Mutual of Omaha Insurance Company

Cancer, Heart Attack and Stroke Insurance rate book

16652

For Producer use only. Not for use with the general public.

4-1-15

Table of Contents

Page Premium Calculation Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Base Plans & Riders – National (AK, AL, AR, DC, DE, GA, HI, IA, ID, IL, KS, KY, LA, ME, MO, MS, NC, NE, NH, NM, NV, OK, OR, PA, RI, TN, TX, UT, WI, WV, WY) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5 Base Plans & Riders – CO, MD, NJ, SD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-8 Base Plans & Riders – IN, MI, ND, OH, SC, VT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-11 Base Plans & Riders – CT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-13

Premium Calculation Modal Premium = (Base Plan Premium + Lump Sum Rider Premium + ICU Rider Premium) x (Cash Value Rate) x Modal Factor - $1 (if using BSP)

Premium Worksheet Example: Nebraska, Family Coverage, Oldest Insured 45

Premium Benefit Description Base Premium_______________ (A) 72.60 $30,000 Lifetime Cancer Coverage



Lump Sum Rider Premium_______________ (B) + 21.20 $10,000 Heart Attack & Stroke Rider



Total Base Premium_______________ (D) = (A) + (B) + (C)



103.90 x 1.75 Cash Value Rider = Yes

Cash Value Rate_______________ (E) (Enter 1 if no CV rider)

Modal Factor_______________ (F) x 1.00 Mode = Monthly



Non Discounted Modal Premium_______________ (G) = (D) x (E) x (F)



+ 10.10 $500 ICU Rider

ICU Rider Premium_______________ (C)

181.83

Enter $1 if using BSP, zero otherwise_______________ (H) - 1.00 BSP = Yes Discounted Modal Premium_______________ = (G) - (H)

180.83

Modes Annual . . . . . . . . . . . . . . 12 Semiannual . . . . . . . . . . . 6 Quarterly . . . . . . . . . . . . . 3 Monthly . . . . . . . . . . . . . . 1 Subtract $1 if paying with BSP

Example: Monthly modal premium x 12 months = annual premium

1

Base Plans and Riders (Lifetime Coverage) – Monthly Premiums (National)

Family

Individual Plus Children

Individual

Age of Oldest Insured 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99

Cancer Heart Attack & Stroke $10,000 $20,000 $30,000 $40,000 $50,000 $10,000 $20,000 $30,000 $40,000 $50,000 5.80 7.60 10.00 12.70 15.80 19.90 24.60 28.90 31.60 33.20 34.50 36.30 36.90 37.60 7.00 8.70 11.10 13.80 16.90 21.00 25.70 30.00 32.70 34.30 35.60 37.40 38.00 38.70 11.10 14.50 19.00 24.20 30.00 37.80 46.70 54.90 60.00 63.00 65.50 68.90 70.10 71.40

11.60 15.20 20.00 25.40 31.60 39.80 49.20 57.80 63.20 66.40 69.00 72.60 73.80 75.20 14.00 17.40 22.20 27.60 33.80 42.00 51.40 60.00 65.40 68.60 71.20 74.80 76.00 77.40 22.20 29.00 38.00 48.40 60.00 75.60 93.40 109.80 120.00 126.00 131.00 137.80 140.20 142.80

17.40 22.80 30.00 38.10 47.40 59.70 73.80 86.70 94.80 99.60 103.50 108.90 110.70 112.80 21.00 26.10 33.30 41.40 50.70 63.00 77.10 90.00 98.10 102.90 106.80 112.20 114.00 116.10 33.30 43.50 57.00 72.60 90.00 113.40 140.10 164.70 180.00 189.00 196.50 206.70 210.30 214.20

23.20 30.40 40.00 50.80 63.20 79.60 98.40 115.60 126.40 132.80 138.00 145.20 147.60 150.40 28.00 34.80 44.40 55.20 67.60 84.00 102.80 120.00 130.80 137.20 142.40 149.60 152.00 154.80 44.40 58.00 76.00 96.80 120.00 151.20 186.80 219.60 240.00 252.00 262.00 275.60 280.40 285.60

29.00 38.00 50.00 63.50 79.00 99.50 123.00 144.50 158.00 166.00 172.50 181.50 184.50 188.00 35.00 43.50 55.50 69.00 84.50 105.00 128.50 150.00 163.50 171.50 178.00 187.00 190.00 193.50 55.50 72.50 95.00 121.00 150.00 189.00 233.50 274.50 300.00 315.00 327.50 344.50 350.50 357.00

Note: Rates for base plans and riders are the same. DC offers cancer coverage only.

3

4.80 7.00 9.30 11.20 13.60 16.80 21.10 26.90 36.30 49.30 64.90 82.40 93.50 106.10 5.30 7.50 9.70 11.70 14.10 17.20 21.60 27.40 36.70 49.70 65.40 82.90 94.00 106.60 9.20 13.30 17.60 21.20 25.80 31.80 40.10 51.10 68.90 93.60 123.30 156.60 177.70 201.70

9.60 14.00 18.60 22.40 27.20 33.60 42.20 53.80 72.60 98.60 129.80 164.80 187.00 212.20 10.60 15.00 19.40 23.40 28.20 34.40 43.20 54.80 73.40 99.40 130.80 165.80 188.00 213.20 18.40 26.60 35.20 42.40 51.60 63.60 80.20 102.20 137.80 187.20 246.60 313.20 355.40 403.40

