LIFE INSURANCE MUTUAL OF OMAHA
Voluntary Life and Accidental Death and Dismemberment If you would like additional coverage, Voluntary Life and AD&D insurance is available to you, your spouse ad your dependent children. You must enroll in coverage for yourself in order to cover your spouse or children. If you don’t enroll in Voluntary Life when it’s first available to you, or elect an amount over the Guaranteed Issue, you may be required to complete an Evidence of Insurability (EOI) form. Please visit this website to submit EOI forms https://www3.mutualofomaha.com/eoi/#/home.
Voluntary Life Options
Coverage Option
Guarantee Issue Limit
Increments of $20,000 to a maximum of $500,00 or 7x annual earning Increments of $10,000 to a maximum of $250,000 or 100& of employee amount $10,000 (100% of employees benefit up to $10,000)
Employee
7x salary up to $100,000
100% of Employee’s benefit up to $30,000
Spouse
Children to age 26
$10,000
Monthly rates
Under age 30
$0.51
60-64
$0.871
30-34
$0.058
65-70
$1.409
35-39
$0.084
70-75
$2.294
40-44
$0.142
75-79
$4.056
45-49
$0.221
80-84
$8.026
50-54
$0.334
85+
$13.193
55-59
$0.531
Employee AD&D Rate
$0.026
Dependent Child(ren) Rate $0.131
Spouse AD&D Rate
$0.012
Child AD&D Rate
0.026
Monthly Premium Calculation Use the rates in the Age/Premium Factor Table to calculate your premium for voluntary life and accidental death and dismemberment disability coverage in the worksheet below, using the example as a guide.
Example: If the rate is $0.096 per $1,000 and an enrollee elects $20,000 in coverage, the monthly premium will be $1.92.
$0.096
x
20
=
$1.92
Plan rate (determined by age)
Coverage per $1,000
Monthly premium
14
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