Monthly Benefit Age 16-25 Age 26-39 Age 40-49 Age 50-59 Age 60-69* $500 2 3 4 6 7 $800   4 6 10 12 $1,000 3 5 8 12 15 $1,200 4 6 10 15 18 $1,400 5 7 11 17 21 $1,600 6 8 13 20 24 $1,800 7 9 14 22 27 $2,000     16 24 30 $2,200 8 10 18 27 32 $2,400   11 19 29 35 $2,600 9 12 21 32 38 $2,800   13 22 34 41 $3,000 10 14 24 37 44 $3,200 11 15 26 39 47 $3,400   16 27 42 50 $3,600 12 17 29 44 53 $3,800 13 18 30 46 56 $4,000 14 19 32 49 59 $4,200   20 34 51 62 $4,400 15 21 35 54 65 $4,600 16 22 37 56 68 $4,800   23 38 59 71 $5,000 17 24 40 61 74

90 - Day Waiting Period
Biweekly Premiums

	Monthly Benefit Age 16-25 Age 26-39 Age 40-49 Age 50-59 Age 60-69* $500   2 3 5 6 $800     5 8 10 $1,000 2 3 6 9 12 $1,200   4 8 11 14 $1,400 3 5 9 13 17 $1,600     10 15 19 $1,800 4 6 12 17 22 $2,000    7 13 19 24 $2,200 5 8 14 21 26 $2,400     15 23 29 $2,600 6 9 17 24 31 $2,800     18 26 33 $3,000 7 10 19 28 36 $3,200   11 21 30 38 $3,400  8 12 22 32 41 $3,600     23 34 43 $3,800   13 24 36 45 $4,000 9 14 26 38 48 $4,200     27 40 50 $4,400 10 15 28 42 53 $4,600   16 30 43 55 $4,800  11 17 31 45 57 $5,000 12 18 32 47 60

180 - Day Waiting Period
Biweekly Premiums

	Monthly Benefit Age 16-25 Age 26-39 Age 40-49 Age 50-59 Age 60-69* $500     2 4 5 $800     4 6 7 $1,000   2 5 8 9 $1,200     6 10 11 $1,400 2 3 7 11 12 $1,600     8 13 14 $1,800     9 15 16 $2,000 3  4 10 16 17 $2,200   5  11 18 19 $2,400     12 19 21 $2,600 4 6 13 21 22 $2,800     14 23 24 $3,000   7 15 24 26 $3,200     16 26 28 $3,400 5  8 17 27 29 $3,600     18 29 31 $3,800     19 31 33 $4,000 6 9 20 32 34 $4,200     21 34 36 $4,400     22 35 38 $4,600  7 10 23 37 40 $4,800     24 39 41 $5,000 8 11 25 40 43

365 - Day Waiting Period
Biweekly Premiums

	Monthly Benefit Age 16-25 Age 26-39 Age 40-49 Age 50-59 Age 60-69* $500     2 4 5 $800     4 6 7 $1,000       7 8 $1,200    2 5 9 10 $1,400     6 10 11 $1,600     7 11 12 $1,800     8 13 14 $2,000  2 3 9 14 15 $2,200     10 16 17 $2,400     11 17 18 $2,600 3 4 12 19 20 $2,800       20 21 $3,000   5 13 21 23 $3,200     14 23 24 $3,400 4  6 15 24 26 $3,600     16 26 27 $3,800     17 27 29 $4,000 5 7 18 29 30 $4,200     19 30 32 $4,400     20 31 33 $4,600 6 8 21 32 35 $4,800       34 36 $5,000 7 9 22 36 38