Replaces pages F-2 and F-4 with new pages F-2 and F-4 of Exhibit F effective January 1, 2010. This amendment updates the stop-loss basis for the local government employee life insurance plans to show the new stop-loss rates effective January 1, 2010. Minnesota Life Insurance Company this ________day of_____________________, 2010 By ____________________________________ Chair The State of Wisconsin Group Insurance Board this ________day of________________, 2010 By ____________________________________ Chair EXHIBIT F STOP-LOSS PROVISION (cont'd) SCHEDULE OF MONTHLY STOP-LOSS PER $1,000 OF INSURANCE for Insurance of a Greater or Lesser Amount will be Proportionate) LOCAL GOVERNMENT EMPLOYEE PLAN Attained Attained Attained Age Rate Age Rate Age Rate 17 $ .07 45 $ .16 73 $ 2.93 18 .07 46 .17 74 3.43 19 .07 47 .19 75 3.85 20 .07 48 .22 76 4.36 21 .07 49 .26 77 4.87 22 .07 50 .24 78 5.44 23 .07 51 .27 79 6.04 24 .07 52 .29 80 6.65 25 .07 53 .32 81 7.30 26 .07 54 .36 82 7.91 27 .07 55 .45 83 8.58
Replaces pages F-2 and F-4 with new pages F-2 and F-4 of Exhibit F effective January 1, 2010. This amendment updates the stop-loss basis for the local government employee life insurance plans to show the new stop-loss rates effective January 1, 2010. Minnesota Life Insurance Company this ________day of_____________________, 2010 By ____________________________________ Chair The State of Wisconsin Group Insurance Board this ________day of________________, 2010 By ____________________________________ Chair EXHIBIT F STOP-LOSS PROVISION (cont'd) SCHEDULE OF MONTHLY STOP-LOSS PER $1,000 OF INSURANCE for Insurance of a Greater or Lesser Amount will be Proportionate) LOCAL GOVERNMENT EMPLOYEE PLAN Attained Age Rate Attained Age Rate Attained Age Rate 17 $ .07 45 $ .16 73 $ 2.93 18 .07 46 .17 74 3.43 19 .07 47 .19 75 3.85 20 .07 48 .22 76 4.36 21 .07 49 .26 77 4.87 22 .07 50 .24 78 5.44 23 .07 51 .27 79 6.04 24 .07 52 .29 80 6.65 25 .07 53 .32 81 7.30 26 .07 54 .36 82 7.91 27 .07 55 .45 83 8.58
State%20of%20Wisconsin%20Administrative%20Agreement%20FINAL%20with%20exhibits%20amendments.docx