Current rates - Attachment 2.pdf

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Health/Life Insurance
Solicitation number
S-CA525-09-R-1037
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Current Rates

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MONTHLY PREMIUM COMPARISON

FOR

EMBASSY OF TIlE UNITED STATES OF AMERICA

POLICY 330488

All Divisions

CUI~RENT

BENEFIT VOLUME RATES PREM

LIFE INSURANCE 14,796,000 $0.23 $3,403.08

LTD 805,412 $2.41 $19,410.43

MAJOR MEDICAL Classes 1-6 and 9-19 single 41 $53.54 $2,195.14 family 183 $179.24 $32,800.92

MAJOR MEDICAL Classes 26 & 27 single 6 $81.25 $487.50 family 11 $224.39 $2,468.29

DENTAL Classes 1-3,5,6,9-11,13-15,17-19 single 42 $44.99 $1,889.58 family 182 $103.18 $18,778.76

DENTAL Classes 4, 12,16 single 0 $39.29 $0.00 family I $91.79 $91.79 j:~

Group Of Employees Official Re s/den

Policy Number: 252591

Effective: February 01, 2009

Summary of Renewal Rates and Premium

CurrentBenefit Vc~ume Rates Premium

Employee Term Life 339,00Q $0.47 $159.33

Long Term Disability 17,795 $2.49 $443.10

Healthcare Single 2 $32.66 $65.32 Family 6 $107.47 $644.82

Dental Single 2 $55.87 $111.74 Family 6 $130.52 $783.12

Total: $2,207.43

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