June 25, 2015
The University of Texas Medical Institutions
Jill Fleishman
Tony Edmond
Misty Gaeke
Devona Gray
Bete Su Williams
Jeanette Turner
Delivered Via Email
Group Numbers 133578 / 133592 / 642900 / 642901 / 642902 / 642903
Thank you for allowing Standard Insurance Company to provide quality products to support your
employees’ insurance needs. We are pleased to renew your policy with continued coverage and services.
All LTD, Life and AD&D rates will be held and guaranteed for a four year period. The next renewal
is scheduled for September 1, 2019. Rates are confirmed in the attached matrix for your review.
We value your business and welcome the opportunity to provide continued assistance to you. Please
call on us if you have any questions or need additional information.
Sincerely yours,
Kisha Turner, ACS
National Accounts Underwriter
cc:
Karen Gracey
Senior National Accounts Consultant
Marni Crume/Orange Employee Benefits Sales and Service Office
Jarrod Sigsby/Orange Employee Benefits Sales and Service Office
Contract file
Premium file
University of Texas Medical Institutions
133578 / 133592 / 642900 / 642901 / 642902 / 642903
Premium Rate Matrix
All Coverage’s
Rates Effective 9/1/2015 are Guaranteed through 8/31/2019
Insurance Coverage
Rates Through 08/31/15
Rates Effective 09/01/15
Additional Life
(Actives or Retirees)
(Members or Spouses)
Age-Graded Rates
per $1,000 of Benefit
Age
Rate
0-24
$0.020
25-29
$0.020
30-34
$0.028
35-39
$0.035
40-44
$0.058
45-49
$0.099
50-54
$0.167
55-59
$0.258
60-64
$0.353
65-69
$0.608
70-74
$0.961
75+
$1.707
Age-Graded Rates
per $1,000 of Benefit
Age
Rate
0-24
$0.020
$0.020
25-29
30-34
$0.028
35-39
$0.035
40-44
$0.058
45-49
$0.099
50-54
$0.167
55-59
$0.258
60-64
$0.353
65-69
$0.608
70-74
$0.961
75+
$1.707
$0.016 per $1,000 of Benefit
$0.016 per $1,000 of Benefit
Additional AD&D
(Members or Dependents)
Dependents Life
(50K spouse/10k child)
$2.70 per Member, Elective
$2.70 per Member, Elective
Long Term Disability
90-day BWP w/ COLA
90-day BWP w/o COLA
180-day BWP w/ COLA
180-day BWP w/o COLA
0.955 Percent of Insured Earnings
0.730 Percent of Insured Earnings
0.719 Percent of Insured Earnings
0.551 Percent of Insured Earnings
0.955 Percent of Insured Earnings
0.730 Percent of Insured Earnings
0.719 Percent of Insured Earnings
0.551 Percent of Insured Earnings