Copeland Insurance Services, Inc.
3385 Marquess Moor
Alpharetta, GA  30022

jpcins@aol.com

(770) 667-0390

PET Sponsored
Accidental Death & Dismemberment Insurance Rates

BASIC COVERAGE

PET automatically provides its members $10,000 of AD&D Coverage at no cost.

OPTIONAL COVERAGE AMOUNTS AND QUARTERLY PREMIUMS

	Premiums by Benefit Amount
	$100,000	$200,000	$300,000
Member Only	$15.00	$30.00	$45.00
Member & Spouse	$30.00	$60.00	$90.00
Member & Child(ren)*	$18.00	$36.00	$54.00
Family (Member, Spouse & Children)*	$33.00	$66.00	$99.00

^*All children have $10,000 of coverage. Coverage ends at age 70. Other coverage amounts are available by calling the administrator. You cannot be signaled out for a rate increase, rates can be increased on a class basis only. Rates and/or benefits can be changed on a class basis. Premiums are billed on a quarterly basis.

At age 65, or if you are already age 65, all benefit amounts reduce by 50%.

If you have questions or need assistance, please call NEBCO Administrators at 1-800-759-0101.
A Customer service representative will assist you.

Administered by: NEBCO 8500 Freeport Parkwas South, Ste. 450 Irving TX 75063 Phone # 1-800-759-0101

Underwritten by: Hartford Life and Accident Insurance Company Simsbury CT 06089

The Hartford® is The Hartford Financial Services Group, Inc. and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company.

Policy Form #7582 A2 (11038).

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