14.40 21.00 27.90 33.60 40.80 50.40 63.30 80.70 108.90 147.90 194.70 247.20 280.50 318.30 15.90 22.50 29.10 35.10 42.30 51.60 64.80 82.20 110.10 149.10 196.20 248.70 282.00 319.80 27.60 39.90 52.80 63.60 77.40 95.40 120.30 153.30 206.70 280.80 369.90 469.80 533.10 605.10

19.20 28.00 37.20 44.80 54.40 67.20 84.40 107.60 145.20 197.20 259.60 329.60 374.00 424.40 21.20 30.00 38.80 46.80 56.40 68.80 86.40 109.60 146.80 198.80 261.60 331.60 376.00 426.40 36.80 53.20 70.40 84.80 103.20 127.20 160.40 204.40 275.60 374.40 493.20 626.40 710.80 806.80

24.00 35.00 46.50 56.00 68.00 84.00 105.50 134.50 181.50 246.50 324.50 412.00 467.50 530.50 26.50 37.50 48.50 58.50 70.50 86.00 108.00 137.00 183.50 248.50 327.00 414.50 470.00 533.00 46.00 66.50 88.00 106.00 129.00 159.00 200.50 255.50 344.50 468.00 616.50 783.00 888.50 1,008.50

ICU and Cash Value Riders – Monthly Premiums (National)

Family

Individual Plus Children

Individual

Age of Oldest Insured 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99

Intensive Care Unit Rider

Only available on lifetime coverage $250

$500

$750

$1,000

2.10 2.10 2.10 2.10 3.00 3.95 4.25

4.20 4.20 4.20 4.20 6.00 7.90 8.50

6.30 6.30 6.30 6.30 9.00 11.85 12.75

8.40 8.40 8.40 8.40 12.00 15.80 17.00

6.30 6.30 6.30 6.30 8.10 10.00 10.60

National Issue Ages: 18-60 (age of oldest insured) Rate: 175%

TX, IL Issue Ages: 18-49 (age of oldest insured) Rate: 200%

Not available in the following states:

N/A 3.15 3.15 3.15 3.15 4.05 5.00 5.30

Cash Value Rider

Only available on lifetime coverage

9.45 9.45 9.45 9.45 12.15 15.00 15.90

12.60 12.60 12.60 12.60 16.20 20.00 21.20

15.15 15.15 15.15 15.15 20.25 25.65 27.38

20.20 20.20 20.20 20.20 27.00 34.20 36.50

AR DE GA IA ID NH PA

N/A 5.05 5.05 5.05 5.05 6.75 8.55 9.13

10.10 10.10 10.10 10.10 13.50 17.10 18.25

N/A

Intensive Care Unit Rider: Not Available in TN, PA

4

Base Plans and Riders (Term Coverage) – Monthly Premiums (National)

Individual Individual Plus Children Family Family Family Family

20-Year Term Coverage

Individual Individual Plus Children Individual Individual Plus Children

15-Year Term Coverage 10-Year Term Coverage

Individual Individual Plus Children

30-Year Term Coverage

Age of Cancer Heart Attack & Stroke Oldest Insured $10,000 $20,000 $30,000 $40,000 $50,000 $10,000 $20,000 $30,000 $40,000 $50,000 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

5.00 6.80 9.20 12.10 15.40 5.90 7.80 10.30 13.20 16.50 9.40 12.90 17.60 23.00 29.20

10.00 13.60 18.40 24.20 30.80 11.80 15.60 20.60 26.40 33.00 18.80 25.80 35.20 46.00 58.40

15.00 20.40 27.60 36.30 46.20 17.70 23.40 30.90 39.60 49.50 28.20 38.70 52.80 69.00 87.60

20.00 27.20 36.80 48.40 61.60 23.60 31.20 41.20 52.80 66.00 37.60 51.60 70.40 92.00 116.80

25.00 34.00 46.00 60.50 77.00 29.50 39.00 51.50 66.00 82.50 47.00 64.50 88.00 115.00 146.00

4.10 6.20 8.60 10.60 13.20 4.50 6.70 9.00 11.10 13.70 7.80 11.80 16.30 20.20 25.10

8.20 12.40 17.20 21.20 26.40 9.00 13.40 18.00 22.20 27.40 15.60 23.60 32.60 40.40 50.20

12.30 18.60 25.80 31.80 39.60 13.50 20.10 27.00 33.30 41.10 23.40 35.40 48.90 60.60 75.30

16.40 24.80 34.40 42.40 52.80 18.00 26.80 36.00 44.40 54.80 31.20 47.20 65.20 80.80 100.40

20.50 31.00 43.00 53.00 66.00 22.50 33.50 45.00 55.50 68.50 39.00 59.00 81.50 101.00 125.50

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

4.40 6.10 8.40 11.10 14.20 5.20 7.00 9.30 12.10 15.30 8.30 11.50 15.90 21.00 27.10

8.80 12.20 16.80 22.20 28.40 10.40 14.00 18.60 24.20 30.60 16.60 23.00 31.80 42.00 54.20

13.20 18.30 25.20 33.30 42.60 15.60 21.00 27.90 36.30 45.90 24.90 34.50 47.70 63.00 81.30

17.60 24.40 33.60 44.40 56.80 20.80 28.00 37.20 48.40 61.20 33.20 46.00 63.60 84.00 108.40

22.00 30.50 42.00 55.50 71.00 26.00 35.00 46.50 60.50 76.50 41.50 57.50 79.50 105.00 135.50

3.60 5.60 7.80 9.70 12.30 4.00 6.00 8.20 10.20 12.70 6.90 10.60 14.70 18.50 23.30

7.20 11.20 15.60 19.40 24.60 8.00 12.00 16.40 20.40 25.40 13.80 21.20 29.40 37.00 46.60

