| STATE OF WYOMING | ||||||
| Group Life/AD & D Plans - Active Employees | ||||||
| Unit Rates Effective January 1, 2008 | ||||||
| DEATH | PREMIUM | |||||
| AGE GROUP | BENEFIT | AD & D | ACTIVE | |||
| 0 - 34 | $ 50,000.00 | $ 20,000.00 | $ 3.60 | |||
| 35 - 39 | $ 50,000.00 | $ 20,000.00 | $ 5.60 | |||
| 40 - 44 | $ 50,000.00 | $ 20,000.00 | $ 7.60 | |||
| 45 - 49 | $ 50,000.00 | $ 20,000.00 | $ 9.10 | |||
| 50 - 54 | $ 50,000.00 | $ 20,000.00 | $ 12.10 | |||
| 55 - 59 | $ 50,000.00 | $ 20,000.00 | $ 17.60 | |||
| 60 - 64 | $ 32,000.00 | $ 13,000.00 | $ 17.03 | |||
| 65 -69 | $ 21,000.00 | $ 9,000.00 | $ 16.23 | |||
| 70 - 74 | $ 14,000.00 | $ 6,000.00 | $ 21.60 | |||
| 75 - 79 | $ 9,000.00 | $ 4,000.00 | $ 13.89 | |||
| 80 - 84 | $ 6,000.00 | $ 3,000.00 | $ 9.27 | |||
| 85 AND OVER | $ 4,500.00 | $ 2,000.00 | $ 6.95 | |||
| NOTE: Dependent coverage is $1.95 per month. | ||||||
| SPOUSE | $ 4,000.00 | |||||
| CHILD: | $ 4,000.00 | |||||
| Your unmarried child from 14 days through age 19 (through age 23 if a registered student in full-time attendance at an accredited educational institution). | ||||||