Historical Benefit Plan Premiums

Health Insurance

2015

2014

2013

2012

2011 (8/26/2011 - 12/31/2011)

2011 (1/1/2011 - 8/25/2011)

2010

Prior Years

Classified Employees
Non-Represented and Represented with Settled Contracts Represented without Settled Contracts
Full Time Less than Half Time Full Time Less than Half Time
2009 2009    
2008 (1/1 - 7/31) 2008 (1/1 - 7/31)    
2008 (8/1 - 12/31) 2008 (8/1 - 12/31)    
2007 2007    
2006 2006    
2005 2005    
2004 2004    
2003 2003 2003 2003
Graduate Assistants and Short Term Academic Staff
Non-Represented and MGAA TAA
2009 2009
2008 (1/1 - 7/31) 2008 (1/1 - 7/31)
2008 (8/1 - 12/31) 2008 (8/1 - 12/31)
2007 2007
2006 2006
2005  
2004  
2003 2003

EPIC Benefits+

Note: Beginning with the 2011 plan year, EPIC Dental and Excess Medical was renamed to EPIC Benefits+

EPIC Benefits+

2018 EPIC Benefits+ Insurance (Group #3180) - Active Employees
Deduction Code Coverage Type Employee Employee + Spouse/Domestic Partner Employee + Child(ren) Family
404 Active Employee Monthly Premium Without Vision Coverage $21.38 $42.76 $42.76 $64.14
Active Employee Monthly Premium With Vision Coverage $25.02 $49.16 $49.16 $73.58
2018 Monthly Rates for Annuitants
Deduction Code Coverage Type Employee Employee +
Spouse/Domestic Partner
Employee + Child(ren) Family
N/A Annuitant Monthly Premium Without Vision Coverage $28.74 $57.36 $66.58 $79.16
Annuitant Monthly Premium With Vision Coverage $32.00 $63.22 $72.14 $87.64
2017 EPIC Benefits+ Insurance (Group #3180) - Active Employees
Deduction Code Coverage Type Employee Employee + Spouse/Domestic Partner Employee + Child(ren) Family
404 Active Employee Monthly Premium Without Vision Coverage $21.56 $43.12 $43.12 $64.68
Active Employee Monthly Premium With Vision Coverage $25.60 $50.24 $50.24 $75.16
2017 Monthly Rates for Annuitants
Deduction Code Coverage Type Employee Employee +
Spouse/Domestic Partner
Employee + Child(ren) Family
N/A Annuitant Monthly Premium Without Vision Coverage $28.90 $57.68 $66.96 $79.62
Annuitant Monthly Premium With Vision Coverage $33.24 $65.50 $74.36 $90.92
2016 EPIC Benefits+ Insurance (Group #3180) - Active Employees
Deduction Code Coverage Type Employee Employee + Spouse/Domestic Partner Employee + Child(ren) Family
404 Active Employee Monthly Premium Without Vision Coverage $19.77 $39.54 $39.54 $59.31
Active Employee Monthly Premium With Vision Coverage $24.02 $47.04 $47.04 $70.34
2016 Monthly Rates for Annuitants
Deduction Code Coverage Type Employee Employee +
Spouse/Domestic Partner
Employee + Child(ren) Family
N/A Annuitant Monthly Premium Without Vision Coverage $26.69 $53.27 $61.90 $73.53
Annuitant Monthly Premium With Vision Coverage $31.26 $61.51 $69.68 $85.43
2015 EPIC Benefits+ Insurance (Group #3180) - Active Employees
Deduction Code Coverage Type Employee Employee + Spouse/Domestic Partner Employee + Child(ren) Family
404 Active Employee Monthly Premium Without Vision Coverage $19.77 $39.54 $39.54 $59.31
Active Employee Monthly Premium With Vision Coverage $24.02 $47.04 $47.04 $70.34
2015 Monthly Rates for Annuitants
Deduction Code Coverage Type Employee Employee +
Spouse/Domestic Partner
Employee + Child(ren) Family
N/A Annuitant Monthly Premium Without Vision Coverage $26.69 $53.27 $61.90 $73.53
Annuitant Monthly Premium With Vision Coverage $31.26 $61.51 $69.68 $85.43
2013 and 2014 EPIC Benefits+ Insurance (Group #3180) — Active Employees
Deduction Code Coverage Type Employee Employee + Spouse/Domestic Partner Employee + Child Family
404 Active Employee Monthly Premium Without Vision Coverage $19.77 $39.54 $39.54 $59.31
Active Employee Monthly Premium With Vision Coverage $24.02 $47.04 $47.04 $70.34
2013 and 2014 Monthly Rates for Annuitants
Deduction Code Coverage Type Employee Employee +
Spouse/Domestic Partner
Employee + Child Family
N/A Annuitant Monthly Premium Without Vision Coverage $26.69 $53.27 $61.90 $73.53
Annuitant Monthly Premium With Vision Coverage $31.26 $61.51 $69.68 $85.43
2012 EPIC Benefits+ Insurance (Group #3180) — Active Employees
Deduction Code Coverage Type Employee Employee + Spouse / Domestic Partner Employee + Child Family
404 Active Employee Monthly Premium Without Vision Coverage $18.99 $37.98 $37.98 $56.97
Active Employee Monthly Premium With Vision Coverage $22.99 $45.05 $45.05 $67.36
2012 Monthly Rates for Non-Medicare Primary Annuitants
Deduction Code Coverage Type Annuitant Annuitant + Spouse / Domestic Partner Annuitant + Child Family
N/A Annuitant Monthly Premium Without Vision Coverage $24.32 $48.53 $56.18 $66.90
Annuitant Monthly Premium With Vision Coverage $28.63 $56.30 $63.52 $78.12
2011 EPIC Benefits+ Insurance (Group #3180)
Deduction Code Coverage Type Employee Employee + Spouse or Domestic Partner Employee + Child Employee + 2 or more
404 Active Employee Monthly Premium Without Vision Coverage $16.70 $33.40 $33.40 $50.10
Active Employee Monthly Premium With Vision Coverage $20.70 $40.47 $40.47 $60.49
N/A Retiree Monthly Premium Without Vision Coverage $20.87 $41.64 $48.25 $57.43
Annuitant Monthly Premium With Vision Coverage $25.18 $49.41 $55.59 $68.65
2009 Dental and Excess Medical (EPIC) Insurance (Group #3180)
Employee Type Premium
Employee Employee + Child Employee + Spouse Family
Active Employee $16.70 $33.40 $33.40 $50.10
Retiree $20.87 $48.25 $41.64 $57.43
2008 Dental and Excess Medical (EPIC) Insurance (Group #3180)
Employee Type Premium
Employee Employee + Child Employee + Spouse Family
Active Employee $12.90 $25.80 $25.80 $38.70
Retiree $16.85 $33.65 $33.65 $46.40
2006 Dental and Excess Medical (EPIC) Insurance (Group #3180)
Employee Type Premium
Employee Employee + Child Employee + Spouse Family
Active Employee $12.90 $25.80 $25.80 $38.70
Retiree $16.85 $33.65 $33.65 $46.40
2005 Dental and Excess Medical (EPIC) Insurance (Group #3180)
Employee Type Premium
Employee Employee + Child Employee + Spouse Family
Active Employee $11.30 $22.60 $22.60 $33.90
Retiree $13.15 $26.30 $30.45 $36.25

