Welcome John Smith
ABC Company
Policy: 123456 Billing Division: 0001-Portland Billing Category: 0200
| Name: Redding, Joe |
Birth Date: 08/14/1963 |
Gender: Male |
Employee ID/SSN: 111-00-9999 |
| Hire Date: 03/01/2005 |
Original Effective Date: 06/01/2005 |
Status: Active |
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| Salary: $75,000 |
Frequency: Annually |
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| Work State: Oregon |
Tobacco Use: No |
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| Reinstatement Date: 02/01/2006 |
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| Coverage | Schedule | Volume | Premium |
|---|---|---|---|
| Basic Life | 1X Annual Earnings | $10,000.00 | $55.00 |
| Basic AD&D | 1X Annual Earnings | $10,000.00 | $55.00 |
| STD | 60% of Weekly Earnings | $425.00 | $20.00 |
| LTD | 60% of Monthly Earnings | $2,500.00 | $30.00 |
| Additional Life | Increments of $10,000 | $50,000.00 | $15.00 |
| Dep. Life - Spouse | Flat $30,000 | $30,000.00 | $7.50 |
| Dep. Life - Elective | Yes | $7.50 |