Infinity Resources, Inc.

Carrier Name - Summary of Billing
04/2002
Location(s): Assembly and Parts Division
Division(s): California
Subtotaled by: Plan

Coverage Level Volume Rates Number of
Enrolled Employees
Premium
1 x Salary (Base) 1,160,500 0.10 100 450.00
Base + 1 x Salary 9,160,500 0.10 30 55.00
Base + 2 x Salary 160,500 0.10 20 89.50
Base + 3 x Salary 60,500 0.10 10 52.00
Base+ 5 x Salary 260,500 0.10 15 51.50
Adjustments 0     0
Basic AD&D Total $10,802,500   175 $698.00

# employees x (Base + Buy up *) = Volume
* Benefit Amount Approved by Carrier



Coverage Level Volume Rates Number of
Enrolled Employees
Premium
1 x Salary (Base) 6,794,400 100.00 25 2,500.00
Adjustments 0     0
Basic Life Total $6,794,400   25 $20,375.00


Coverage Level Rates Number of
Enrolled Employees
Premium
Employee 100.00 25 2,500.00
Employee + Spouse 200.00 10 2,000.00
Employee + Child(ren) 175.00 20 3,500.00
Family 270.00 45 12,375.00
Adjustments 0 0
HMO Total 100 $20,375.00


Coverage Level Volume Rates Number of
Enrolled Employees
Premium
50% of monthly salary $2,500.00 0.12 1 $2,500.00
Adjustments 0     0
Long Term Disability Total $2,500.00   1 $2,500.00


Coverage Level Rates Number of
Enrolled Employees
Premium
Employee 100.00 25 2,500.00
Employee + Spouse 200.00 10 2,000.00
Employee + Child(ren) 175.00 20 3,500.00
Family 270.00 45 12,375.00
Adjustments 0 0
PPO Total 100 $20,375.00


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