Page 1 of 3 Reliance Standard Plans Supplemental and Dependent Life and AD&D Insurance Premium Table Plan Holder: The Life is Good Company Scheduled Benefit: Each eligible employee may elect for himself/herself and/or his/her eligible spouse an amount of insurance shown in the table below. For employees age 65 and older: Benefit amounts are reduced according to the age-based reduction chart shown in the Supplemental Life brochure. Employee/Spouse Premiums: To find you and your spouse's premium:  Determine your age band: Your age = your age at your last birthday.  Select a benefit amount (employees age 65 and older: see above comment).  Spouse premium: Repeat the steps above for your spouse at his/her age at his/her last birthday.  Employee and spouse rates change as they respectively move from one age bracket to the next. Employee Weekly Premiums Benefit Amount Age 18-24 Age 25-29 Age 30-34 Age 35-39 Age 40-44 Age 45-49 Age 50-54 Age 55-59 Age 60-64 Age 65-69 Age 70+ $10,000 $0.15 $0.15 $0.22 $0.22 $0.31 $0.54 $0.87 $1.44 $2.20 $3.91 $7.12 $20,000 $0.30 $0.30 $0.44 $0.44 $0.62 $1.08 $1.73 $2.88 $4.41 $7.82 $14.24 $30,000 $0.45 $0.45 $0.66 $0.66 $0.93 $1.63 $2.60 $4.33 $6.61 $11.73 $21.36 $40,000 $0.60 $0.60 $0.88 $0.88 $1.25 $2.17 $3.46 $5.77 $8.82 $15.65 $28.48 $50,000 $0.75 $0.75 $1.10 $1.10 $1.56 $2.71 $4.33 $7.21 $11.02 $19.56 $35.60 $60,000 $0.90 $0.90 $1.32 $1.32 $1.87 $3.25 $5.19 $8.65 $13.22 $23.47 $42.72 $70,000 $1.05 $1.05 $1.53 $1.53 $2.18 $3.80 $6.06 $10.10 $15.43 $27.38 $49.83 $80,000 $1.20 $1.20 $1.75 $1.75 $2.49 $4.34 $6.92 $11.54 $17.63 $31.29 $56.95 $90,000 $1.35 $1.35 $1.97 $1.97 $2.80 $4.88 $7.79 $12.98 $19.83 $35.20 $64.07 $100,000 $1.50 $1.50 $2.19 $2.19 $3.12 $5.42 $8.65 $14.42 $22.04 $39.12 $71.19 $110,000 $1.65 $1.65 $2.41 $2.41 $3.43 $5.97 $9.52 $15.87 $24.24 $43.03 $78.31 $120,000 $1.80 $1.80 $2.63 $2.63 $3.74 $6.51 $10.38 $17.31 $26.45 $46.94 $85.43 $130,000 $1.95 $1.95 $2.85 $2.85 $4.05 $7.05 $11.25 $18.75 $28.65 $50.85 $92.55 $140,000 $2.10 $2.10 $3.07 $3.07 $4.36 $7.59 $12.12 $20.19 $30.85 $54.76 $99.67 $150,000 $2.25 $2.25 $3.29 $3.29 $4.67 $8.13 $12.98 $21.63 $33.06 $58.67 $106.79 $160,000 $2.40 $2.40 $3.51 $3.51 $4.98 $8.68 $13.85 $23.08 $35.26 $62.58 $113.91 $170,000 $2.55 $2.55 $3.73 $3.73 $5.30 $9.22 $14.71 $24.52 $37.47 $66.50 $121.03 $180,000 $2.70 $2.70 $3.95 $3.95 $5.61 $9.76 $15.58 $25.96 $39.67 $70.41 $128.15 $190,000 $2.85 $2.85 $4.17 $4.17 $5.92 $10.30 $16.44 $27.40 $41.87 $74.32 $135.27 $200,000 $3.00 $3.00 $4.38 $4.38 $6.23 $10.85 $17.31 $28.85 $44.08 $78.23 $142.38 $210,000 $3.15 $3.15 $4.60 $4.60 $6.54 $11.39 $18.17 $30.29 $46.28 $82.14 $149.50 $220,000 $3.30 $3.30 $4.82 $4.82 $6.85 $11.93 $19.04 $31.73 $48.48 $86.05 $156.62 $230,000 $3.45 $3.45 $5.04 $5.04 $7.17 $12.47 $19.90 $33.17 $50.69 $89.97 $163.74 $240,000 $3.60 $3.60 $5.26 $5.26 $7.48 $13.02 $20.77 $34.62 $52.89 $93.88 $170.86 $250,000 $3.75 $3.75 $5.48 $5.48 $7.79 $13.56 $21.63 $36.06 $55.10 $97.79 $177.98 $260,000 $3.90 $3.90 $5.70 $5.70 $8.10 $14.10 $22.50 $37.50 $57.30 $101.70 $185.10 $270,000 $4.05 $4.05 $5.92 $5.92 $8.41 $14.64 $23.37 $38.94 $59.50 $105.61 $192.22 $280,000 $4.20 $4.20 $6.14 $6.14 $8.72 $15.18 $24.23 $40.38 $61.71 $109.52 $199.34 $290,000 $4.35 $4.35 $6.36 $6.36 $9.03 $15.73 $25.10 $41.83 $63.91 $113.43 $206.46 $300,000 $4.50 $4.50 $6.58 $6.58 $9.35 $16.27 $25.96 $43.27 $66.12 $117.35 $213.58 $310,000 $4.65 $4.65 $6.80 $6.80 $9.66 $16.81 $26.83 $44.71 $68.32 $121.26 $220.70 $320,000 $4.80 $4.80 $7.02 $7.02 $9.97 $17.35 $27.69 $46.15 $70.52 $125.17 $227.82 $330,000 $4.95 $4.95 $7.23 $7.23 $10.28 $17.90 $28.56 $47.60 $72.73 $129.08 $234.93 $340,000 $5.10 $5.10 $7.45 $7.45 $10.59 $18.44 $29.42 $49.04 $74.93 $132.99 $242.05 $350,000 $5.25 $5.25 $7.67 $7.67 $10.90 $18.98 $30.29 $50.48 $77.13 $136.90 $249.17 $360,000 $5.40 $5.40 $7.89 $7.89 $11.22 $19.52 $31.15 $51.92 $79.34 $140.82 $256.29 $370,000 $5.55 $5.55 $8.11 $8.11 $11.53 $20.07 $32.02 $53.37 $81.54 $144.73 $263.41 $380,000 $5.70 $5.70 $8.33 $8.33 $11.84 $20.61 $32.88 $54.81 $83.75 $148.64 $270.53 $390,000 $5.85 $5.85 $8.55 $8.55 $12.15 $21.15 $33.75 $56.25 $85.95 $152.55 $277.65