Anthem DentalBlue Insurance · Dental Wisconsin · Union Dental Plans

Anthem DentalBlue Insurance

Note: Effective January 1, 2011, only Classified Represented employees will be eligible to carry Anthem DentalBlue coverage. All other employees wishing to have dental coverage should enroll in the Dental Wisconsin plan. Premiums are deducted one month in advance of the month of coverage.

2012 DentalBlue Insurance — Monthly Premiums Effective for Coverage 1/1/2012
UW Deduction Codes Plan Employee Employee + 1 Employee + 2 or more
467
Group Nos. 00166271 and 00166260

Anthem BCBS Dentacare HMO — Region 1

(Kenosha, Milwaukee, Ozaukee, Racine, Washington & Waukesha Counties

$23.27 $46.55 $74.47

Anthem BCBS Dentacare HMO — Region 2

(All other Wisconsin Counties)

$28.78 $57.56 $92.10
478
Group Nos. 00166270 and 00166212

Anthem BCBS Preferred PPO

(Region 1 and Region 2)

$23.51 $47.01 $77.56
479
Group Nos. 00166272 and 00166261

Anthem BCBS Supplemental

(Region 1 and Region 2)

$18.08 $36.17 $54.28
2010/2011 DentalBlue Insurance — Monthly Premiums Effective for Coverage 1/1/2010
UW Deduction Codes Plan Employee Employee + 1 Employee + 2 or more
467
Group Nos. 00166271 and 00166260

Anthem BCBS Dentacare HMO — Region 1

(Kenosha, Milwaukee, Ozaukee, Racine, Washington & Waukesha Counties

$23.27 $46.55 $74.47

Anthem BCBS Dentacare HMO — Region 2

(All other Wisconsin Counties)

$28.78 $57.56 $92.10
478
Group Nos. 00166270 and 00166212

Anthem BCBS PPO

(Region 1 and Region 2)

$23.51 $47.01 $77.56
479
Group Nos. 00166272 and 00166261

Anthem BCBS Supplemental

(Region 1 and Region 2)

$16.59 $33.19 $49.80
2009 DentalBlue (Dentacare) — Monthly Premiums Effective for Coverage 01/01/2009
UW Deduction Codes Plan Employee Employee + 1 Employee +2
467
Group Nos. 00166271 and 00166260

Anthem BCBS HMO — Region 1

(Kenosha, Milwaukee, Ozaukee, Racine, Washington & Waukesha Counties

$23.27 $46.55 $74.47

Anthem BCBS HMO — Region 2

(All other Wisconsin Counties)

$28.78 $57.56 $92.10
478
Group Nos. 00166270 and 00166212

Anthem BCBS PPO

(Region 1 and Region 2)

$23.51 $47.01 $77.56
479
Group Nos. 00166272 and 00166261

Anthem BCBS Supplemental

(Region 1 and Region 2)

$16.59 $33.19 $49.80
2008 DentalBlue (Dentacare) — Monthly Premiums Effective for Coverage 01/01/2008
UW Deduction Codes Plan Employee Employee + 1 Employee +2
467
Group Nos. 00166271 and 00166260

Anthem BCBS HMO — Region 1

(Kenosha, Milwaukee, Ozaukee, Racine, Washington & Waukesha Counties

$23.27 $46.55 $74.47

Anthem BCBS HMO — Region 2

(All other Wisconsin Counties)

$28.78 $57.56 $92.10
478
Group Nos. 00166270 and 00166212

Anthem BCBS PPO

(Region 1 and Region 2)

$21.70 $43.38 $71.58
479
Group Nos. 00166272 and 00166261

Anthem BCBS Supplemental

(Region 1 and Region 2)

$14.28 $28.56 $42.86
2007 DentalBlue (Dentacare)
(Group #83445-7)
OSER Deduction Code UW Deduction Code Plan Employee Employee + 1 Employee + 2
484 467

Dentacare HMO—Region 1

(Kenosha, Milwaukee, Ozaukee, Racine, Washington & Waukesha Counties

$19.12 $38.25 $61.19

Dentacare HMO—Region 2

(All other Wisconsin Counties)

$23.65 $47.30 $75.68
485 478 Preferred PPO $19.38 $38.75 $63.94
486 479 Supplemental Plan $11.48 $22.96 $34.45
2006 DentalBlue (Dentacare)
(Group #83445-7)
UW Deduction Codes Plan Employee Employee + 1 Employee + 2
467

