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Amer. Samoa
Birthdate
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1916
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1930
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1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
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1951
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1953
1954
1955
1956
1957
1958
1959
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1963
1964
1965
1966
1967
1968
1969
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1974
1975
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1984
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1991
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1993
1994
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1996
1997
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1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
Gender
Male
Female
Smoker / Tobacco
No
Yes
Health Class
Preferred Plus
Preferred
Regular Plus
Regular
Table Rating 1 or A
Table Rating 2 or B
Table Rating 3 or C
Table Rating 4 or D
Table Rating 5 or E
Table Rating 6 or F
Table Rating 7 or G
Table Rating 8 or H
Table Rating 9 or I
Table Rating 10 or J
Table Rating 11 or K
Table Rating 12 or L
Table Rating 13 or M
Table Rating 14 or N
Table Rating 15 or O
Table Rating 16 or P
Type of Insurance
1 Year Level Term
5 Year Level Term
10 Year Level Term
15 Year Level Term
20 Year Level Term
25 Year Level Term
30 Year Level Term
35 Year Level Term
40 Year Level Term
To Age 90 Level
To Age 95 Level
To Age 100 Level
15 Year Return of Premium
20 Year Return of Premium
25 Year Return of Premium
30 Year Return of Premium
To Age 121 Level (No Lapse U/L)
To Age 121 Level - Pay to 100
Amount of Insurance
$10,000
$25,000
$50,000
$75,000
$100,000
$125,000
$150,000
$175,000
$200,000
$225,000
$250,000
$300,000
$350,000
$400,000
$450,000
$500,000
$550,000
$600,000
$650,000
$700,000
$750,000
$800,000
$900,000
$1,000,000
$1,100,000
$1,250,000
$1,500,000
$1,750,000
$2,000,000
$2,500,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
$8,000,000
$9,000,000
$10,000,000
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