10.80 16.80 23.40 29.10 36.90 12.00 18.00 24.60 30.60 38.10 20.70 31.80 44.10 55.50 69.90

14.40 22.40 31.20 38.80 49.20 16.00 24.00 32.80 40.80 50.80 27.60 42.40 58.80 74.00 93.20

18.00 28.00 39.00 48.50 61.50 20.00 30.00 41.00 51.00 63.50 34.50 53.00 73.50 92.50 116.50

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

4.00 5.70 7.90 10.40 13.40 4.80 6.50 8.80 11.40 14.40 7.60 10.80 15.00 19.80 25.50

8.00 11.40 15.80 20.80 26.80 9.60 13.00 17.60 22.80 28.80 15.20 21.60 30.00 39.60 51.00

12.00 17.10 23.70 31.20 40.20 14.40 19.50 26.40 34.20 43.20 22.80 32.40 45.00 59.40 76.50

16.00 22.80 31.60 41.60 53.60 19.20 26.00 35.20 45.60 57.60 30.40 43.20 60.00 79.20 102.00

20.00 28.50 39.50 52.00 67.00 24.00 32.50 44.00 57.00 72.00 38.00 54.00 75.00 99.00 127.50

3.30 5.20 7.30 9.20 11.60 3.70 5.60 7.70 9.60 12.00 6.30 9.90 13.90 17.40 22.00

6.60 10.40 14.60 18.40 23.20 7.40 11.20 15.40 19.20 24.00 12.60 19.80 27.80 34.80 44.00

9.90 15.60 21.90 27.60 34.80 11.10 16.80 23.10 28.80 36.00 18.90 29.70 41.70 52.20 66.00

13.20 20.80 29.20 36.80 46.40 14.80 22.40 30.80 38.40 48.00 25.20 39.60 55.60 69.60 88.00

16.50 26.00 36.50 46.00 58.00 18.50 28.00 38.50 48.00 60.00 31.50 49.50 69.50 87.00 110.00

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

3.60 5.20 7.40 9.80 12.50 4.30 6.00 8.30 10.60 13.40 6.80 9.90 14.10 18.50 23.70

7.20 10.40 14.80 19.60 25.00 8.60 12.00 16.60 21.20 26.80 13.60 19.80 28.20 37.00 47.40

10.80 15.60 22.20 29.40 37.50 12.90 18.00 24.90 31.80 40.20 20.40 29.70 42.30 55.50 71.10

14.40 20.80 29.60 39.20 50.00 17.20 24.00 33.20 42.40 53.60 27.20 39.60 56.40 74.00 94.80

18.00 26.00 37.00 49.00 62.50 21.50 30.00 41.50 53.00 67.00 34.00 49.50 70.50 92.50 118.50

3.00 4.80 6.90 8.60 10.80 3.30 5.10 7.20 8.90 11.10 5.60 9.10 13.10 16.30 20.40

6.00 9.60 13.80 17.20 21.60 6.60 10.20 14.40 17.80 22.20 11.20 18.20 26.20 32.60 40.80

9.00 14.40 20.70 25.80 32.40 9.90 15.30 21.60 26.70 33.30 16.80 27.30 39.30 48.90 61.20

12.00 19.20 27.60 34.40 43.20 13.20 20.40 28.80 35.60 44.40 22.40 36.40 52.40 65.20 81.60

15.00 24.00 34.50 43.00 54.00 16.50 25.50 36.00 44.50 55.50 28.00 45.50 65.50 81.50 102.00

Note: Rates for base plans and riders are the same. Term Coverage: Not Available in ME, UT 5

Base Plans and Riders (Lifetime Coverage) – Monthly Premiums (CO, MD, NJ, SD)

Family

Individual Plus Children

Individual

Age of Oldest Insured 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99

Cancer Heart Attack & Stroke $10,000 $20,000 $30,000 $40,000 $50,000 $10,000 $20,000 $30,000 $40,000 $50,000 4.80 6.30 8.30 10.60 13.20 16.60 20.50 24.10 26.30 27.70 28.80 30.30 30.80 31.30 5.80 7.30 9.30 11.50 14.10 17.50 21.40 25.00 27.30 28.60 29.70 31.20 31.70 32.30 9.30 12.10 15.80 20.20 25.00 31.50 38.90 45.80 50.00 52.50 54.60 57.40 58.40 59.50

9.60 12.60 16.60 21.20 26.40 33.20 41.00 48.20 52.60 55.40 57.60 60.60 61.60 62.60 11.60 14.60 18.60 23.00 28.20 35.00 42.80 50.00 54.60 57.20 59.40 62.40 63.40 64.60 18.60 24.20 31.60 40.40 50.00 63.00 77.80 91.60 100.00 105.00 109.20 114.80 116.80 119.00

14.40 18.90 24.90 31.80 39.60 49.80 61.50 72.30 78.90 83.10 86.40 90.90 92.40 93.90 17.40 21.90 27.90 34.50 42.30 52.50 64.20 75.00 81.90 85.80 89.10 93.60 95.10 96.90 27.90 36.30 47.40 60.60 75.00 94.50 116.70 137.40 150.00 157.50 163.80 172.20 175.20 178.50

19.20 25.20 33.20 42.40 52.80 66.40 82.00 96.40 105.20 110.80 115.20 121.20 123.20 125.20 23.20 29.20 37.20 46.00 56.40 70.00 85.60 100.00 109.20 114.40 118.80 124.80 126.80 129.20 37.20 48.40 63.20 80.80 100.00 126.00 155.60 183.20 200.00 210.00 218.40 229.60 233.60 238.00

24.00 31.50 41.50 53.00 66.00 83.00 102.50 120.50 131.50 138.50 144.00 151.50 154.00 156.50 29.00 36.50 46.50 57.50 70.50 87.50 107.00 125.00 136.50 143.00 148.50 156.00 158.50 161.50 46.50 60.50 79.00 101.00 125.00 157.50 194.50 229.00 250.00 262.50 273.00 287.00 292.00 297.50

Note: Rates for base plans and riders are the same.