Dentacare HMO—Region 1

(Kenosha, Milwaukee, Ozaukee, Racine, Washington & Waukesha Counties

$19.12 $38.25 $61.19

Dentacare HMO—Region 2

(All other Wisconsin Counties)

$23.65 $47.30 $75.68
478 Preferred PPO $19.38 $38.75 $63.94
479 Supplemental Plan $11.48 $22.96 $34.45
2005 DentalBlue (Dentacare)
(Group #83445-7)
UW Deduction Codes Plan Employee Employee + 1 Employee + 2
467

Dentacare HMO—Region 1

(Kenosha, Milwaukee, Ozaukee, Racine, Washington & Waukesha Counties

$17.40 $34.80 $55.68

Dentacare HMO—Region 2

(All other Wisconsin Counties)

$21.52 $43.04 $68.86
478 Preferred PPO $17.94 $35.88 $59.20
479 Supplemental Plan $9.95 $19.90 $29.85

Dental Wisconsin

2016 Dental Wisconsin Insurance (Group #31800D) — Active Employees
UW Deduction Codes Plan Employee Employee +
Spouse/Domestic Partner
Employee + Child(ren) Family
487 Preferred Provider Plan (PPO) $25.49 $53.96 $60.34 $91.21
488 Select Plan $20.52 $42.19 $48.68 $71.59
2015 Dental Wisconsin Insurance (Group #31800D) — Active Employees
UW Deduction Codes Plan Employee Employee +
Spouse/Domestic Partner
Employee + Child(ren) Family
487 Preferred Provider Plan (PPO) $25.49 $53.96 $60.34 $91.21
488 Select Plan $20.52 $42.19 $48.68 $71.59
2013 and 2014 Dental Wisconsin Insurance (Group #31800D) — Monthly Premiums Effective for Coverage 1/1/2013
UW Deduction Codes Plan Employee Employee +
Spouse/Domestic Partner
Employee + Child(ren) Family
487 Preferred Provider Plan (PPO) $28.32 $59.96 $67.04 $101.34
488 Select Plan $20.52 $42.19 $48.68 $71.59
2012 Dental Wisconsin Insurance (Group #31800D) — Monthly Premiums Effective for Coverage 1/1/2012
UW Deduction Codes Plan Employee Employee + Spouse/Domestic Partner Employee + Child(ren) Family
487 Preferred Provider Plan (PPO) $26.82 $56.78 $63.49 $95.97
488 Select Plan $17.84 $36.68 $42.32 $62.24
2011 Dental Wisconsin Insurance (Group #31800D) — Monthly Premiums Effective for Coverage 1/1/2011
UW Deduction Codes Plan Employee Employee + Spouse/Domestic Partner Employee + Child(ren) Family
487 Preferred Provider Plan (PPO) $25.54 $54.08 $60.47 $91.41
488 Select Plan $16.99 $34.93 $40.30 $59.28

Union Dental Plans

2011 Union Represented Dental Monthly Rates
Deduction Code Plan Name Bargaining Unit Rate Effective Date Premium
Single 2 Person Family
462 Care Plus Prepaid WSEU 2,3,5,6,12 01/01/2011 $32.99 N/A $81.07
463 DentalBlue WSP 15 09/01/2005 $36.90 N/A $99.62
464 DentaCare Smile Plus UPQHC 11 07/01/2010 $42.05 N/A $113.55
465 Freedom Advance WEAC 13 09/01/2008 $56.21 $105.25 $176.50
466 Delta Exclusive Provider WSEU 2,3,5,6,12 01/01/2010 $27.28 $53.87 $102.98
466 Delta Premier WSEU 2,3,5,6,12 01/01/2010 $29.85 $58.83 $111.09
504 Freedom Basic WPEC 7
PERSA 8
WSP 15
01/01/2011 $25.53 $52.87 $94.83
505 Freedom Advance WPEC 7
PERSA 8
WSP 15
01/01/2011 $40.70 $81.23 $133.43
2009 Union Represented Dental Monthly Rates
Deduction Code Plan Name Bargaining Unit Rate Effective Date Premium
Single 2 Person Family
462 Care Plus Prepaid WSEU 2,3,5,6,12 01/01/09 $30.50 N/A $74.96
463 DentalBlue WSP 15 09/01/05 $36.90 N/A $99.62
464 DentaCare Smile Plus UPQHC 11 07/01/09 $38.23 N/A $103.23
465 Freedom Advance WEAC 13 09/01/08 $56.21 $105.25 $176.50
466 Delta Exclusive Provider WSEU 2,3,5,6,12 01/01/08 $27.28 $53.87 $102.98
466 Delta Premier WSEU 2,3,5,6,12 01/01/08 $29.85 $58.83 $111.09
504 Freedom Basic WPEC 7
PERSA 8
WSP 15
08/01/06 $24.32 $50.36 $90.32
505 Freedom Advance WPEC 7
PERSA 8
WSP 15
08/01/06 $38.77 $77.37 $127.19
N/A Madison Teachers Assistants Association TAA N/A NONE NONE NONE
2006 Union Represented Dental Premiums
Deduction Code Plan Name Bargaining Unit Rate Effective Date Premium
Single 2 Person Family
462 Care Plus Prepaid WSEU 2,3,5,6,12 01/01/06 $26.65 N/A $65.50
462 Care Plus Prepaid WSEU 2,3,5,6,12 01/01/08 $29.05 N/A $71.39
463 DentalBlue WSP 15 09/01/05 $36.90 N/A $99.62
464 DentaCare Smile Plus UPQHC 11 07/01/08 $36.07 N/A $97.39
07/01/07 $34.03 N/A $91.88
07/01/06 $32.10 N/A $86.68
465 Freedom Advance WEAC 13 08/01/07 $54.31 $101.70 $170.54
466 Delta Exclusive Provider WSEU 2,3,5,6,12 01/01/07 $23.73 $46.85 $89.55
466 Delta Premier WSEU 2,3,5,6,12 01/01/07 $26.67 $52.53 $99.03
504 Freedom Basic WPEC 7
PERSA 8
WSP 15
08/01/06 $24.32 $50.36 $90.32
505 Freedom Advance WPEC 7
PERSA 8
WSP 15
08/01/06 $38.77 $77.37 $127.19
N/A Madison Teachers Assistants Association TAA N/A NONE NONE NONE
2005 Union Represented Dental Premiums
Deduction Code Plan Name Bargaining Unit Rate Effective Date Premium
Single 2 Person Family
462 Care Plus Prepaid WSEU 2,3,5,6,12 01/01/05 $26.65 N/A $65.50
463 DentalBlue WSP 15 09/01/03 $25.11 N/A $67.80
464 DentaCare Smile Plus UPQHC 11 07/01/04 $28.57 N/A $77.14
465 Freedom Advance WEAC 13 08/01/04 $36.25 $67.88 $113.83
466 Delta Care WSEU 2,3,5,6,12 02/01/04 $16.87 $33.07 $57.76
466 Delta Preferred WSEU 2,3,5,6,12 02/01/04 $17.22 $33.91 $58.74
466 Delta Premier WSEU 2,3,5,6,12 02/01/04 $26.70 $51.80 $81.56
468

