Plan Administrator's Guide — List Bill - RBC Insurance

4. Sample Premium CalculationsThe purpose of these samples is to provide a reference for benefit calculations for group productofferings. Our hope is to aid you in understanding the information shown on your GROUP PREMIUMSTATEMENT. The Plan specifics and benefit schedules used represent those typical to each product.Please refer to your Group Insurance Policy (ies) for specifics of your Plan.The sample calculations shown are for changes that would appear on the June 1st Premium Statement.As such, these changes would have reached RBC Insurance, Group Customer Account Services prior tothe printing of the June Premium Statement. All employee names used within the sample are fictional.Sample Plan Specifics:■■All products have one class■■All products are 100% employee paid■■All new employees have a 3 month waiting period■■All employees reside in OntarioBasic Life:■■Benefit schedule is 3x annual earnings to a maximum of $500,000 of coverage■ Non-evidence maximum (NEM) is $300,000 (benefits over $300,000 are referred to as Excess Life)■■Rate is $0.28 per $1,000 of coverageDependent Life■■Coverage is sold on a per unit basis■■Rate is $1.08 per employeeAccidental Death and Dismemberment (AD&D):■■Benefit schedule is 3x annual earnings to a maximum of $500,000 of coverage■■No non-evidence maximum (NEM)■■Rate is $0.03 per $1,000 of coverageShort Term Disability (STD):■■Benefit schedule is at 66.6667% of weekly earnings to a maximum of $750 of coverage■■No non-evidence maximum (NEM)■■Rate is $0.15 per $10 of coverageLong Term Disability (LTD):■■Benefit schedule is a split, 66.6667% of first $4,000 of monthly earnings + 50% of the next$6,666 of monthly earnings to a maximum of $6,000 of coverage■■Non-evidence maximum (NEM) is $4,500■■Rate is $1.10 per $100 of coverage22 Plan Administrator’s Guide — List Bill