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Inv# NYLife062022 - LIFE INSURANCE COMPANY OF NORTH AMERICA - 07/21/2022 (2)
City of Dania Beach MONTHLY PREMIUM STATEMENT BILLING PERIOD: Cigna New York Life ilr\#"."I 112 112 112 112 109 109 0 7 12 1l 10 6 5 8 1 0 0 0 28 137 137 RATE June-2022 BASIC LIFE INSURANCE TOTAL BASIC AI{D AD&D LIFE BASIC AD&D INSURANCE TOTAL BASIC AND AD&O LIFE RETIREE BASIC LIFE INSURANCE TOTAL RETIREE BASIC LIFE VOLUNTARY EMPLOYEE LIFE 0-29 30-34 35-39 4044 45-49 50-54 55-59 6044 6569 70-74 75+ TOTAL VOLUNTARY EMPLOYEE LIFE VOLUNTARY SPOUSE LIFE G29 30-34 35-39 4044 45-49 50-54 6064 6569 70-74 75+ TOTAL VOLU TARY SPOUSE LIFE VOLUNTARY CHILO(REN) LIFE $5,000 TOTAL VOLUI{TARY CHILO(REI} LIFE LONG TERM DISABILITY INSURANCE TOTAL LONG TERiI DISABILITY TOTAL PRETIIIUITI DUE $ $ $ $t $ t $ $ $ $ $ 0.180 0.020 0.200 0.090 0.100 0.140 0.210 0.3E0 0.580 0.9,(0 1.070 1.510 3.520 3.520 0.090 0.r00 0.1,r0 0.210 0.380 0.5E0 0.940 1.070 1.510 3.520 3.520 0.170 0.320 $ $ $ $ $ I $ $ $ t $ 0 0 7 5 1 4 4 0 0 0 0 l- $r-d6Ei.rs-r7Tl I---6o0-8-I ADJUSTED i'O THLY ll $i7.798,ooo.odl l-$43r-_5jo-oolt------$86-Offi