SUPPLEMENTAL GROUP TERM LIFE INSURANCE
Issued by the Prudential Insurance Company of America


Add an extra layer of benefit protection for you or your spouse

Eligibility Requirements


You must be enrolled in SAMBA's Group Term Life Insurance Plan. If you desire supplemental benefits for your spouse, he or she must be enrolled in the Dependent Group Term Life Insurance Plan. Evidence of insurability is required.

Benefits offered by the Plan:


Group Term Life Insurance: This program supplements your Group Term Life Insurance benefit amount with additional protection -- up to $300,000. Plus, your spouse may continue his/her coverage should you die. View rate table.

Accelerated Death Benefit: If you have a Terminal Medical Condition (explain), this feature allows you to use up to 75% of your Supplemental Group Term Life insurance amount, up to $250,000 to help with medical expenses or put your financial affairs in order.

How benefits and rates are determined


Supplemental benefits start at $30,000 and go up to $300,000. The premiums are age-driven and increase in five-year increments beginning at age 25.

Your coverage can continue when you retire


The Supplemental Plan may be continued into retirement with no reduction in the amount of coverage.

Rate Table

Rates Effective January 1, 2004
Supplemental Group Term Life Insurance
Age Biweekly Rates for Coverage Amounts
$30,000 $60,000 $90,000 $120,000 $150,000 $180,000 $210,000 $240,000 $270,000 $300,000
18-24 $ 0.90 $ 1.80 $ 2.70 $ 3.60 $ 4.50 $ 5.40 $ 6.30 $ 7.20 $ 8.10 $ 9.00
25-29 $ 1.14 $ 2.28 $ 3.42 $ 4.56 $ 5.70 $ 6.84 $ 7.98 $ 9.12 $10.26 $11.40
30-34 $ 1.35 $ 2.70 $ 4.05 $ 5.40 $ 6.75 $ 8.10 $ 9.45 $10.80 $12.15 $13.50
35-39 $ 1.65 $ 3.30 $ 4.95 $ 6.60 $ 8.25 $ 9.90 $11.55 $13.20 $14.85 $16.50
40-44 $ 2.25 $ 4.50 $ 6.75 $ 9.00 $11.25 $13.50 $15.75 $18.00 $20.25 $22.50
45-49 $ 5.25 $10.50 $15.75 $21.00 $26.25 $31.50 $36.75 $42.00 $47.25 $52.50
50-54 $ 9.00 $18.00 $27.00 $36.00 $45.00 $54.00 $63.00 $72.00 $81.00 $90.00
55-59 $15.00 $30.00 $45.00 $60.00 $75.00 $90.00 $105.00 $120.00 $135.00 $150.00
60-64 $22.50 $45.00 $67.50 $90.00 $112.50 $135.00 $157.50 $180.00 $202.50 $225.00
65-69 $40.50 $81.00 $121.50 $162.00 $202.50 $243.00 $283.50 $324.00 $364.50 $405.00

Your spouse's Term Life Insurance coverage under all policies issued to SAMBA may not exceed 50% of your coverage. Insured's coverage terminates at age 70. Spouse's coverage terminates when the spouse reaches age 70.