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Disability Insurance Worksheet
Monthly expenses you should consider
(For illustrative purposes only. This worksheet may help you decide how much coverage you need.)

Mortgage/rent$
Transportation (gas, car, payments, repairs)$
Utilities (electric, water, cable, internet)$
Insurance (health, life, car, home)$
Food & clothing (groceries, restaurants)$
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Disability Insurance Calculator
Premium Calculator
   Quick tool for matching coverage to cost.
1. Enter your age:
2. Enter Annual Salary:
3. Select the STD Elimination Period:
30 days
14 days
Your Weekly Short Term Disability (STD) benefit:
Your Bi-Weekly Short Term Disability (STD) cost:

Your Monthly Long Term Disability (LTD) benefit:
Your Monthly Long Term Disability (LTD) cost:

Your cost:

Calculated premium is for illustration purposes only and is based on the age and choices selected. Eligibility for, entitlement to, and amount of actual benefits will be determined according to the terms of the policy.

See the Plan Highlights document on the Enrollment page for disclosures regarding this plan.
CE-806100 (8-21)