Annual Premiums

Principal SumMemberMember, Spouse and/or Children**
$ 25,000 17.50 23.75
$ 50,00035.0047.50
$100,000 70.0095.00
$150,000105.00 142.50
$200,000140.00 190.00
$250,000175.00237.50
**Each Insured Dependent: the following percentage of the Member’s Coverage Principal Sum: Insured Spouse Only: 50%

Insured Spouse and Children: Insured Spouse 40%, Insured Child(ren) 10% Insured Children Only: 15%

Termination Age Date for: Insured Member is Age 75; Survivor Spouse is Age 75; Insured Child is Age 19, or to Age 25 if a full-time student.

*Premiums current as of 11/2010

How to Enroll:

  1. Complete Enrollment Form.
  2. Return with first annual payment to:
Mass Benefits Consultants, Inc. UPMA Administrator
PO Box 828
Annandale, VA 22003

 

Download Enrollment Form


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