Laserfiche WebLink
PREMIUM SCHEDULE <br />Long Term Disability Benefits: <br />CITY OF SANTA - LTD CORE: <br />$8.78 per insured person <br />CITY OF SANTA ANA - LTD B/U: <br />$15.93 per insured person <br />CITY OF SANTA ANA: <br />$.352 per $100 of covered payroll <br />Basic Life Insurance: <br />$.102 per $1,000 <br />Supplemental Life Insurance: <br />For each $1,000 of Supplemental Life Insurance the <br />monthly premium rate shall be determined in accordance <br />with the employee's age as follows: <br />Employee Age Rate <br />Less than 30 $.055 <br />30 - 34 $.083 <br />35 - 39 $.11 <br />40 - 44 $.166 <br />45 - 49 $.294 <br />50 - 54 $.552 <br />55 - 59 $.672 <br />60 - 64 $1.095 <br />65 - 69 $1.978 <br />70 - 74 $1.978 <br />75 or over $1.978 <br />Supplemental Dependent Life Insurance: <br />Spouse: <br />For each $1,000 of Supplemental Dependent Life <br />Insurance the monthly premium rate shall be <br />determined in accordance with the employee's age <br />as follows: <br />Employee Age Rate <br />Less than 30 $.055 <br />30 - 34 $.083 <br />35 - 39 $.11 <br />40 - 44 $.166 <br />45 - 49 $.294 <br />50 - 54 $.552 <br />55 - 59 $.672 <br />60 - 64 $1.095 <br />65 - 69 $1.978 <br />70 - 74 $1.978 <br />75 or over $1.978 <br />Child(ren): <br />$.10 per $1,000 unit <br />Basic Accidental Death & Dismemberment and $.02 per $1,000 <br />Loss of Sight Benefit: <br />Supplemental Accidental Death & <br />Dismemberment and Loss of Sight <br />Benefit: <br />Form GBD-1000 A (10/08) (CA) <br />55A-11 <br />