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Inv# July 2024 - LIFE INSURANCE COMPANY OF NORTH AMERICA - 09/26/2024
City of Dania Beach MONTHLY PREMIUM STATEMENT Cigna New York Life BILLING PERIOD:July-2024 COVERAGE COVERED LIVES RATE VOLUME MONTHLY PREMIUM ADJUSTMENTS ADJUSTED MONTHLY PREMIUM BASIC LIFE INSURANCE 156 0.180$ $21,690,500.00 $3,904.29 $0.00 $3,904.29 TOTAL BASIC AND AD&D LIFE 156 $21,690,500.00 $3,904.29 BASIC AD&D INSURANCE 156 0.020$ $21,690,500.00 $433.81 $0.00 $433.81 TOTAL BASIC AND AD&D LIFE 156 $21,690,500.00 $433.81 RETIREE BASIC LIFE INSURANCE 116 0.200$ $442,500.00 $88.50 $0.00 $88.50 TOTAL RETIREE BASIC LIFE 116 $442,500.00 $88.50 VOLUNTARY EMPLOYEE LIFE 0-29 2 0.090$ $60,000.00 $5.40 $0.00 $5.40 30-34 6 0.100$ $610,000.00 $61.00 $0.00 $61.00 35-39 11 0.140$ $1,260,000.00 $176.40 $0.00 $176.40 40-44 6 0.210$ $660,000.00 $138.60 $0.00 $138.60 45-49 13 0.380$ $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 $714.40 60-64 5 1.070$ $270,000.00 $288.90 $0.00 $288.90 65-69 1 1.510$ $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 58 $5,760,000.00 $2,439.20 VOLUNTARY SPOUSE LIFE 0-29 0 0.090$ $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 $12.60 40-44 4 0.210$ $140,000.00 $29.40 $0.00 $29.40 45-49 6 0.380$ $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 $75.20 60-64 4 1.070$ $75,000.00 $80.25 $0.00 $80.25 65-69 1 1.510$ $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 23 $760,000.00 $418.45 VOLUNTARY CHILD(REN) LIFE $5,000 28 0.170$ $140,000.00 $23.80 $0.00 $23.80 TOTAL VOLUNTARY CHILD(REN) LIFE 28 $140,000.00 $23.80 LONG TERM DISABILITY INSURANCE 151 0.320$ $889,905.49 $2,847.77 $0.00 $2,847.77 TOTAL LONG TERM DISABILITY 151 $889,905.49 $2,847.77 TOTAL PREMIUM DUE $29,682,905.49 $9,722.01