Acc. Death Paycheck Provider

Accidental Death Family Protection

Paycheck Provider

ACCORDING THE NATIONAL SAFETY COUNCIL 2005 INJURY FACTS: • Unintentional Injury is the 5th leading cause of death. The number of over all unintentional injury deaths in 2005 were 176,406. • There was a death caused by motor vehicle crash every 11.5 minutes (45,343). • In the home or workplace a fatal injury occurs every 8 minutes. • The five leading causes of accidental deaths have remained constant since 1970: motor vehicle, falls, solid and liquid poisoning, drowning, and fires and burns.

Whether it is for current expenses or future needs, Paycheck Provider can guarantee your family an income for 5 or 10 years after your death. WHO ELSE IS GOING TO DO THIS FOR YOUR FAMILY? • Provide a guaranteed monthly income for your family in the event of premature death due to accident. • Premium payments do not increase from policy date to age 70 when the plan automatically terminates. MONTHLY CASH PAID DIRECTLY TO YOUR FAMILY FOR: • House Payment • Rent • Car Payment • Groceries • Tuition • Clothing • Health Insurance Premiums • Living Expenses Lump sum insurance settlements can be exhausted in the first few months after the death of a family member. Paycheck Provider guarantees your family a tax-free paycheck for 5 or 10 years. You Choose! Paycheck Provider offers time for your family to make wise financial choices during the grieving and adjustments period. Your family counts on your paycheck. The Paycheck Provider provides a monthly income that you provide now. Other settlement options are available.

This is a Accidental Death Benefit Policy

Underwritten by ManhattanLife Insurance Company of America

PCKP-BR 0820

ACCIDENTAL DEATH FAMILY PROTECTION Minimum $500 Maximum $1,500 per month

Male Annual Premium

$100 Monthly Benefit

60 Months

120 Months

Issue Age 18-39 40-49 50-59 60-69 Issue Age 18-39 40-49 50-59 60-69

Premium

Waiver

Premium

Waiver

3.63 3.97 4.48 6.03

.14 .28 .42 NA

6.76 7.39 8.53

.27 .53 .80 NA

11.23

Female Annual Premium

$100 Monthly Benefit

60 Months

120 Months

Premium

Waiver

Premium

Waiver

1.62 1.84 1.90 2.96

.09 .19 .28 NA

3.02 3.43 3.54 5.51

.18 .35 .53 NA

PREMIUM MODE FACTOR

+ POLICY FEE

POLICY FEE $25.00 Add the policy fee after applying the mode.

Annual

1.00

+ 25.00 + 15.00

Semi-Annual

.52

Quarterly

.265 .086

+ 7.50 + 2.50 + 2.50

Special Monthly

Payroll

.08333

This is not a complete disclosure of plan qualifications and limitations. Please access our website to obtain a completed list for the Paycheck Provider product at disclosure.manhattanlife.com . Please review this information before applying for coverage. The amounts of benefits provided depend on the plan selected. Premiums will vary according to the selection made.

Policy Form ADB-09, ADB-09-TX (including state variations)

Underwritten by: ManhattanLife Assurance Company of America 10777 Northwest Freeway, Houston, Texas 77092 800-669-9030

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