DentalBlue DentaCare HMO — Region 1

(Kenosha, Milwaukee, Ozaukee, Racine, Washington and Waukesha counties)

WSEU 2,3,5,6,12 01/01/05 $18.14 $35.47 $58.22

DentalBlue DentaCare HMO — Region 2

(All other Wisconsin counties)

$22.49 $44.98 $71.95
469 DentalBlue Preferred PPO WSEU 2,3,5,6,12 02/01/04 $16.97 $32.89 $57.98
480 DentalBlue Choice WSEU 2,3,5,6,12 02/01/04 $42.50 $85.01 $123.55
481 DentalBlue Supplemental WSEU 2,3,5,6,12 01/01/05 $12.07 $24.14 $37.34
504 Freedom Basic WPEC 7
PERSA 8
WSP 15
08/01/02 $18.55 $38.41 $68.93
505 Freedom Advance WPEC 7
PERSA 8
WSP 15
08/01/02 $29.57 $59.01 $97.01
N/A Madison Teachers Assistants Association TAA N/A NONE NONE NONE

Vision Insurance

VSP Vision Plan Monthly Premiums
Year UW Deduction Code Employee Employee + Spouse/Domestic Partner Employee + Child(ren) Employee + Family
2019 411 $6.38 $12.76 $14.38 $22.98
2018 411 $6.54 $13.08 $14.73 $23.54
2017 411 $6.54 $13.08 $14.73 $23.54
2016 411 $6.54 $13.08 $14.73 $23.54
2015 411 $6.54 $13.08 $14.73 $23.54
2014 411 $6.35 $12.70 $14.30 $22.85
2013 411 $5.24 $10.49 $11.23 $17.93
2012 411 $5.24 $10.49 $11.23 $17.93
2011 411 $5.24 $10.49 $11.23 $17.93
2010 411 $5.24 $10.49 $11.23 $17.93
2009 410 $5.83 $11.34 $11.88 $17.82
2008 410 $5.83 $11.34 $11.88 $17.82
2007 410 $5.40 $10.50 $11.00 $16.50

Income Continuation Insurance (ICI)

For Coverage Effective 2/1/2019

For Coverage Effective 2/1/2018

For Coverage Effective 2/1/2017

For Coverage Before 2/1/2017

  • Effective Dates 2/1/2016 - 1/31/2017: Excel · PDF
  • Effective Dates 2/1/2015 - 1/31/2016: Excel · PDF
  • Effective Dates 2/1/2014 - 1/31/2015: Excel · PDF
  • Effective Dates 2/1/2013 - 1/31/2014: Excel · PDF
  • Effective Dates 2/1/2012 - 1/31/2013: Excel · PDF
  • Effective Dates 2/1/2010 - 1/31/2012: Excel · PDF
  • Effective Dates 2/1/2007 - 1/31/2010: Excel · PDF

Accidental Death & Dismemberment · Individual and Family Group Life Insurance · State Group Life · University Insurance Association (UIA) Life Insurance · UW Employees, Inc. Life

