4.1 FY 17 LIFE INS AND EAP RATES EXHIBIT A FINAL.DOC

Exhibit A
Employee Benefits – Plan Year 2016-17 Premium Rates
FY 2016-17 Life Insurance
Monthly Monthly
Monthly Total Employee Employer
Premium per Premium Per Premium Per
Life Insurance $1000 $1000 $1000
Basic Life 1X Salary 0.060 0.060
Basic AD&D 1X Salary 0.015 0.015
Employee Additional ADD 1X Salary/$1000 0.020 0.020
Family Additional ADD 2X Salary/$1000 0.035 0.035
Dependent Child Life /$5,000 0.100 0.100
Additional - Non-Smoker Under 25 0.032 0.032
Additional - Non-Smoker 25-29 0.38 0.38
Additional - Non-Smoker 30-34 0.050 0.050
Additional - Non-Smoker 35-39 0.056 0.056
Additional - Non-Smoker 40-44 0.074 0.074
Additional - Non-Smoker 45-49 0.120 0.120
Additional - Non-Smoker 50-54 0.184 0.184
Additional - Non-Smoker 55-59 0.312 0.312
Additional - Non-Smoker 60-64 0.528 0.528
Additional - Non-Smoker 65-69 0.76 0.760
Additional - Non-Smoker 70 and older 1.408 1.408
Additional - Smoker Under 25 0.052 0.052
Additional - Smoker 25-29 0.056 0.056
Additional - Smoker 30-34 0.064 0.064
Additional - Smoker 35-39 0.109 0.109
Additional - Smoker 40-44 0.155 0.155
Additional - Smoker 45-49 0.308 0.308
Additional - Smoker 50-54 0.567 0.567
Additional - Smoker 55-59 0.578 0.578
Additional - Smoker 60-64 0.896 0.896
Additional - Smoker 65-69 1.096 1.096
Additional - Smoker 70 and older 1.800 1.800
FY 2016-17 Employee Assistance Program
Monthly
Monthly Eligible
Monthly Total Employer Participant
Other Services Premium Premium Premium
Employee Assistance 2.58 2.58 0.00