PAID Rates Available Payment Modes List Bill Applications: Weekly, Bi-Weekly, Semi-Monthly, Monthly Individual Applications: Monthly
Forms AK7025, AK7024 Accident Policy Rate Schedule Weekly Premium Bi ‐ Weekly Premium Semi ‐ Monthly Premium
Monthly Premium
One Unit
Two Units One Unit
Two Units One Unit
Two Units One Unit
Two Units
24 ‐ Hour Coverage
Individual Individual/ Spouse* Individual/ Child(ren)
$4.23
$5.08
$8.46 $10.15 $9.17 $11.00 $18.33 $22.00
$5.96
$7.38 $11.92 $14.77 $12.92 $16.00 $25.83 $32.00
$5.96
$7.38 $11.92 $14.77 $12.92 $16.00 $25.83 $32.00
Family
$7.69
$9.69 $15.38 $19.38 $16.67 $21.00 $33.33 $42.00 Off-the-Job Coverage Only
Individual Individual/ Spouse* Individual/ Child(ren)
$3.58
$4.15
$7.15
$8.31
$7.75
$9.00 $15.50 $18.00
$5.60
$6.75 $11.19 $13.50 $12.13 $14.63 $24.25 $29.25
$5.60
$6.75 $11.19 $13.50 $12.13 $14.63 $24.25 $29.25
Family
$6.52
$8.08 $13.04 $16.15 $14.13 $17.50 $28.25 $35.00
Wellness Rider**
Weekly Premium
Monthly Premium
Bi ‐ Weekly Premium
Semi ‐ Monthly Premium
Individual Individual/ Spouse* Individual/ Child(ren)
$0.69
$1.38
$1.50
$3.00
$1.38
$2.77
$3.00
$6.00
$1.38
$2.77
$3.00
$6.00
Family
$2.08
$4.15
$4.50
$9.00
* In CA and NV, Spouse or Domestic Partner. ** Not approved in CA, ID, MI, MO and PA.
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