Voluntary Short Term Disability (STD) Insurance Monthly Cost

Option I	30 Day Elimination Period
Annual Salary must be at least	$7,800	$11,708	$15,600	$19,500	$23,400	$27,300	$31,200	$35,100	$39,000	$42,900	$46,800
Age Category	Weekly Benefit
	$100	$150	$200	$250	$300	$350	$400	$450	$500	$550	$600
< 30	$2.20	$3.30	$4.40	$5.50	$6.60	$7.70	$8.80	$9.90	$11.00	$12.10	$13.20
30-34	$2.80	$4.20	$5.60	$7.00	$8.40	$9.80	$11.20	$12.60	$14.00	$15.40	$16.80
35-39	$2.80	$4.20	$5.60	$7.00	$8.40	$9.80	$11.20	$12.60	$14.00	$15.40	$16.80
40-44	$3.50	$5.25	$7.00	$8.75	$10.50	$12.25	$14.00	$15.75	$17.50	$19.25	$21.00
45-49	$3.50	$5.25	$7.00	$8.75	$10.50	$12.25	$14.00	$15.75	$17.50	$19.25	$21.00
50-54	$4.30	$6.45	$8.60	$10.75	$12.90	$15.05	$17.20	$19.35	$21.50	$23.65	$25.80
55-59	$5.20	$7.80	$10.40	$13.00	$15.60	$18.20	$20.80	$23.40	$26.00	$28.60	$31.20
60-64	$8.40	$12.60	$16.80	$21.00	$25.20	$29.40	$33.60	$37.80	$42.00	$46.20	$50.40
65 +	$9.40	$14.10	$18.80	$23.50	$28.20	$32.90	$37.60	$42.30	$47.00	$51.70	$56.40
Option II	15 Day Elimination Period
Annual Salary must be at least	$7,800	$11,708	$15,600	$19,500	$23,400	$27,300	$31,200	$35,100	$39,000	$42,900	$46,800
Age Category	Weekly Benefit
	$100	$150	$200	$250	$300	$350	$400	$450	$500	$550	$600
< 30	$4.00	$6.00	$8.00	$10.00	$12.00	$14.00	$16.00	$18.00	$20.00	$22.00	$24.00
30-34	$5.20	$7.80	$10.40	$13.00	$15.60	$18.20	$20.80	$23.40	$26.00	$28.60	$31.20
35-39	$5.20	$7.80	$10.40	$13.00	$15.60	$18.20	$20.80	$23.40	$26.00	$28.60	$31.20
40-44	$6.60	$9.90	$13.20	$16.50	$19.80	$23.10	$26.40	$29.70	$33.00	$36.30	$39.60
45-49	$6.60	$9.90	$13.20	$16.50	$19.80	$23.10	$26.40	$29.70	$33.00	$36.30	$39.60
50-54	$8.60	$12.90	$17.20	$21.50	$25.80	$30.10	$34.40	$38.70	$43.00	$47.30	$51.60
55-59	$10.90	$16.35	$21.80	$27.25	$32.70	$38.15	$43.60	$49.05	$54.50	$59.95	$65.40
60-64	$15.80	$23.70	$31.60	$39.50	$47.40	$55.30	$63.20	$71.10	$79.00	$86.90	$94.80
65 +	$17.30	$25.95	$34.60	$43.25	$51.90	$60.55	$69.20	$77.85	$86.50	$95.15	$103.80

Revision Date: 10/09/08