Individual and Family Life Insurance Premiums

University of Wisconsin
Individual and Family Group Life Insurance - Group #32871-G

INITIAL PREMIUM DETERMINATION: Use the employee’s age for determining the premiums for both the employee and spouse or domestic partner. Employee’s age is the age on the coverage effective date, whether before or after May 1.
- Effective before May 1: Age is based on the attained age in the previous calendar year. Example: Employee date of birth is August 1, 1960 and insurance is effective on March 1, 2007. The age for initial premium determination is 46. NOTE: Premiums may increase as of May 1 as explained in Annual Premium Review below.
- Effective On or After May 1: Age is based on the attained age in the current calendar year. Example: Employee date of birth is August 1, 1960 and insurance is effective on or after May 1, 2007. The age for initial premium determination is 47.
ANNUAL PREMIUM REVIEW: Premiums are reviewed each year and any changes are effective May 1. Premiums are deducted one month in advance, therefore premiums deducted in April are for May coverage. calendar year.

Monthly Premium Tables – Effective May 2007 – Deduction Code 428
Employee Attained Age	Employee			Spouse or Domestic Partner
Employee Attained Age	$20,000	$10,000	$5,000	$10,000	$5,000
27 or less	$ .72	$ .36	$ .18	$ .36	$ .18
28-30	.80	.40	.20	.40	.20
31-33	1.00	.50	.25	.50	.25
34-36	1.20	.60	.30	.60	.30
37-39	1.44	.72	.36	.72	.36
40-42	2.16	1.08	.54	1.08	.54
43-45	3.44	1.72	.86	1.72	.86
46-48	4.16	2.08	1.04	2.08	1.04
49-51	5.76	2.88	1.44	2.88	1.44
52-54	7.40	3.70	1.85	3.70	1.85
55-57	10.28	5.14	2.57	5.14	2.57
58-60	12.80	6.40	3.20	6.22	3.11
61-63	17.64	8.82	4.41	7.74	3.87
64-66	25.40	12.70	6.35	10.80	5.40
67-69	35.48	17.74	8.87	15.04	7.52
70-72	54.72	27.36	13.68	23.32	11.66
73-75	78.32	39.16	19.58	33.30	16.65

Premiums for insuring all dependent children under age 25 are as follows.

$2,500 – Code Y	$5,000 – Code A	$7,500 – Code B	$10,000 – Code C
$.30	$.60	$.90	$1.20

UW1125 04/07