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EMPLOYEE SEMI-MONTHLY PREMIUM RATE TABLE
AGE
$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
0-24
$0.43
$0.85
$1.28
$1.70
$2.13
$2.55
$2.98
$3.40
$3.83
$4.25
25-29
$0.43
$0.85
$1.28
$1.70
$2.13
$2.55
$2.98
$3.40
$3.83
$4.25
30-34
$0.43
$0.85
$1.28
$1.70
$2.13
$2.55
$2.98
$3.40
$3.83
$4.25
35-39
$0.58
$1.15
$1.73
$2.30
$2.88
$3.45
$4.03
$4.60
$5.18
$5.75
40-44
$0.83
$1.65
$2.48
$3.30
$4.13
$4.95
$5.78
$6.60
$7.43
$8.25
45-49
$1.33
$2.65
$3.98
$5.30
$6.63
$7.95
$9.28 $10.60
$11.93
$13.25
50-54
$1.88
$3.75
$5.63
$7.50
$9.38 $11.25 $13.13 $15.00
$16.88
$18.75
55-59
$2.73
$5.45
$8.18
$10.90
$13.63 $16.35 $19.08 $21.80
$24.53
$27.25
60-64
$4.43
$8.85
$13.28
$17.70
$22.13 $26.55 $30.98 $35.40
$39.83
$44.25
65-69
$7.93
$15.85
$23.78
$31.70
$39.63 $47.55 $55.48 $63.40
$71.33
$79.25
70-74
$11.13
$22.25
$33.38
$44.50
$55.63 $66.75 $77.88 $89.00 $100.13
$111.25
75-79
$23.88
$47.75
$71.63
$95.50 $119.38 $143.25 $167.13 $191.00 $214.88
$238.75
80+
$23.88
$47.75
$71.63
$95.50 $119.38 $143.25 $167.13 $191.00 $214.88
$238.75
SPOUSE SEMI-MONTHLY PREMIUM RATE TABLE
AGE
$5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000
$50,000
0-24
$0.21
$0.43
$0.64
$0.85
$1.06
$1.28
$1.49
$1.70
$1.91
$2.13
25-29
$0.21
$0.43
$0.64
$0.85
$1.06
$1.28
$1.49
$1.70
$1.91
$2.13
30-34
$0.21
$0.43
$0.64
$0.85
$1.06
$1.28
$1.49
$1.70
$1.91
$2.13
35-39
$0.29
$0.58
$0.86
$1.15
$1.44
$1.73
$2.01
$2.30
$2.59
$2.88
40-44
$0.41
$0.83
$1.24
$1.65
$2.06
$2.48
$2.89
$3.30
$3.71
$4.13
45-49
$0.66
$1.33
$1.99
$2.65
$3.31
$3.98
$4.64
$5.30
$5.96
$6.63
50-54
$0.94
$1.88
$2.81
$3.75
$4.69
$5.63
$6.56
$7.50
$8.44
$9.38
55-59
$1.36
$2.73
$4.09
$5.45
$6.81
$8.18
$9.54 $10.90
$12.26
$13.63
60-64
$2.21
$4.43
$6.64
$8.85
$11.06 $13.28 $15.49 $17.70
$19.91
$22.13
65-69
$3.96
$7.93
$11.89
$15.85
$19.81 $23.78 $27.74 $31.70
$35.66
$39.63
ALL CHILDREN SEMI-MONTHLY PREMIUM RATE TABLE*
$1,000
$2,000
$3,000
$4,000
$5,000 $6,000 $7,000 $8,000
$9,000
$10,000
RATE
$0.10
$0.20
$0.30
$0.40
$0.50
$0.60
$0.70
$0.80
$0.90
$1.00
* Regardless of howmany children you have, they are included in the all children premium amounts listed in the above table
Employee premium Spouse Premium
Child(ren) Premium
Total Semi-Monthly Premium
Voluntary Life Insurance is available at a cost to the employee through payroll deduction. The employee and/or dependents
may need to qualify for benefits. Guarantee Issue means if you sign up when you are newly hired, you automatically receive
the Guarantee Issue amount without completing an Evidence of Insurability form (EOI). EOI includes your health information
assessment.
Employee Only:
$10,000 up to 7x annual salary up to $350,000 -
Guarantee Issue:
Up to $100,000 (at initial eligibility)
Spouse:
$5,000up to$100,00not toexceed50%of employeebenefit -
Guarantee Issue:
Up to $30,000 (at initial eligibility)
Child(ren):
$1,000 up to $10,000 -
Guarantee Issue:
Up to $10,000 (at initial eligibility)
Mutual of Omaha Voluntary Life/AD&D
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