Accidental Death & Dismemberment

2016 AD&D Monthly Premium per Principal Sum Elected (Group #GTU 83-64-005)
Year Principal Sum Elected Employee Only Premium Family Plan Premium
2019 25000 $0.73 $1.10
2019 50000 $1.45 $2.20
2019 100000 $2.90 $4.40
2019 150000 $4.35 $6.60
2019 200000 $5.80 $8.80
2019 250000 $7.25 $11.00
2019 300000 $8.70 $13.20
2019 350000 $10.15 $15.40
2019 400000 $11.60 $17.60
2019 450000 $13.05 $19.80
2019 500000 $14.50 $22.00
2018 25000 $0.65 $0.98
2018 50000 $1.30 $1.95
2018 100000 $2.60 $3.90
2018 150000 $3.90 $5.85
2018 200000 $5.20 $7.80
2018 250000 $6.50 $9.75
2018 300000 $7.80 $11.70
2018 350000 $9.10 $13.65
2018 400000 $10.40 $15.60
2018 450000 $11.70 $17.55
2018 500000 $13.00 $19.50
2017 25000 $0.65 $0.98
2017 50000 $1.30 $1.95
2017 100000 $2.60 $3.90
2017 150000 $3.90 $5.85
2017 200000 $5.20 $7.80
2017 250000 $6.50 $9.75
2017 300000 $7.80 $11.70
2017 350000 $9.10 $13.65
2017 400000 $10.40 $15.60
2017 450000 $11.70 $17.55
2017 500000 $13.00 $19.50
2016 25000 $0.73 $1.10
2016 50000 $1.45 $2.20
2016 100000 $2.90 $4.40
2016 150000 $4.35 $6.60
2016 200000 $5.80 $8.80
2016 250000 $7.25 $11.00
2016 300000 $8.70 $13.20
2016 350000 $10.15 $15.40
2016 400000 $11.60 $17.60
2016 450000 $13.05 $19.80
2016 500000 $14.50 $22.00
2015 25000 $0.73 $1.10
2015 50000 $1.45 $2.20
2015 100000 $2.90 $4.40
2015 150000 $4.35 $6.60
2015 200000 $5.80 $8.80
2015 250000 $7.25 $11.00
2015 300000 $8.70 $13.20
2015 350000 $10.15 $15.40
2015 400000 $11.60 $17.60
2015 450000 $13.05 $19.80
2015 500000 $14.50 $22.00
2014 25000 $0.73 $1.10
2014 50000 $1.45 $2.20
2014 100000 $2.90 $4.40
2014 150000 $4.35 $6.60
2014 200000 $5.80 $8.80
2014 250000 $7.25 $11.00
2014 300000 $8.70 $13.20
2014 350000 $10.15 $15.40
2014 400000 $11.60 $17.60
2014 450000 $13.05 $19.80
2014 500000 $14.50 $22.00
2013 25000 $0.73 $1.10
2013 50000 $1.45 $2.20
2013 100000 $2.90 $4.40
2013 150000 $4.35 $6.60
2013 200000 $5.80 $8.80
2013 250000 $7.25 $11.00
2013 300000 $8.70 $13.20
2013 350000 $10.15 $15.40
2013 400000 $11.60 $17.60
2013 450000 $13.05 $19.80
2013 500000 $14.50 $22.00
2012 25000 $0.73 $1.10
2012 50000 $1.45 $2.20
2012 100000 $2.90 $4.40
2012 150000 $4.35 $6.60
2012 200000 $5.80 $8.80
2012 250000 $7.25 $11.00
2012 300000 $8.70 $13.20
2012 350000 $10.15 $15.40
2012 400000 $11.60 $17.60
2012 450000 $13.05 $19.80
2012 500000 $14.50 $22.00
2011 25000 $0.73 $1.10
2011 50000 $1.45 $2.20
2011 100000 $2.90 $4.40
2011 150000 $4.35 $6.60
2011 200000 $5.80 $8.80
2011 250000 $7.25 $11.00
2011 300000 $8.70 $13.20
2011 350000 $10.15 $15.40
2011 400000 $11.60 $17.60
2011 450000 $13.05 $19.80
2011 500000 $14.50 $22.00