6

4.00 5.80 7.80 9.30 11.30 14.00 17.60 22.40 30.30 41.10 54.10 68.70 77.90 88.40 4.40 6.30 8.10 9.80 11.80 14.30 18.00 22.80 30.60 41.40 54.50 69.10 78.30 88.80 7.70 11.10 14.70 17.70 21.50 26.50 33.40 42.60 57.40 78.00 102.80 130.50 148.10 168.10

8.00 11.60 15.60 18.60 22.60 28.00 35.20 44.80 60.60 82.20 108.20 137.40 155.80 176.80 8.80 12.60 16.20 19.60 23.60 28.60 36.00 45.60 61.20 82.80 109.00 138.20 156.60 177.60 15.40 22.20 29.40 35.40 43.00 53.00 66.80 85.20 114.80 156.00 205.60 261.00 296.20 336.20

12.00 17.40 23.40 27.90 33.90 42.00 52.80 67.20 90.90 123.30 162.30 206.10 233.70 265.20 13.20 18.90 24.30 29.40 35.40 42.90 54.00 68.40 91.80 124.20 163.50 207.30 234.90 266.40 23.10 33.30 44.10 53.10 64.50 79.50 100.20 127.80 172.20 234.00 308.40 391.50 444.30 504.30

16.00 23.20 31.20 37.20 45.20 56.00 70.40 89.60 121.20 164.40 216.40 274.80 311.60 353.60 17.60 25.20 32.40 39.20 47.20 57.20 72.00 91.20 122.40 165.60 218.00 276.40 313.20 355.20 30.80 44.40 58.80 70.80 86.00 106.00 133.60 170.40 229.60 312.00 411.20 522.00 592.40 672.40

20.00 29.00 39.00 46.50 56.50 70.00 88.00 112.00 151.50 205.50 270.50 343.50 389.50 442.00 22.00 31.50 40.50 49.00 59.00 71.50 90.00 114.00 153.00 207.00 272.50 345.50 391.50 444.00 38.50 55.50 73.50 88.50 107.50 132.50 167.00 213.00 287.00 390.00 514.00 652.50 740.50 840.50

ICU and Cash Value Riders – Monthly Premiums (CO, MD, NJ, SD)

Family

Individual Plus Children

Individual

Age of Oldest Insured 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99

Intensive Care Unit Rider

Only available on lifetime coverage $250

$500

$750

$1,000

1.75 1.75 1.75 1.75 2.50 3.29 3.54

3.50 3.50 3.50 3.50 5.00 6.58 7.08

5.25 5.25 5.25 5.25 7.50 9.88 10.63

7.00 7.00 7.00 7.00 10.00 13.17 14.17

Cash Value Rider

Only available on lifetime coverage

Issue Ages: 18-60 (age of oldest insured) Rate: 175%

Not available in the following states: NJ

N/A 2.63 2.63 2.63 2.63 3.38 4.17 4.42

5.25 5.25 5.25 5.25 6.75 8.33 8.83

7.88 7.88 7.88 7.88 10.13 12.50 13.25

10.50 10.50 10.50 10.50 13.50 16.67 17.67

N/A 4.21 4.21 4.21 4.21 5.63 7.13 7.60

8.42 8.42 8.42 8.42 11.25 14.25 15.21

12.63 12.63 12.63 12.63 16.88 21.38 22.81

16.83 16.83 16.83 16.83 22.50 28.50 30.42

N/A

Intensive Care Unit Rider: Not Available in NJ

7

Base Plans and Riders (Term Coverage) – Monthly Premiums (CO, MD, NJ, SD)

Individual Individual Plus Children Family Individual Individual Plus Children Family Individual Individual Plus Children Family Individual Individual Plus Children Family

10-Year Term Coverage

15-Year Term Coverage

20-Year Term Coverage

30-Year Term Coverage

Age of Cancer Heart Attack & Stroke Oldest Insured $10,000 $20,000 $30,000 $40,000 $50,000 $10,000 $20,000 $30,000 $40,000 $50,000 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

4.20 5.70 7.70 10.10 12.80 4.90 6.50 8.60 11.00 13.80 7.80 10.80 14.70 19.20 24.30

8.40 11.40 15.40 20.20 25.60 9.80 13.00 17.20 22.00 27.60 15.60 21.60 29.40 38.40 48.60

12.60 17.10 23.10 30.30 38.40 14.70 19.50 25.80 33.00 41.40 23.40 32.40 44.10 57.60 72.90

16.80 22.80 30.80 40.40 51.20 19.60 26.00 34.40 44.00 55.20 31.20 43.20 58.80 76.80 97.20

21.00 28.50 38.50 50.50 64.00 24.50 32.50 43.00 55.00 69.00 39.00 54.00 73.50 96.00 121.50

3.40 5.20 7.20 8.80 11.00 3.80 5.60 7.50 9.30 11.40 6.50 9.80 13.60 16.80 20.90

6.80 10.40 14.40 17.60 22.00 7.60 11.20 15.00 18.60 22.80 13.00 19.60 27.20 33.60 41.80

10.20 15.60 21.60 26.40 33.00 11.40 16.80 22.50 27.90 34.20 19.50 29.40 40.80 50.40 62.70

