Calculate your monthly premium using the rate table below.
| 1. | Select a coverage amount up to $500,000 in increments of $50,000. | = | _____________ Coverage amount |
| 2. | Divide your coverage amount by 1,000 | = | _____________ $1,000 increments of coverage |
| 3. | From the table below, find the rate that corresponds with your age and tobacco use. | = | _____________ Rate from table |
| X | _____________ Answer from #2 |
||
| = | Your monthly insurance premium |
|---|
| Age | Tobacco user | Non-tobacco user |
|---|---|---|
| Under 25 | $0.040 | $0.024 |
| 25-29 | $0.040 | $0.025 |
| 30-34 | $0.070 | $0.036 |
| 35-39 | $0.100 | $0.054 |
| 40-44 | $0.140 | $0.076 |
| 45-49 | $0.200 | $0.108 |
| 50-54 | $0.350 | $0.187 |
| 55-59 | $0.575 | $0.323 |
| 60-64 | $1.000 | $0.547 |
| 65-69 | $2.000 | $1.143 |
| 70-74* | $4.000 | $2.286 |
| 75 & Over* | $8.000 | $4.572 |
* Only members and spouses under age 70 may apply for coverage. Once accepted, coverage for active members can continue until age 80.
Premium rates increase with age and are subject to change.