Life Insurance

Individual and Family Group Life Insurance

Cost per $1000 of Coverage for Employee and Spouse/Domestic Partner
Year Employee Attained Age Employee Spouse/Domestic Partner
2019 27 0.023 0.036
2019 28 0.025 0.040
2019 31 0.032 0.050
2019 34 0.037 0.059
2019 37 0.045 0.072
2019 40 0.068 0.108
2019 43 0.108 0.171
2019 46 0.130 0.207
2019 49 0.181 0.288
2019 52 0.232 0.369
2019 55 0.323 0.513
2019 58 0.403 0.621
2019 61 0.556 0.774
2019 64 0.799 1.080
2019 67 1.117 1.503
2019 70 1.724 2.331
2019 73 2.466 3.330
2018 27 0.023 0.036
2018 28 0.025 0.040
2018 31 0.032 0.050
2018 34 0.037 0.059
2018 37 0.045 0.072
2018 40 0.068 0.108
2018 43 0.108 0.171
2018 46 0.130 0.207
2018 49 0.181 0.288
2018 52 0.232 0.369
2018 55 0.323 0.513
2018 58 0.403 0.621
2018 61 0.556 0.774
2018 64 0.799 1.080
2018 67 1.117 1.503
2018 70 1.724 2.331
2018 73 2.466 3.330
2017 27 0.023 0.036
2017 28 0.025 0.040
2017 31 0.032 0.050
2017 34 0.037 0.059
2017 37 0.045 0.072
2017 40 0.068 0.108
2017 43 0.108 0.171
2017 46 0.130 0.207
2017 49 0.181 0.288
2017 52 0.232 0.369
2017 55 0.323 0.513
2017 58 0.403 0.621
2017 61 0.556 0.774
2017 64 0.799 1.080
2017 67 1.117 1.503
2017 70 1.724 2.331
2017 73 2.466 3.330
2016 27 0.023 0.036
2016 28 0.025 0.04
2016 31 0.032 0.05
2016 34 0.037 0.059
2016 37 0.045 0.072
2016 40 0.068 0.108
2016 43 0.108 0.171
2016 46 0.13 0.207
2016 49 0.181 0.288
2016 52 0.232 0.369
2016 55 0.323 0.513
2016 58 0.403 0.621
2016 61 0.556 0.774
2016 64 0.799 1.08
2016 67 1.117 1.503
2016 70 1.724 2.331
2016 73 2.466 3.33
2015 27 0.023 0.036
2015 28 0.025 0.04
2015 31 0.032 0.05
2015 34 0.037 0.059
2015 37 0.045 0.072
2015 40 0.068 0.108
2015 43 0.108 0.171
2015 46 0.13 0.207
2015 49 0.181 0.288
2015 52 0.232 0.369
2015 55 0.323 0.513
2015 58 0.403 0.621
2015 61 0.556 0.774
2015 64 0.799 1.08
2015 67 1.117 1.503
2015 70 1.724 2.331
2015 73 2.466 3.33
2014 27 0.023 0.036
2014 28 0.025 0.04
2014 31 0.032 0.05
2014 34 0.037 0.059
2014 37 0.045 0.072
2014 40 0.068 0.108
2014 43 0.108 0.171
2014 46 0.13 0.207
2014 49 0.181 0.288
2014 52 0.232 0.369
2014 55 0.323 0.513
2014 58 0.403 0.621
2014 61 0.556 0.774
2014 64 0.799 1.08
2014 67 1.117 1.503
2014 70 1.724 2.331
2014 73 2.466 3.33
2013 27 0.023 0.036
2013 28 0.025 0.04
2013 31 0.032 0.05
2013 34 0.037 0.059
2013 37 0.045 0.072
2013 40 0.068 0.108
2013 43 0.108 0.171
2013 46 0.13 0.207
2013 49 0.181 0.288
2013 52 0.232 0.369
2013 55 0.323 0.513
2013 58 0.403 0.621
2013 61 0.556 0.774
2013 64 0.799 1.08
2013 67 1.117 1.503
2013 70 1.724 2.331
2013 73 2.466 3.33
2012 27 0.023 0.036
2012 28 0.025 0.04
2012 31 0.032 0.05
2012 34 0.037 0.059
2012 37 0.045 0.072
2012 40 0.068 0.108
2012 43 0.108 0.171
2012 46 0.13 0.207
2012 49 0.181 0.288
2012 52 0.232 0.369
2012 55 0.323 0.513
2012 58 0.403 0.621
2012 61 0.556 0.774
2012 64 0.799 1.08
2012 67 1.117 1.503
2012 70 1.724 2.331
2012 73 2.466 3.33
2011 27 0.023 0.036
2011 28 0.025 0.04
2011 31 0.032 0.05
2011 34 0.037 0.059
2011 37 0.045 0.072
2011 40 0.068 0.108
2011 43 0.108 0.171
2011 46 0.13 0.207
2011 49 0.181 0.288
2011 52 0.232 0.369
2011 55 0.323 0.513
2011 58 0.403 0.621
2011 61 0.556 0.774
2011 64 0.799 1.08
2011 67 1.117 1.503
2011 70 1.724 2.331
2011 73 2.466 3.33
Monthly Premium Table for Employee and Spouse/Domestic Partner Coverage (Deduction Code 428)
Employee Spouse/Domestic Partner
Year Employee Attained Age $5,000 $10,000 $15,000 $20,000 $5,000 $10,000
2019 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2019 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2019 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2019 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2019 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2019 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2019 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2019 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2019 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2019 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2019 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2019 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2019 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2019 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2019 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2019 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2019 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2019 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2019 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2019 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2019 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2019 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2019 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2019 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2019 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2019 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2019 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2019 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2019 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2019 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2019 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2019 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2019 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2019 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2019 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2019 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2019 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2019 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2019 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2019 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2019 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2019 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2019 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2019 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2019 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2019 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2019 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
2018 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2018 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2018 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2018 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2018 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2018 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2018 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2018 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2018 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2018 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2018 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2018 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2018 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2018 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2018 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2018 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2018 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2018 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2018 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2018 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2018 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2018 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2018 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2018 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2018 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2018 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2018 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2018 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2018 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2018 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2018 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2018 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2018 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2018 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2018 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2018 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2018 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2018 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2018 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2018 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2018 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2018 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2018 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2018 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2018 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2018 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2018 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
2017 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2017 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2017 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2017 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2017 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2017 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2017 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2017 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2017 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2017 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2017 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2017 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2017 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2017 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2017 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2017 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2017 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2017 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2017 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2017 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2017 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2017 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2017 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2017 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2017 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2017 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2017 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2017 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2017 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2017 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2017 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2017 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2017 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2017 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2017 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2017 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2017 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2017 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2017 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2017 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2017 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2017 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2017 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2017 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2017 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2017 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2017 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
2016 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2016 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2016 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2016 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2016 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2016 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2016 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2016 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2016 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2016 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2016 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2016 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2016 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2016 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2016 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2016 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2016 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2016 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2016 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2016 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2016 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2016 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2016 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2016 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2016 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2016 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2016 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2016 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2016 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2016 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2016 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2016 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2016 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2016 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2016 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2016 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2016 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2016 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2016 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2016 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2016 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2016 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2016 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2016 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2016 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2016 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2016 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
2015 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2015 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2015 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2015 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2015 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2015 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2015 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2015 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2015 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2015 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2015 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2015 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2015 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2015 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2015 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2015 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2015 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2015 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2015 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2015 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2015 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2015 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2015 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2015 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2015 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2015 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2015 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2015 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2015 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2015 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2015 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2015 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2015 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2015 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2015 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2015 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2015 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2015 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2015 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2015 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2015 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2015 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2015 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2015 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2015 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2015 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2015 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
2014 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2014 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2014 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2014 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2014 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2014 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2014 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2014 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2014 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2014 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2014 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2014 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2014 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2014 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2014 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2014 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2014 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2014 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2014 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2014 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2014 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2014 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2014 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2014 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2014 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2014 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2014 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2014 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2014 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2014 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2014 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2014 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2014 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2014 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2014 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2014 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2014 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2014 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2014 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2014 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2014 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2014 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2014 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2014 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2014 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2014 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2014 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
2013 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2013 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2013 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2013 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2013 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2013 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2013 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2013 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2013 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2013 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2013 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2013 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2013 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2013 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2013 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2013 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2013 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2013 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2013 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2013 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2013 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2013 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2013 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2013 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2013 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2013 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2013 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2013 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2013 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2013 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2013 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2013 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2013 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2013 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2013 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2013 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2013 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2013 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2013 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2013 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2013 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2013 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2013 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2013 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2013 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2013 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2013 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
2012 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2012 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2012 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2012 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2012 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2012 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2012 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2012 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2012 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2012 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2012 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2012 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2012 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2012 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2012 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2012 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2012 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2012 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2012 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2012 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2012 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2012 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2012 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2012 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2012 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2012 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2012 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2012 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2012 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2012 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2012 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2012 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2012 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2012 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2012 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2012 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2012 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2012 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2012 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2012 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2012 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2012 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2012 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2012 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2012 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2012 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2012 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
2011 27 $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
2011 28 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2011 29 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2011 30 $0.13 $0.25 $0.38 $0.50 $0.20 $0.40
2011 31 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2011 32 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2011 33 $0.16 $0.32 $0.48 $0.64 $0.25 $0.50
2011 34 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2011 35 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2011 36 $0.19 $0.37 $0.56 $0.74 $0.30 $0.59
2011 37 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2011 38 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2011 39 $0.23 $0.45 $0.68 $0.90 $0.36 $0.72
2011 40 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2011 41 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2011 42 $0.34 $0.68 $1.02 $1.36 $0.54 $1.08
2011 43 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2011 44 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2011 45 $0.54 $1.08 $1.62 $2.16 $0.86 $1.71
2011 46 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2011 47 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2011 48 $0.65 $1.30 $1.95 $2.60 $1.04 $2.07
2011 49 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2011 50 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2011 51 $0.91 $1.81 $2.72 $3.62 $1.44 $2.88
2011 52 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2011 53 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2011 54 $1.16 $2.32 $3.48 $4.64 $1.85 $3.69
2011 55 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2011 56 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2011 57 $1.62 $3.23 $4.85 $6.46 $2.57 $5.13
2011 58 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2011 59 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2011 60 $2.02 $4.03 $6.05 $8.06 $3.11 $6.21
2011 61 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2011 62 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2011 63 $2.78 $5.56 $8.34 $11.12 $3.87 $7.74
2011 64 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2011 65 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2011 66 $4.00 $7.99 $11.99 $15.98 $5.40 $10.80
2011 67 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2011 68 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2011 69 $5.59 $11.17 $16.76 $22.34 $7.52 $15.03
2011 70 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2011 71 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2011 72 $8.62 $17.24 $25.86 $34.48 $11.66 $23.31
2011 73 $12.33 $24.66 $36.99 $49.32 $16.65 $33.30
Monthly Premium Table for Child Coverage
Year Amount of Insurance Monthly Premium
$2500 (Code Y) $0.18
$5000 (Code A) 0.35
$7500 (Code B) 0.53
$10,000 (Code C) 0.70