13.60 20.80 28.80 35.20 44.00 15.20 22.40 30.00 37.20 45.60 26.00 39.20 54.40 67.20 83.60

17.00 26.00 36.00 44.00 55.00 19.00 28.00 37.50 46.50 57.00 32.50 49.00 68.00 84.00 104.50

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

3.70 5.10 7.00 9.30 11.80 4.30 5.80 7.80 10.10 12.80 6.90 9.60 13.30 17.50 22.60

7.40 10.20 14.00 18.60 23.60 8.60 11.60 15.60 20.20 25.60 13.80 19.20 26.60 35.00 45.20

11.10 15.30 21.00 27.90 35.40 12.90 17.40 23.40 30.30 38.40 20.70 28.80 39.90 52.50 67.80

14.80 20.40 28.00 37.20 47.20 17.20 23.20 31.20 40.40 51.20 27.60 38.40 53.20 70.00 90.40

18.50 25.50 35.00 46.50 59.00 21.50 29.00 39.00 50.50 64.00 34.50 48.00 66.50 87.50 113.00

3.00 4.70 6.50 8.10 10.30 3.30 5.00 6.80 8.50 10.60 5.80 8.80 12.30 15.40 19.40

6.00 9.40 13.00 16.20 20.60 6.60 10.00 13.60 17.00 21.20 11.60 17.60 24.60 30.80 38.80

9.00 14.10 19.50 24.30 30.90 9.90 15.00 20.40 25.50 31.80 17.40 26.40 36.90 46.20 58.20

12.00 18.80 26.00 32.40 41.20 13.20 20.00 27.20 34.00 42.40 23.20 35.20 49.20 61.60 77.60

15.00 23.50 32.50 40.50 51.50 16.50 25.00 34.00 42.50 53.00 29.00 44.00 61.50 77.00 97.00

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

3.30 4.80 6.60 8.70 11.20 4.00 5.40 7.30 9.50 12.00 6.30 9.00 12.50 16.50 21.30

6.60 9.60 13.20 17.40 22.40 8.00 10.80 14.60 19.00 24.00 12.60 18.00 25.00 33.00 42.60

9.90 14.40 19.80 26.10 33.60 12.00 16.20 21.90 28.50 36.00 18.90 27.00 37.50 49.50 63.90

13.20 19.20 26.40 34.80 44.80 16.00 21.60 29.20 38.00 48.00 25.20 36.00 50.00 66.00 85.20

16.50 24.00 33.00 43.50 56.00 20.00 27.00 36.50 47.50 60.00 31.50 45.00 62.50 82.50 106.50

2.80 4.30 6.10 7.70 9.70 3.10 4.70 6.40 8.00 10.00 5.30 8.30 11.60 14.50 18.30

5.60 8.60 12.20 15.40 19.40 6.20 9.40 12.80 16.00 20.00 10.60 16.60 23.20 29.00 36.60

8.40 12.90 18.30 23.10 29.10 9.30 14.10 19.20 24.00 30.00 15.90 24.90 34.80 43.50 54.90

11.20 17.20 24.40 30.80 38.80 12.40 18.80 25.60 32.00 40.00 21.20 33.20 46.40 58.00 73.20

14.00 21.50 30.50 38.50 48.50 15.50 23.50 32.00 40.00 50.00 26.50 41.50 58.00 72.50 91.50

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

3.00 4.30 6.20 8.20 10.40 3.60 5.00 6.90 8.80 11.20 5.70 8.30 11.80 15.40 19.80

6.00 8.60 12.40 16.40 20.80 7.20 10.00 13.80 17.60 22.40 11.40 16.60 23.60 30.80 39.60

9.00 12.90 18.60 24.60 31.20 10.80 15.00 20.70 26.40 33.60 17.10 24.90 35.40 46.20 59.40

12.00 17.20 24.80 32.80 41.60 14.40 20.00 27.60 35.20 44.80 22.80 33.20 47.20 61.60 79.20

15.00 21.50 31.00 41.00 52.00 18.00 25.00 34.50 44.00 56.00 28.50 41.50 59.00 77.00 99.00

2.50 4.00 5.80 7.20 9.00 2.80 4.30 6.00 7.40 9.30 4.70 7.60 10.90 13.60 17.00

5.00 8.00 11.60 14.40 18.00 5.60 8.60 12.00 14.80 18.60 9.40 15.20 21.80 27.20 34.00

7.50 12.00 17.40 21.60 27.00 8.40 12.90 18.00 22.20 27.90 14.10 22.80 32.70 40.80 51.00

10.00 16.00 23.20 28.80 36.00 11.20 17.20 24.00 29.60 37.20 18.80 30.40 43.60 54.40 68.00

12.50 20.00 29.00 36.00 45.00 14.00 21.50 30.00 37.00 46.50 23.50 38.00 54.50 68.00 85.00

Term Coverage: Not Available in NJ 8

Base Plans and Riders (Lifetime Coverage) – Monthly Premiums (IN, MI, ND, OH, SC, VT)

Family

Individual Plus Children

Individual

Age of Oldest Insured 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99

Cancer Heart Attack & Stroke $10,000 $20,000 $30,000 $40,000 $50,000 $10,000 $20,000 $30,000 $40,000 $50,000 5.30 6.90 9.10 11.50 14.40 18.10 22.40 26.30 28.70 30.20 31.40 33.00 33.50 34.20 6.40 7.90 10.10 12.50 15.40 19.10 23.40 27.30 29.70 31.20 32.40 34.00 34.50 35.20 10.10 13.20 17.30 22.00 27.30 34.40 42.50 49.90 54.50 57.30 59.50 62.60 63.70 64.90

