$400,000 $16.00 $16.00 $21.33 $24.00 $26.67 $40.00 $61.33 $114.67 $176.00 $338.67 $549.33 $549.33 $410,000 $16.40 $16.40 $21.87 $24.60 $27.33 $41.00 $62.87 $117.53 $180.40 $347.13 $563.07 $563.07 $420,000 $16.80 $16.80 $22.40 $25.20 $28.00 $42.00 $64.40 $120.40 $184.80 $355.60 $576.80 $576.80 $430,000 $17.20 $17.20 $22.93 $25.80 $28.67 $43.00 $65.93 $123.27 $189.20 $364.07 $590.53 $590.53 $440,000 $17.60 $17.60 $23.47 $26.40 $29.33 $44.00 $67.47 $126.13 $193.60 $372.53 $604.27 $604.27 $450,000 $18.00 $18.00 $24.00 $27.00 $30.00 $45.00 $69.00 $129.00 $198.00 $381.00 $618.00 $618.00 $460,000 $18.40 $18.40 $24.53 $27.60 $30.67 $46.00 $70.53 $131.87 $202.40 $389.47 $631.73 $631.73 $470,000 $18.80 $18.80 $25.07 $28.20 $31.33 $47.00 $72.07 $134.73 $206.80 $397.93 $645.47 $645.47 $480,000 $19.20 $19.20 $25.60 $28.80 $32.00 $48.00 $73.60 $137.60 $211.20 $406.40 $659.20 $659.20 $490,000 $19.60 $19.60 $26.13 $29.40 $32.67 $49.00 $75.13 $140.47 $215.60 $414.87 $672.93 $672.93 $500,000 $20.00 $20.00 $26.67 $30.00 $33.33 $50.00 $76.67 $143.33 $220.00 $423.33 $686.67 $686.67 Spouse 18 Payment Periods Premiums Benefit Age Age Age Age Age Age Age Age Age Age Age Age Amount 18-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ $5,000 $0.20 $0.20 $0.27 $0.30 $0.33 $0.50 $0.77 $1.43 $2.20 $4.23 $6.87 $6.87 $10,000 $0.40 $0.40 $0.53 $0.60 $0.67 $1.00 $1.53 $2.87 $4.40 $8.47 $13.73 $13.73 $15,000 $0.60 $0.60 $0.80 $0.90 $1.00 $1.50 $2.30 $4.30 $6.60 $12.70 $20.60 $20.60 $20,000 $0.80 $0.80 $1.07 $1.20 $1.33 $2.00 $3.07 $5.73 $8.80 $16.93 $27.47 $27.47 $25,000 $1.00 $1.00 $1.33 $1.50 $1.67 $2.50 $3.83 $7.17 $11.00 $21.17 $34.33 $34.33 $30,000 $1.20 $1.20 $1.60 $1.80 $2.00 $3.00 $4.60 $8.60 $13.20 $25.40 $41.20 $41.20 $35,000 $1.40 $1.40 $1.87 $2.10 $2.33 $3.50 $5.37 $10.03 $15.40 $29.63 $48.07 $48.07 $40,000 $1.60 $1.60 $2.13 $2.40 $2.67 $4.00 $6.13 $11.47 $17.60 $33.87 $54.93 $54.93 $45,000 $1.80 $1.80 $2.40 $2.70 $3.00 $4.50 $6.90 $12.90 $19.80 $38.10 $61.80 $61.80 $50,000 $2.00 $2.00 $2.67 $3.00 $3.33 $5.00 $7.67 $14.33 $22.00 $42.33 $68.67 $68.67 $55,000 $2.20 $2.20 $2.93 $3.30 $3.67 $5.50 $8.43 $15.77 $24.20 $46.57 $75.53 $75.53 $60,000 $2.40 $2.40 $3.20 $3.60 $4.00 $6.00 $9.20 $17.20 $26.40 $50.80 $82.40 $82.40 $65,000 $2.60 $2.60 $3.47 $3.90 $4.33 $6.50 $9.97 $18.63 $28.60 $55.03 $89.27 $89.27 $70,000 $2.80 $2.80 $3.73 $4.20 $4.67 $7.00 $10.73 $20.07 $30.80 $59.27 $96.13 $96.13 $75,000 $3.00 $3.00 $4.00 $4.50 $5.00 $7.50 $11.50 $21.50 $33.00 $63.50 $103.00 $103.00 $80,000 $3.20 $3.20 $4.27 $4.80 $5.33 $8.00 $12.27 $22.93 $35.20 $67.73 $109.87 $109.87 $85,000 $3.40 $3.40 $4.53 $5.10 $5.67 $8.50 $13.03 $24.37 $37.40 $71.97 $116.73 $116.73 $90,000 $3.60 $3.60 $4.80 $5.40 $6.00 $9.00 $13.80 $25.80 $39.60 $76.20 $123.60 $123.60 $95,000 $3.80 $3.80 $5.07 $5.70 $6.33 $9.50 $14.57 $27.23 $41.80 $80.43 $130.47 $130.47 $100,000 $4.00 $4.00 $5.33 $6.00 $6.67 $10.00 $15.33 $28.67 $44.00 $84.67 $137.33 $137.33 $105,000 $4.20 $4.20 $5.60 $6.30 $7.00 $10.50 $16.10 $30.10 $46.20 $88.90 $144.20 $144.20 $110,000 $4.40 $4.40 $5.87 $6.60 $7.33 $11.00 $16.87 $31.53 $48.40 $93.13 $151.07 $151.07 $115,000 $4.60 $4.60 $6.13 $6.90 $7.67 $11.50 $17.63 $32.97 $50.60 $97.37 $157.93 $157.93 $120,000 $4.80 $4.80 $6.40 $7.20 $8.00 $12.00 $18.40 $34.40 $52.80 $101.60 $164.80 $164.80 $125,000 $5.00 $5.00 $6.67 $7.50 $8.33 $12.50 $19.17 $35.83 $55.00 $105.83 $171.67 $171.67 $130,000 $5.20 $5.20 $6.93 $7.80 $8.67 $13.00 $19.93 $37.27 $57.20 $110.07 $178.53 $178.53 $135,000 $5.40 $5.40 $7.20 $8.10 $9.00 $13.50 $20.70 $38.70 $59.40 $114.30 $185.40 $185.40 $140,000 $5.60 $5.60 $7.47 $8.40 $9.33 $14.00 $21.47 $40.13 $61.60 $118.53 $192.27 $192.27 $145,000 $5.80 $5.80 $7.73 $8.70 $9.67 $14.50 $22.23 $41.57 $63.80 $122.77 $199.13 $199.13 $150,000 $6.00 $6.00 $8.00 $9.00 $10.00 $15.00 $23.00 $43.00 $66.00 $127.00 $206.00 $206.00 $155,000 $6.20 $6.20 $8.27 $9.30 $10.33 $15.50 $23.77 $44.43 $68.20 $131.23 $212.87 $212.87 $160,000 $6.40 $6.40 $8.53 $9.60 $10.67 $16.00 $24.53 $45.87 $70.40 $135.47 $219.73 $219.73 $165,000 $6.60 $6.60 $8.80 $9.90 $11.00 $16.50 $25.30 $47.30 $72.60 $139.70 $226.60 $226.60 $170,000 $6.80 $6.80 $9.07 $10.20 $11.33 $17.00 $26.07 $48.73 $74.80 $143.93 $233.47 $233.47 $175,000 $7.00 $7.00 $9.33 $10.50 $11.67 $17.50 $26.83 $50.17 $77.00 $148.17 $240.33 $240.33 $180,000 $7.20 $7.20 $9.60 $10.80 $12.00 $18.00 $27.60 $51.60 $79.20 $152.40 $247.20 $247.20 $185,000 $7.40 $7.40 $9.87 $11.10 $12.33 $18.50 $28.37 $53.03 $81.40 $156.63 $254.07 $254.07 $190,000 $7.60 $7.60 $10.13 $11.40 $12.67 $19.00 $29.13 $54.47 $83.60 $160.87 $260.93 $260.93 $195,000 $7.80 $7.80 $10.40 $11.70 $13.00 $19.50 $29.90 $55.90 $85.80 $165.10 $267.80 $267.80 $200,000 $8.00 $8.00 $10.67 $12.00 $13.33 $20.00 $30.67 $57.33 $88.00 $169.33 $274.67 $274.67 $205,000 $8.20 $8.20 $10.93 $12.30 $13.67 $20.50 $31.43 $58.77 $90.20 $173.57 $281.53 $281.53 $210,000 $8.40 $8.40 $11.20 $12.60 $14.00 $21.00 $32.20 $60.20 $92.40 $177.80 $288.40 $288.40 $215,000 $8.60 $8.60 $11.47 $12.90 $14.33 $21.50 $32.97 $61.63 $94.60 $182.03 $295.27 $295.27 $220,000 $8.80 $8.80 $11.73 $13.20 $14.67 $22.00 $33.73 $63.07 $96.80 $186.27 $302.13 $302.13 $225,000 $9.00 $9.00 $12.00 $13.50 $15.00 $22.50 $34.50 $64.50 $99.00 $190.50 $309.00 $309.00 $230,000 $9.20 $9.20 $12.27 $13.80 $15.33 $23.00 $35.27 $65.93 $101.20 $194.73 $315.87 $315.87 $235,000 $9.40 $9.40 $12.53 $14.10 $15.67 $23.50 $36.03 $67.37 $103.40 $198.97 $322.73 $322.73 $240,000 $9.60 $9.60 $12.80 $14.40 $16.00 $24.00 $36.80 $68.80 $105.60 $203.20 $329.60 $329.60 $245,000 $9.80 $9.80 $13.07 $14.70 $16.33 $24.50 $37.57 $70.23 $107.80 $207.43 $336.47 $336.47 $250,000 $10.00 $10.00 $13.33 $15.00 $16.67 $25.00 $38.33 $71.67 $110.00 $211.67 $343.33 $343.33 Page 2 of 3