State Group Life Insurance

Basic/Supplemental/Additional Coverage Monthly Premium Rates
(Deduction Codes: Basic=412, Basic Supplemental=414, Additional 1 Unit=419, Additional 2 Units=416, Additional 3 Units=417, Spouse & Dependent=420)
Year Age as of April 1 Basic and Supplemental
Rate per $1000
Additional
Rate per $1000
Spouse and Dependent
2019 0 - 29 0.04 0.06 --
2019 30 - 34 0.06 0.04 --
2019 35 - 39 0.06 0.04 --
2019 40 - 44 0.09 0.06 --
2019 45 - 49 0.16 0.11 --
2019 50 - 54 0.25 0.17 --
2019 55 - 59 0.35 0.23 --
2019 60 - 64 0.47 0.32 --
2019 65 - 69 0.6 0.41 --
2018 0 - 29 0.06 0.04 --
2018 30 - 34 0.06 0.04 --
2018 35 - 39 0.06 0.04 --
2018 40 - 44 0.09 0.06 --
2018 45 - 49 0.15 0.10 --
2018 50 - 54 0.24 0.16 --
2018 55 - 59 0.33 0.22 --
2018 60 - 64 0.45 0.30 --
2018 65 - 69 0.39 0.59 --
2017 0 - 29 0.06 0.04 --
2017 30 - 34 0.06 0.04 --
2017 35 - 39 0.06 0.04 --
2017 40 - 44 0.09 0.06 --
2017 45 - 49 0.10 0.15 --
2017 50 - 54 0.16 0.24 --
2017 55 - 59 0.22 0.33 --
2017 60 - 64 0.30 0.45 --
2017 65 - 69 0.39 0.59 --
2016 0 - 29 0.04 0.06 --
2016 30 - 34 0.04 0.06 --
2016 35 - 39 0.06 0.04 --
2016 40 - 44 0.09 0.06 --
2016 45 - 49 0.15 0.10 --
2016 50 - 54 0.24 0.16 --
2016 55 - 59 0.33 0.22 --
2016 60 - 64 0.30 0.45 --
2016 65 - 69 0.39 0.59 --
2015 0 - 29 0.04 0.06 --
2015 30 - 34 0.04 0.06 --
2015 35 - 39 0.06 0.04 --
2015 40 - 44 0.09 0.06 --
2015 45 - 49 0.15 0.10 --
2015 50 - 54 0.24 0.16 --
2015 55 - 59 0.33 0.22 --
2015 60 - 64 0.45 0.30 --
2015 65 - 69 0.39 0.59 --

State Group Life Insurance

Basic/Supplemental/Additional Coverage Monthly Premium Rates
(Deduction Codes: Basic=412, Basic Supplemental=414, Additional 1 Unit=419, Additional 2 Units=416, Additional 3 Units=417, Spouse & Dependent=420)
Effective through 3/31/2016
Age As of April 1 Basic and Supplemental Additional Spouse & Dependent
2013/2014/2015
Rate per $1000
2013/2014/2015
Rate per $1000
Under age 30 $.04 $.06