10.60 13.80 18.20 23.00 28.80 36.20 44.80 52.60 57.40 60.40 62.80 66.00 67.00 68.40 12.80 15.80 20.20 25.00 30.80 38.20 46.80 54.60 59.40 62.40 64.80 68.00 69.00 70.40 20.20 26.40 34.60 44.00 54.60 68.80 85.00 99.80 109.00 114.60 119.00 125.20 127.40 129.80

15.90 20.70 27.30 34.50 43.20 54.30 67.20 78.90 86.10 90.60 94.20 99.00 100.50 102.60 19.20 23.70 30.30 37.50 46.20 57.30 70.20 81.90 89.10 93.60 97.20 102.00 103.50 105.60 30.30 39.60 51.90 66.00 81.90 103.20 127.50 149.70 163.50 171.90 178.50 187.80 191.10 194.70

21.20 27.60 36.40 46.00 57.60 72.40 89.60 105.20 114.80 120.80 125.60 132.00 134.00 136.80 25.60 31.60 40.40 50.00 61.60 76.40 93.60 109.20 118.80 124.80 129.60 136.00 138.00 140.80 40.40 52.80 69.20 88.00 109.20 137.60 170.00 199.60 218.00 229.20 238.00 250.40 254.80 259.60

26.50 34.50 45.50 57.50 72.00 90.50 112.00 131.50 143.50 151.00 157.00 165.00 167.50 171.00 32.00 39.50 50.50 62.50 77.00 95.50 117.00 136.50 148.50 156.00 162.00 170.00 172.50 176.00 50.50 66.00 86.50 110.00 136.50 172.00 212.50 249.50 272.50 286.50 297.50 313.00 318.50 324.50

Note: Rates for base plans and riders are the same.

9

4.40 6.40 8.50 10.20 12.40 15.30 19.20 24.50 33.00 44.80 59.00 74.90 85.00 96.50 4.80 6.80 8.80 10.60 12.80 15.60 19.60 24.90 33.40 45.20 59.50 75.40 85.50 96.90 8.40 12.10 16.00 19.30 23.50 28.90 36.50 46.50 62.60 85.10 112.10 142.40 161.50 183.40

8.80 12.80 17.00 20.40 24.80 30.60 38.40 49.00 66.00 89.60 118.00 149.80 170.00 193.00 9.60 13.60 17.60 21.20 25.60 31.20 39.20 49.80 66.80 90.40 119.00 150.80 171.00 193.80 16.80 24.20 32.00 38.60 47.00 57.80 73.00 93.00 125.20 170.20 224.20 284.80 323.00 366.80

13.20 19.20 25.50 30.60 37.20 45.90 57.60 73.50 99.00 134.40 177.00 224.70 255.00 289.50 14.40 20.40 26.40 31.80 38.40 46.80 58.80 74.70 100.20 135.60 178.50 226.20 256.50 290.70 25.20 36.30 48.00 57.90 70.50 86.70 109.50 139.50 187.80 255.30 336.30 427.20 484.50 550.20

17.60 25.60 34.00 40.80 49.60 61.20 76.80 98.00 132.00 179.20 236.00 299.60 340.00 386.00 19.20 27.20 35.20 42.40 51.20 62.40 78.40 99.60 133.60 180.80 238.00 301.60 342.00 387.60 33.60 48.40 64.00 77.20 94.00 115.60 146.00 186.00 250.40 340.40 448.40 569.60 646.00 733.60

22.00 32.00 42.50 51.00 62.00 76.50 96.00 122.50 165.00 224.00 295.00 374.50 425.00 482.50 24.00 34.00 44.00 53.00 64.00 78.00 98.00 124.50 167.00 226.00 297.50 377.00 427.50 484.50 42.00 60.50 80.00 96.50 117.50 144.50 182.50 232.50 313.00 425.50 560.50 712.00 807.50 917.00

ICU and Cash Value Riders – Monthly Premiums (IN, MI, ND, OH, SC, VT)

Family

Individual Plus Children

Individual

Age of Oldest Insured 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99

Intensive Care Unit Rider

Only available on lifetime coverage $250

$500

$750

$1,000

1.91 1.91 1.91 1.91 2.73 3.59 3.87

3.82 3.82 3.82 3.82 5.45 7.18 7.73

5.73 5.73 5.73 5.73 8.18 10.78 11.59

7.63 7.63 7.63 7.63 10.91 14.37 15.46

Cash Value Rider

Only available on lifetime coverage

Issue Ages: 18-60 (age of oldest insured) Rate: 175%

N/A 2.87 2.87 2.87 2.87 3.68 4.55 4.82

5.73 5.73 5.73 5.73 7.36 9.09 9.64

8.59 8.59 8.59 8.59 11.04 13.64 14.46

11.46 11.46 11.46 11.46 14.73 18.18 19.28

N/A 4.58 4.58 4.58 4.58 6.14 7.78 8.30

9.16 9.16 9.16 9.16 12.27 15.55 16.59

13.74 13.74 13.74 13.74 18.41 23.33 24.89

18.33 18.33 18.33 18.33 24.54 31.11 33.18

N/A

10

Base Plans and Riders (Term Coverage) – Monthly Premiums (IN, MI, ND, OH, SC, VT)

Individual Individual Plus Children Family Individual Individual Plus Children Family Individual Individual Plus Children Family Individual Individual Plus Children Family

10-Year Term Coverage

15-Year Term Coverage

20-Year Term Coverage

30-Year Term Coverage

Age of Cancer Heart Attack & Stroke Oldest Insured $10,000 $20,000 $30,000 $40,000 $50,000 $10,000 $20,000 $30,000 $40,000 $50,000 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

