Life and AD&D Benefit Summary

Calculate Your Dependent Spouse Cost Use the appropriate rate provided in the tables to the left to calculate your cost based on the amount of coverage you select. The following example calculates the monthly cost for a 36-year-old employee who would like to purchase $100,000 in spouse optional term life insurance coverage.

Group Life Rates for Your Spouse

Employee Age Range

Life Premium Rate

0 - 29

$0.070 $0.080 $0.110 $0.160 $0.250 $0.430 $0.780 $1.170 $2.207 $3.440

Calculation Example

Example

You

30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69

Using the table above, enter the rate that corresponds with your age. Enter the desired coverage amount in dollars. Enter the desired coverage amount in increments of $1,000. To calculate, divide the coverage amount by $1,000. Calculate the monthly cost. Multiply Step 1 by Step 3.

Step 1

$0.110

Step 2

$100,000

Step 3

100

Step 4

$11.00

70 +

Note: Rates are subject to change and can vary over time.

Group AD&D Rates for Your Spouse AD&D Premium Rate $0.030

Group Life and AD&D Rates for your Dependent Child(ren)

Child(ren) Life Premium Rate, per $1,000

Child(ren) AD&D Premium Rate, per $1,000

$0.120

$0.030

One affordable monthly premium covers all of your eligible dependent children.

Note: To be eligible for coverage, a spouse or dependent child cannot be confined on the date the increase or addition is to take effect, it will take effect when the confinement ends.

Please see prior page for product information. Optional Life Insurance Premium Calculation

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