Member and Associate Member Life Insurance
Schedule of Benefits - Quarterly Premiums

Coverage Amount $25,000 - $750,000 in $25K increments 		 
Coverage Amount $25,000 - $300,000
Level    1    2    3    4    5    6    7    8    9    10    11    12
Life Insurance  $25,000  $50,000  $75,000  $100,000  $125,000  $150,000  $175,000  $200,000  $225,000  $250,000  $275,000  $300,000 
AD & D* 5,000  10,000  15,000  20,000  25,000  30,000  35,000  40,000  45,000  50,000  55,000  60,000 
Common Carrier   10,000  20,000  30,000  40,000  50,000  60,000  70,000  80,000  90,000  100,000  110,000  120,000 

          Member's Age 
Under 25  2.63  5.25  7.88  10.50  13.13  15.75  18.38  21.00  23.63  26.25  28.88  31.50 
25-29  2.63  5.25  7.88  10.50  13.13  15.75  18.38  21.00  23.63  26.25  28.88  31.50 
30-34  2.63  5.25  7.88  10.50  13.13  15.75  18.38  21.00  23.63  26.25  28.88  31.50 
35-39  3.75  7.50  11.25  15.00  18.75  22.50  26.25  30.00  33.75  37.50  41.25  45.00 
40-44  7.00  14.00  21.00  28.00  35.00  42.00  49.00  56.00  63.00  70.00  77.00  84.00 
45-49  10.00  20.00  30.00  40.00  50.00  60.00  70.00  80.00  90.00  100.00  110.00  120.00 
50-54  15.25  30.50  45.75  61.00  76.25  91.50  106.75  122.00  137.25  152.50  167.75  183.00 
55-59  23.25  46.50  69.75  93.00  116.75  139.50  162.75  186.00  209.25  232.50  255.75  279.00 
60-64  39.25  78.50  117.75  157.00  196.25  235.50  274.75  314.00  <<<    <<<    <<<    <<<   
65-69  95.25  190.50  285.75  381.00  <<<    <<<    <<<    <<<    <<<    <<<    <<<    <<<   
70-74  221.25  442.50  <<<    <<<    <<<    <<<    <<<    <<<    <<<    <<<    <<<    <<<   
75-79  356.25  <<<    <<<    <<<    <<<    <<<    <<<    <<<    <<<    <<<    <<<    <<<   
80-84      At age 80, the amount of coverage is 12,500 for 309.50 


Coverage Amount $325,000 - $500,000
Level        13        14        15        16        17        18        19        20
Life Insurance  $325,000  $350,000  $375,000  $400,000  $425,000  $450,000  $475,000  $500,000 
AD & D* 65,000  70,000  75,000  80,000  85,000  90,000  95,000  100,000 
Common Carrier   130,000  140,000  150,000  160,000  170,000  180,000  190,000  200,000 

                Member's Age
Under 25  34.13  36.75  39.38  42.00  44.63  47.25  49.88  52.50 
25-29  34.13  36.75  39.38  42.00  44.63  47.25  49.88  52.50 
30-34  34.13  36.75  39.38  42.00  44.63  47.25  49.88  52.50 
35-39  48.75  52.50  56.25  60.00  63.75  67.50  71.25  75.00 
40-44  91.00  98.00  105.00  112.00  119.00  126.00  133.00  140.00 
45-49  130.00  140.00  150.00  160.00  170.00  180.00  190.00  200.00 
50-54  198.25  213.50  228.75  244.00  259.25  274.50  289.75  305.00 
55-59  302.25  325.50  348.75  372.00  395.25  418.50  441.75  465.00 
IMPORTANT INFORMATION FOR LEVELS 13 - 20:
  • At age 60, the maximum coverage under Level 13 through Level 20 is $250,000 for $392.50 quarterly. You may select $225,000 for $353.25 quarterly.
  • At age 65, the maximum coverage under Level 13 through Level 20 is $125,000 for $476.25 quarterly.
  • At age 70, the maximum coverage under Level 13 through Level 20 is $75,000 for $663.75 quarterly.
  • At age 75, the maximum coverage under Level 13 through Level 20 is $50,000 for $712.50 quarterly.
  • At age 80, the maximum coverage under Level 13 through Level 20 is $25,000 for $618.75 quarterly.


Coverage Amount $525,000 - $750,000
Level       21       22       23       24       25       26       27       28       29       30
Life Insurance  $525,000  $550,000  $575,000  $600,000  $625,000  $650,000  $675,000  $700,000  $725,000  $750,000 
AD & D*   105,000  110,000  115,000  120,000  125,000  130,000  135,000  140,000  145,000  150,000 
Common Carrier   210,000  220,000  230,000  240,000  250,000  260,000  270,000  280,000  290,000  300,000 

          Member's Age
Under 25  55.13  57.75  60.38  63.00  65.63  68.25  70.88  73.50  76.13  78.75 
25-29  55.13  57.75  60.38  63.00  65.63  68.25  70.88  73.50  76.13  78.75 
30-34  55.13  57.75  60.38  63.00  65.63  68.25  70.88  73.50  76.13  78.75 
35-39  78.75  82.50  86.25  90.00  93.75  97.50  101.25  105.00  108.75  112.50 
40-44  147.00  154.00  161.00  168.00  175.00  182.00  189.00  196.00  203.00  210.00 
45-49  210.00  220.00  230.00  240.00  250.00  260.00  270.00  280.00  290.00  300.00 
50-54  320.25  335.50  350.75  366.00  381.25  396.50  411.75  427.00  442.25  457.50 
55-59  488.25  511.50  534.75  558.00  581.25  604.50  627.75  651.00  674.25  697.50 
IMPORTANT INFORMATION FOR LEVELS 21 - 30:
  • At age 60, the maximum coverage under Level 21 through Level 30 is $250,000 for $392.50 quarterly. You may select $225,000 for $353.25 quarterly.
  • At age 65, the maximum coverage under Level 21 through Level 30 is $125,000 for $476.25 quarterly.
  • At age 70, the maximum coverage under Level 21 through Level 30 is $75,000 for $663.75 quarterly.
  • At age 75, the maximum coverage under Level 21 through Level 30 is $50,000 for $712.50 quarterly.
  • At age 80, the maximum coverage under Level 21 through Level 30 is $25,000 for $618.75 quarterly.


IMPORTANT INFORMATION FOR ALL LEVELS:
  • * AD & D (Accidental Death and Dismemberment) and Common Carrier Coverage terminate for all Levels at age 65.
  • Premiums for Member's and Associate Member's Life Insurance and your Dependent's Life Insurance automatically increase when you enter a new age group.
  • If your group insurance coverage exceeds the amount permitted when you reach a new age group, your insurance coverage will automatically reduce to the amount permitted as shown in the schedule of benefits.
  • You may reduce your coverage at any time upon written notification to WAEPA. All coverage terminates at age 85.
  • You may reduce your coverage at any time upon written notification to WAEPA. All coverage terminates at age 85.

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