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Inv# MAR 2024 Life - LIFE INSURANCE COMPANY OF NORTH AMERICA - 03/27/2024
City of Dania Beach MONTHLY PREMIUM STATEMENT Cigna New York Life BILLING PERIOD:March-2024 COVERAGE COVERED LIVES RATE VOLUME MONTHLY PREMIUM ADJUSTMENTS ADJUSTED MONTHLY PREMIUM BASIC LIFE INSURANCE 150 0.180$ $20,947,500.00 $3,770.55 $0.00 $3,770.55 TOTAL BASIC AND AD&D LIFE 150 $20,947,500.00 $3,770.55 BASIC AD&D INSURANCE 150 0.020$ $20,947,500.00 $418.95 $0.00 $418.95 TOTAL BASIC AND AD&D LIFE 150 $20,947,500.00 $418.95 RETIREE BASIC LIFE INSURANCE 114 0.200$ $432,500.00 $86.50 $0.00 $86.50 TOTAL RETIREE BASIC LIFE 114 $432,500.00 $86.50 VOLUNTARY EMPLOYEE LIFE 0-29 2 0.090$ $60,000.00 $5.40 $0.00 $5.40 30-34 7 0.100$ $620,000.00 $62.00 $0.00 $62.00 35-39 11 0.140$ $1,260,000.00 $176.40 $0.00 $176.40 40-44 7 0.210$ $760,000.00 $159.60 $0.00 $159.60 45-49 13 0.380$ $1,460,000.00 $554.80 $0.00 $554.80 50-54 7 0.580$ $610,000.00 $353.80 $0.00 $353.80 55-59 6 0.940$ $760,000.00 $714.40 $0.00 $714.40 60-64 6 1.070$ $420,000.00 $449.40 $0.00 $449.40 65-69 1 1.510$ $50,000.00 $75.50 $0.00 $75.50 70-74 1 3.520$ $20,000.00 $70.40 $0.00 $70.40 75+0 3.520$ $0.00 $0.00 $0.00 $0.00 TOTAL VOLUNTARY EMPLOYEE LIFE 61 $6,020,000.00 $2,621.70 VOLUNTARY SPOUSE LIFE 0-29 0 0.090$ $0.00 $0.00 $0.00 $0.00 30-34 0 0.100$ $0.00 $0.00 $0.00 $0.00 35-39 3 0.140$ $90,000.00 $12.60 $0.00 $12.60 40-44 5 0.210$ $170,000.00 $35.70 $0.00 $35.70 45-49 6 0.380$ $215,000.00 $81.70 $0.00 $81.70 50-54 3 0.580$ $110,000.00 $63.80 $0.00 $63.80 55-59 2 0.940$ $80,000.00 $75.20 $0.00 $75.20 60-64 5 1.070$ $105,000.00 $112.35 $0.00 $112.35 65-69 1 1.510$ $50,000.00 $75.50 $0.00 $75.50 70-74 0 3.520$ $0.00 $0.00 $0.00 $0.00 75+0 3.520$ $0.00 $0.00 $0.00 $0.00 TOTAL VOLUNTARY SPOUSE LIFE 25 $820,000.00 $456.85 VOLUNTARY CHILD(REN) LIFE $5,000 29 0.170$ $145,000.00 $24.65 $0.00 $24.65 TOTAL VOLUNTARY CHILD(REN) LIFE 29 $145,000.00 $24.65 LONG TERM DISABILITY INSURANCE 145 0.320$ $861,223.44 $2,755.97 $0.00 $2,755.97 TOTAL LONG TERM DISABILITY 145 $861,223.44 $2,755.97 TOTAL PREMIUM DUE $29,226,223.44 $9,716.223/27/24