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Inv# SEPT 2024 - LIFE INSURANCE COMPANY OF NORTH AMERICA - 09/26/2024
City of Dania Beach MONTHLY PREMIUM STATEMENT Cigna New York Life BILLING PERIOD:September-2024 COVERAGE COVERED LIVES RATE VOLUME MONTHLY PREMIUM ADJUSTMEN TS ADJUSTED MONTHLY BASIC LIFE INSURANCE 158 0.180$ $21,939,500.00 $3,949.11 $0.00 $3,949.11 TOTAL BASIC AND AD&D LIFE 158 $21,939,500.00 $3,949.11 BASIC AD&D INSURANCE 158 0.020$ $21,939,500.00 $438.79 $0.00 $438.79 TOTAL BASIC AND AD&D LIFE 158 $21,939,500.00 $438.79 RETIREE BASIC LIFE INSURANCE 116 0.200$ $445,000.00 $89.00 $0.00 $89.00 TOTAL RETIREE BASIC LIFE 116 $445,000.00 $89.00 VOLUNTARY EMPLOYEE LIFE 0-29 2 0.090$ $60,000.00 $5.40 $0.00 $5.40 30-34 6 0.100$ $610,000.00 $61.00 $0.00 $61.00 35-39 12 0.140$ $1,410,000.00 $197.40 $0.00 $197.40 40-44 7 0.210$ $810,000.00 $170.10 $0.00 $170.10 45-49 12 0.380$ $1,410,000.00 $535.80 $0.00 $535.80 50-54 8 0.580$ $760,000.00 $440.80 $0.00 $440.80 55-59 5 0.940$ $750,000.00 $705.00 $0.00 $705.00 60-64 5 1.070$ $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 59 $6,150,000.00 $2,550.30 VOLUNTARY SPOUSE LIFE 0-29 0 0.090$ $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 $29.40 45-49 5 0.380$ $185,000.00 $70.30 $0.00 $70.30 50-54 3 0.580$ $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 22 $730,000.00 $407.05 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 $23.80 LONG TERM DISABILITY INSURANCE 153 0.320$ $898,777.03 $2,876.18 $0.00 $2,876.18 TOTAL LONG TERM DISABILITY 153 $898,777.03 $2,876.18 TOTAL PREMIUM DUE $30,303,277.03 $9,895.44