International Citizens Rate Tables

International Citizens Rate Tables

Platinum
Premier
Risk Share
Optional Term Life and AD&D Insurance

Platinum
Annual Premium -- For Insurance Effective Through 12/31/02

	$250 DEDUCTIBLE		$500 DEDUCTIBLE		$1,000 DEDUCTIBLE		$2,500 DEDUCTIBLE
Age	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9*	First 2 free, then $413		First 2 free, then $372		First 2 free, then $280		First 2 free, then $250
10 to 18*	$431		$391		$300		$269
19-24	$1015	$1,650	$904	$1,550	$719	$1,129	$639	$1,006
25-29	$1,119	$1,815	$1,013	$1,710	$795	$1,247	$704	$1,111
30-34	$1,199	$2,029	$1,067	$1,898	$839	$1,431	$749	$1,275
35-39	$1,392	$2,257	$1,181	$2,047	$925	$1,584	$825	$1,410
40-44	$1,546	$1,873	$1,314	$1,642	$1,029	$1,287	$920	$1,151
45-49	$1,694	$2,050	$1,452	$1,809	$1,139	$1,421	$1,015	$1,265
50-54	$2,032	$2,232	$1,779	$1,980	$1,399	$1,560	$1,281	$1,422
55-59	$2,552	$2,552	$2,281	$2,281	$1,735	$1,735	$1,652	$1,652
60-64	$3,417	$3,206	$3,155	$2,946	$2,627	$2,431	$2,436	$2,230
65-69	$7,074	$6,145	$6,813	$5,883	$6,276	$5,348	$4,966	$4,036
70	$8,393	$7,265	$8,130	$7,002	$7,605	$6,477	$5,996	$4,868
71	$8,786	$7,604	$8,524	$7,342	$7,999	$6,817	$6,315	$5,132
72	$9,123	$7,893	$8,863	$7,633	$8,343	$7,113	$6,590	$5,360
73	$9,470	$8,183	$9,212	$7,926	$8,697	$7,411	$6,874	$5,588
74	$9,930	$8,575	$9,673	$8,317	$9,158	$7,802	$7,241	$5,885
*First 2 children age 14 days to 9 years are free only when both parents are insured under the Platinum Plan. The Dependent Child rate is only available when parent (guardian) is insured under the Platinum Plan. Dependent children alone must pay the age 19 to 24 rate.

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Premier

	$250 DEDUCTIBLE		$500 DEDUCTIBLE		$1,000 DEDUCTIBLE		$2,500 DEDUCTIBLE
Age	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9*	First 1 free, then $285		First 1 free, then $255		First 1 free, then $195		First 1 free, then $175
10 to 18*	$265		$235		$175		$155
19-25	$545	$754	$483	$696	$380	$514	$336	$454
25-29	$600	$830	$542	$771	$420	$568	$370	$502
30-34	$644	$917	$571	$844	$444	$636	$393	$563
35-39	$749	$1,033	$631	$916	$489	$702	$434	$622
40-44	$832	$1,015	$702	$886	$544	$687	$484	$611
45-49	$912	$1,110	$777	$975	$603	$758	$534	$672
50-54	$1,087	$1,202	$946	$1,062	$736	$828	$670	$752
55-59	$1,308	$1,308	$1,162	$1,162	$870	$870	$823	$823
60-64	$2,173	$2,068	$1,918	$1,813	$1,408	$1,303	$1,298	$1,193
65-69	$4,128	$3,631	$3,873	$3,376	$3,363	$2,866	$2,627	$2,129
70	$5,025	$4,394	$4,768	$4,136	$4,253	$3,621	$2,708	$2,179
71	$5,245	$4,584	$4,987	$4,326	$4,472	$3,811	$2,850	$2,189
72	$5,429	$4,741	$5,174	$4,484	$4,664	$3,976	$3,032	$2,344
73	$5,619	$4,900	$5,366	$4,647	$4,861	$4,142	$3,220	$2,501
74	$5,876	$5,119	$5,624	$4,866	$5,119	$4,361	$3,452	$2,695
*First child age 14 days to 9 years is free only when both parents are insured under the Premier Plan. The Dependent Child rate is only available when parent (guardian) is insured under the Premier Plan. Dependent children alone must pay the age 19 to 24 rate.

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Risk Share

	$1,000 DEDUCTIBLE		$2,500 DEDUCTIBLE		$5,000 DEDUCTIBLE
Age	Male	Female	Male	Female	Male	Female
14 days to 18*	$210		$185		$150
19-39	$261	$413	$232	$365	$175	$274
40-49	$325	$405	$285	$360	$215	$270
50-59	$470	$470	$445	$445	$335	$335
60-69	$1,820	$1,550	$815	$800	$610	$600
70-74	$2,790	$2,400	$1,300	$1,125	$1,000	$850
*The Dependent Child rate is only available when parent (guardian) is insured under the Risk Share Plan. Dependent children alone must pay the age 19 to 24 rate.
A one-time, non-refundable Policy Fee is required with each Application for the Risk-Share Plan.

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Optional Term Life and AD&D Insurance

AGE	BASIC PREMIUM	SUPPLEMENTAL PREMIUM
19-29	$130	$100
30-39	$210	$160
40-44	$310	$235
45-49	$450	$340
50-54	$570	$430
55-59	$770	$580
60-64	$585	$440
65-69	$315	Not Available
Dependent Child	$85	Not Available

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THIS MEDICAL AND LIFE INSURANCE IS UNDERWRITTEN BY CERTAIN UNDERWRITERS AT LLOYD'S, LONDON, AND IS AVAILABLE TO MEMBERS OF THE ATLAS/INTERNATIONAL CITIZEN GROUP INSURANCE TRUST, HAMILTON, BERMUDA.
LLOYD'S IS AN APPROVED NON-ADMITTED INSURER IN ALL STATES OF THE UNITED STATES, EXCEPT KENTUCKY AND ILLINOIS WHERE THEY ARE ADMITTED. CLAIMS UNDER THIS INSURANCE MAY NOT BE MADE AGAINST ANY STATE GUARANTY FUND.

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