One Unit of Coverage: $2.50 per $10,000 Spouse and $5000 for each dependent

Two Units of Coverage: $5.00 per $20,000 Spouse and $10,000 for each dependent

30-34 .04 .06
35-39 .04 .06
40-44 .06 .09
45-49 .10 .15
50-54 .16 .24
55-59 .22 .33
60-64 .30 .45
65-69 .39 .59
Over Age 70 Additional Coverage (Deduction Code: 418)
Effective through 3/31/2016
Year Age as of April 1 Rate per $1000
2019 70 1.00
2019 71 1.15
2019 72 1.25
2019 73 1.45
2019 74 1.6
2019 75 1.8
2019 76 1.95
2019 77 2.06
2018 70 1.00
2018 71 1.15
2018 72 1.25
2018 73 1.45
2018 74 1.60
2018 75 1.80
2018 76 1.95
2018 77 2.06
2017 70 1.00
2017 71 1.15
2017 72 1.25
2017 73 1.45
2017 74 1.60
2017 75 1.80
2017 76 1.95
2017 77 2.06
2016 70 1.00
2016 71 1.15
2016 72 1.25
2016 73 1.45
2016 74 1.60
2016 75 1.80
2016 76 1.95
2016 77 2.06
2015 70 1.00
2015 71 1.15
2015 72 1.25
2015 73 1.45
2015 74 1.60
2015 75 1.80
2015 76 1.95
2015 77 2.06
State Group Life Insurance Premiums Effective through 03/31/2013
Age As of April 1 Basic & Supplemental Per $1,000 Additional Per $1,000 Spouse & Dependent
Under age 30 $.04 $.06

One Unit of Coverage: $2.50 per $10,000 Spouse and $5,000 for each dependent

Two Units of Coverage: $5.00 per $20,000 Spouse and $10,000 for each dependent

30-34 .04 .06
35-39 .05 .06
40-44 .06 .09
45-49 .10 .15
50-54 .16 .24
55-59 .22 .33
60-64 .30 .45
65-69 .39 .59
Over Age 70 Additional Coverage (Deduction Code: 418) — Effective through 03/31/2013
Age as of April 1 Rate per $1,000
70 $1.00
71 1.15
72 1.25
73 1.45
74 1.60
75 1.80
76 1.95
77+ 2.06
State Group Life Insurance Premiums Effective through 03/31/2012
Age As of April 1 Basic & Supplemental Per $1,000 Additional Per $1,000 Spouse & Dependent
Under age 30 $.04 $.06

One Unit of Coverage: $2.50 per $10,000 Spouse and $5,000 for each dependent

Two Units of Coverage: $5.00 per $20,000 Spouse and $10,000 for each dependent

30-34 .04 .07
35-39 .05 .07
40-44 .06 .09
45-49 .10 .15
50-54 .16 .24
55-59 .25 .37
60-64 .33 .50
65-69 .44 .66
Over Age 70 Additional Coverage (Deduction Code: 418) — Effective through 03/31/2012
Age as of April 1 Rate per $1,000
70 $1.00
71 1.15
72 1.25
73 1.45
74 1.60
75 1.80
76 1.95
77+ 2.06
State Group Life Insurance Premiums Effective through 03/31/2011
Age As of April 1 Basic & Supplemental Per $1,000 Additional Per $1,000 Spouse & Dependent
Under age 30 $.05 $.07

One Unit of Coverage: $2.50 per $10,000 Spouse and $5,000 for each dependent

Two Units of Coverage: $5.00 per $20,000 Spouse and $10,000 for each dependent

30-34 .05 .08
35-39 .05 .08
40-44 .07 .10
45-49 .11 .17
50-54 .18 .27
55-59 .28 .42
60-64 .38 .57
65-69 .50 .75
Over Age 70 Additional Coverage (Deduction Code: 418) — Effective through 03/31/2011
Age as of April 1 Rate per $1,000
70 $1.00
71 1.15
72 1.25
73 1.45
74 1.60
75 1.80
76 1.95
77 2.15
78 2.45
79 2.75
80 3.10
81 3.40
82 3.70
83 4.10
84 4.50
85 4.90
86 5.30
87 5.70
88 6.35
89 7.00
90+ Available upon request

University Insurance Association (UIA) Life Insurance

University Insurance Association Schedule of Benefits/Coverage Amounts (Group #32872-G)
Age as of Oct 1 Premium Benefit Amount
Under 28 $2.00 $101000
28-30 98100
31-33 90900
34-36 78900
37-39 65000
40-42 50900
43-45 39100
46-48 30000
49-51 22600
52-54 17200
55-57 13100
58-60 10300
61-63 8200
64-66 6100
67-69 4500
70+ 3400

University of Wisconsin Employees, Inc. Life Insurance

UW Employees, Inc. Monthly Premium Table — Premium and Coverage Amounts Effective 2014
Employee Age Coverage Amount Premium
under 35 $33,000 $1.00
35 - 39 28,000 1.25
40 - 44 25,000 1.60
45 - 49 18,000 2.00
50 - 54 15,000 2.40
55 - 59 13,000 3.80
60 - 64 12,000 4.35
65 and over 7,000 3.00
UW Employees, Inc. Monthly Premium Table — Premium and Coverage Amounts Effective 2019
Employee Age Coverage Amount Premium
under 35 $33,000 $0.75
35 - 39 28,000 0.94
40 - 44 25,000 1.20
45 - 49 18,000 1.50
50 - 54 15,000 1.80
55 - 59 13,000 2.85
60 - 64 12,000 3.26
65 and over 7,000 2.25
UW Employees, Inc. Monthly Premium Table — Premium and Coverage Amounts Effective October 1, 2011
Employee Age Coverage Amount Premium
under 35 $30,000 $1.00
35 - 39 25,000 1.25
40 - 44 22,000 1.60
45 - 49 15,000 2.00
50 - 54 12,000 2.40
55 - 59 10,000 3.80
60 - 64 9000 4.35
65 and over 4000 3.00
UW Employees, Inc. Monthly Premium Table — Premium and Coverage Amounts Effective January 1, 2010
Employee Age Coverage Amount Premium
under 35 $25,000 $1.00
35 - 39 21,000 1.25
40 - 44 18,000 1.60
45 - 49 12,000 2.00
50 - 54 9,000 2.40
55 - 59 7,500 3.80
60 - 64 7,000 4.35
over 64 3,000 3.00