4.50 6.20 8.40 11.00 14.00 5.40 7.10 9.40 12.00 15.00 8.50 11.70 16.00 20.90 26.50

9.00 12.40 16.80 22.00 28.00 10.80 14.20 18.80 24.00 30.00 17.00 23.40 32.00 41.80 53.00

13.50 18.60 25.20 33.00 42.00 16.20 21.30 28.20 36.00 45.00 25.50 35.10 48.00 62.70 79.50

18.00 24.80 33.60 44.00 56.00 21.60 28.40 37.60 48.00 60.00 34.00 46.80 64.00 83.60 106.00

22.50 31.00 42.00 55.00 70.00 27.00 35.50 47.00 60.00 75.00 42.50 58.50 80.00 104.50 132.50

3.70 5.60 7.80 9.60 12.00 4.10 6.10 8.20 10.10 12.50 7.10 10.70 14.80 18.40 22.80

7.40 11.20 15.60 19.20 24.00 8.20 12.20 16.40 20.20 25.00 14.20 21.40 29.60 36.80 45.60

11.10 16.80 23.40 28.80 36.00 12.30 18.30 24.60 30.30 37.50 21.30 32.10 44.40 55.20 68.40

14.80 22.40 31.20 38.40 48.00 16.40 24.40 32.80 40.40 50.00 28.40 42.80 59.20 73.60 91.20

18.50 28.00 39.00 48.00 60.00 20.50 30.50 41.00 50.50 62.50 35.50 53.50 74.00 92.00 114.00

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

4.00 5.50 7.60 10.10 12.90 4.70 6.40 8.50 11.00 13.90 7.50 10.50 14.50 19.10 24.60

8.00 11.00 15.20 20.20 25.80 9.40 12.80 17.00 22.00 27.80 15.00 21.00 29.00 38.20 49.20

12.00 16.50 22.80 30.30 38.70 14.10 19.20 25.50 33.00 41.70 22.50 31.50 43.50 57.30 73.80

16.00 22.00 30.40 40.40 51.60 18.80 25.60 34.00 44.00 55.60 30.00 42.00 58.00 76.40 98.40

20.00 27.50 38.00 50.50 64.50 23.50 32.00 42.50 55.00 69.50 37.50 52.50 72.50 95.50 123.00

3.30 5.10 7.10 8.80 11.20 3.60 5.50 7.50 9.30 11.50 6.30 9.60 13.40 16.80 21.20

6.60 10.20 14.20 17.60 22.40 7.20 11.00 15.00 18.60 23.00 12.60 19.20 26.80 33.60 42.40

9.90 15.30 21.30 26.40 33.60 10.80 16.50 22.50 27.90 34.50 18.90 28.80 40.20 50.40 63.60

13.20 20.40 28.40 35.20 44.80 14.40 22.00 30.00 37.20 46.00 25.20 38.40 53.60 67.20 84.80

16.50 25.50 35.50 44.00 56.00 18.00 27.50 37.50 46.50 57.50 31.50 48.00 67.00 84.00 106.00

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

3.60 5.20 7.20 9.50 12.20 4.40 5.90 8.00 10.40 13.10 6.90 9.80 13.60 18.00 23.20

7.20 10.40 14.40 19.00 24.40 8.80 11.80 16.00 20.80 26.20 13.80 19.60 27.20 36.00 46.40

10.80 15.60 21.60 28.50 36.60 13.20 17.70 24.00 31.20 39.30 20.70 29.40 40.80 54.00 69.60

14.40 20.80 28.80 38.00 48.80 17.60 23.60 32.00 41.60 52.40 27.60 39.20 54.40 72.00 92.80

18.00 26.00 36.00 47.50 61.00 22.00 29.50 40.00 52.00 65.50 34.50 49.00 68.00 90.00 116.00

3.00 4.70 6.60 8.40 10.50 3.40 5.10 7.00 8.70 10.90 5.70 9.00 12.60 15.80 20.00

6.00 9.40 13.20 16.80 21.00 6.80 10.20 14.00 17.40 21.80 11.40 18.00 25.20 31.60 40.00

9.00 14.10 19.80 25.20 31.50 10.20 15.30 21.00 26.10 32.70 17.10 27.00 37.80 47.40 60.00

12.00 18.80 26.40 33.60 42.00 13.60 20.40 28.00 34.80 43.60 22.80 36.00 50.40 63.20 80.00

15.00 23.50 33.00 42.00 52.50 17.00 25.50 35.00 43.50 54.50 28.50 45.00 63.00 79.00 100.00

18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54 18-34 35-39 40-44 45-49 50-54

3.30 4.70 6.70 8.90 11.40 3.90 5.50 7.50 9.60 12.20 6.20 9.00 12.80 16.80 21.50

6.60 9.40 13.40 17.80 22.80 7.80 11.00 15.00 19.20 24.40 12.40 18.00 25.60 33.60 43.00

9.90 14.10 20.10 26.70 34.20 11.70 16.50 22.50 28.80 36.60 18.60 27.00 38.40 50.40 64.50

13.20 18.80 26.80 35.60 45.60 15.60 22.00 30.00 38.40 48.80 24.80 36.00 51.20 67.20 86.00

16.50 23.50 33.50 44.50 57.00 19.50 27.50 37.50 48.00 61.00 31.00 45.00 64.00 84.00 107.50

2.70 4.40 6.30 7.80 9.80 3.00 4.60 6.50 8.10 10.10 5.10 8.30 11.90 14.80 18.50

5.40 8.80 12.60 15.60 19.60 6.00 9.20 13.00 16.20 20.20 10.20 16.60 23.80 29.60 37.00

