(Group #GTU 83-64-005)
(Premiums paid one month in advance)
| Monthly Premium per Principal Sum Elected | ||||||
Principal Sum |
$25,000 |
$50,000 |
$100,000 |
$150,000 |
$200,000 |
**$250,000 |
| Employee Only Premium | $ .73 |
1.45 |
2.90 |
4.35 |
5.80 |
7.25 |
Family/ Domestic Partner Premium |
$ 1.10 |
2.20 |
4.40 |
6.60 |
8.80 |
11.00 |
| ** Amounts in excess of $200,000 cannot exceed ten times annual salary | ||||||
Pilot and Air Ambulance Coverage Requires underwriting approval |
|
Monthly Premium (in addition to above) |
|
Pilot Coverage |
Air Ambulance Coverage |
$ .55 per $10,000 |
$1.00 per $10,000 |
File last updated: March 19, 2007
Feedback, questions or accessibility issues: ohrwebmaster@ohr.wisc.edu
Copyright © 2002 The Board of Regents of the University of Wisconsin SystemUW1152