrates consistent enrollment across age groups ranging from 14-24 years through 65-99 years, with dependent life coverage available under Option 1 (at $1.75 per dependent unit) and Option 2 (at $3.50 per dependent unit). Billing cycles show relatively stable payroll volumes and participation rates across the reporting period, with applied premiums totaling thousands of dollars monthly across all coverage types.

Premium rates have remained consistent throughout most of the reporting period, with rates for basic life coverage ranging from $0.050 per $1,000 for the youngest age band to $0.570 per $1,000 for employees aged 60-64 and 65-99. Notably, the most recent billing period (July 2025) reflects rate adjustments for Supplemental Life insurance, with younger age bands experiencing reduced rates (ranging from $0.035 to $0.070 per $1,000) and older age bands seeing increased rates (up to $0.399 per $1,000), suggesting a potential rate restructuring for voluntary coverage. The City's payroll volumes fluctuate slightly month-to-month but maintain consistent patterns, with total salary bases ranging from approximately $150 million to $190 million monthly depending on the period. All premiums documented in the report show zero unapplied amounts, indicating full collection and application of calculated charges. The self-administered nature of these bills indicates the City manages claims and administrative functions internally while the insurance carrier provides underwriting and rate setting.