8.10 13.20 18.90 23.40 29.40 9.00 13.80 19.50 24.30 30.30 15.30 24.90 35.70 44.40 55.50

10.80 17.60 25.20 31.20 39.20 12.00 18.40 26.00 32.40 40.40 20.40 33.20 47.60 59.20 74.00

13.50 22.00 31.50 39.00 49.00 15.00 23.00 32.50 40.50 50.50 25.50 41.50 59.50 74.00 92.50

11

Base Plans and Riders (Lifetime Coverage) – Monthly Premiums (CT)

Family

Individual Plus Children

Individual

Age of Oldest Insured 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99

Cancer Heart Attack & Stroke $10,000 $20,000 $30,000 $40,000 $50,000 $10,000 $20,000 $30,000 $40,000 $50,000 4.50 5.80 7.70 9.80 12.20 15.30 18.90 22.20 24.30 25.50 26.50 27.90 28.40 28.90 8.50 11.20 14.60 18.60 23.10 29.10 35.90 42.20 46.20 48.50 50.40 53.00 53.90 54.90 5.40 6.70 8.50 10.60 13.00 16.20 19.80 23.10 25.20 26.40 27.40 28.80 29.20 29.80

9.00 11.60 15.40 19.60 24.40 30.60 37.80 44.40 48.60 51.00 53.00 55.80 56.80 57.80 17.00 22.40 29.20 37.20 46.20 58.20 71.80 84.40 92.40 97.00 100.80 106.00 107.80 109.80 10.80 13.40 17.00 21.20 26.00 32.40 39.60 46.20 50.40 52.80 54.80 57.60 58.40 59.60

13.50 17.40 23.10 29.40 36.60 45.90 56.70 66.60 72.90 76.50 79.50 83.70 85.20 86.70 25.50 33.60 43.80 55.80 69.30 87.30 107.70 126.60 138.60 145.50 151.20 159.00 161.70 164.70 16.20 20.10 25.50 31.80 39.00 48.60 59.40 69.30 75.60 79.20 82.20 86.40 87.60 89.40

18.00 23.20 30.80 39.20 48.80 61.20 75.60 88.80 97.20 102.00 106.00 111.60 113.60 115.60 34.00 44.80 58.40 74.40 92.40 116.40 143.60 168.80 184.80 194.00 201.60 212.00 215.60 219.60 21.60 26.80 34.00 42.40 52.00 64.80 79.20 92.40 100.80 105.60 109.60 115.20 116.80 119.20

22.50 29.00 38.50 49.00 61.00 76.50 94.50 111.00 121.50 127.50 132.50 139.50 142.00 144.50 42.50 56.00 73.00 93.00 115.50 145.50 179.50 211.00 231.00 242.50 252.00 265.00 269.50 274.50 27.00 33.50 42.50 53.00 65.00 81.00 99.00 115.50 126.00 132.00 137.00 144.00 146.00 149.00

Term Coverage: Not Available in CT

12

3.70 5.40 7.20 8.60 10.50 12.90 16.20 20.70 27.90 37.90 49.90 63.40 71.90 81.60 7.10 10.20 13.50 16.30 19.80 24.50 30.80 39.30 53.00 72.00 94.80 120.50 136.70 155.20 4.10 5.80 7.50 9.00 10.80 13.20 16.60 21.10 28.20 38.20 50.30 63.80 72.30 82.00

7.40 10.80 14.40 17.20 21.00 25.80 32.40 41.40 55.80 75.80 99.80 126.80 143.80 163.20 14.20 20.40 27.00 32.60 39.60 49.00 61.60 78.60 106.00 144.00 189.60 241.00 273.40 310.40 8.20 11.60 15.00 18.00 21.60 26.40 33.20 42.20 56.40 76.40 100.60 127.60 144.60 164.00

11.10 16.20 21.60 25.80 31.50 38.70 48.60 62.10 83.70 113.70 149.70 190.20 215.70 244.80 21.30 30.60 40.50 48.90 59.40 73.50 92.40 117.90 159.00 216.00 284.40 361.50 410.10 465.60 12.30 17.40 22.50 27.00 32.40 39.60 49.80 63.30 84.60 114.60 150.90 191.40 216.90 246.00

14.80 21.60 28.80 34.40 42.00 51.60 64.80 82.80 111.60 151.60 199.60 253.60 287.60 326.40 28.40 40.80 54.00 65.20 79.20 98.00 123.20 157.20 212.00 288.00 379.20 482.00 546.80 620.80 16.40 23.20 30.00 36.00 43.20 52.80 66.40 84.40 112.80 152.80 201.20 255.20 289.20 328.00

18.50 27.00 36.00 43.00 52.50 64.50 81.00 103.50 139.50 189.50 249.50 317.00 359.50 408.00 35.50 51.00 67.50 81.50 99.00 122.50 154.00 196.50 265.00 360.00 474.00 602.50 683.50 776.00 20.50 29.00 37.50 45.00 54.00 66.00 83.00 105.50 141.00 191.00 251.50 319.00 361.50 410.00

ICU and Cash Value Riders – Monthly Premiums (CT)

Family

Individual Plus Children

Individual

Age of Oldest Insured 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 18-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99

Intensive Care Unit Rider

Only available on lifetime coverage $250

$500

$750

Cash Value Rider

Only available on lifetime coverage

$1,000

Issue Ages: 18-60 (age of oldest insured) Not Available in CT

Not Available in CT

Not Available in CT

Not Available in CT

13

Underwritten by:

Mutual of Omaha Insurance Company 3300 Mutual of Omaha Plaza Omaha, NE 68175 mutualofomaha.com

For producer use only. Not for use with the general public.