Acc. Death Paycheck Provider

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

Made with FlippingBook - Online Brochure Maker