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Inv# Life Ins Feb 202 - LIFE INSURANCE COMPANY OF NORTH AMERICA - 02/25/2025
City of Dania Beach MONTHLY PREMIUM STATEMENT Cigna New York Life BILLING PERIOD:February-2025 COVERAGE COVERED LIVES RATE VOLUME MONTHLY PREMIUM ADJUSTMENTS ADJUSTED MONTHLY PREMIUM BASIC LIFE INSURANCE 168 0.180$ $24,139,500.00 $4,345.11 $0.00 $4,345.11 TOTAL BASIC AND AD&D LIFE 168 $24,139,500.00 $4,345.11 BASIC AD&D INSURANCE 168 0.020$ $24,139,500.00 $482.79 $0.00 $482.79 TOTAL BASIC AND AD&D LIFE 168 $24,139,500.00 $482.79 RETIREE BASIC LIFE INSURANCE 113 0.200$ $432,500.00 $86.50 $0.00 $86.50 TOTAL RETIREE BASIC LIFE 113 $432,500.00 $86.50 VOLUNTARY EMPLOYEE LIFE 0-29 1 0.090$ $40,000.00 $3.60 $0.00 $3.60 30-34 6 0.100$ $580,000.00 $58.00 $0.00 $58.00 35-39 11 0.140$ $1,220,000.00 $170.80 $0.00 $170.80 40-44 8 0.210$ $710,000.00 $149.10 $0.00 $149.10 45-49 13 0.380$ $1,570,000.00 $596.60 $0.00 $596.60 50-54 8 0.580$ $930,000.00 $539.40 $0.00 $539.40 55-59 4 0.940$ $420,000.00 $394.80 $0.00 $394.80 60-64 2 1.070$ $150,000.00 $160.50 $0.00 $160.50 65-69 3 1.510$ $120,000.00 $181.20 $0.00 $181.20 70-74 1 3.520$ $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 57 $5,760,000.00 $2,324.40 VOLUNTARY SPOUSE LIFE 0-29 0 0.090$ $0.00 $0.00 $0.00 $0.00 30-34 0 0.100$ $0.00 $0.00 $0.00 $0.00 35-39 3 0.140$ $85,000.00 $11.90 $0.00 $11.90 40-44 4 0.210$ $115,000.00 $24.15 $0.00 $24.15 45-49 6 0.380$ $215,000.00 $81.70 $0.00 $81.70 50-54 4 0.580$ $160,000.00 $92.80 $0.00 $92.80 55-59 2 0.940$ $40,000.00 $37.60 $0.00 $37.60 60-64 2 1.070$ $35,000.00 $37.45 $0.00 $37.45 65-69 2 1.510$ $65,000.00 $98.15 $0.00 $98.15 70-74 0 3.520$ $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 $715,000.00 $383.75 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 $24.65 LONG TERM DISABILITY INSURANCE 163 0.320$ $988,295.16 $3,162.66 $0.00 $3,162.66 TOTAL LONG TERM DISABILITY 163 $988,295.16 $3,162.66 TOTAL PREMIUM DUE $32,180,295.16 $10,327.07 2/25/25