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SUPPLEMENTAL LIFE/AD&D

THIS ENROLLMENT PAGE IS FOR EMPLOYEES WHO

WISH TO PURCHASE SUPPLEMENTAL LIFE/AD&D

In addition to the employer-paid Basic Life/AD&D -

Supplemental (VOLUNTARY) Life/AD&D is available to purchase through your employer.

Pricing for both employee and spouse is based on the employee's age.  

The per pay period deduction is calculated as follows using the

Age/Rate grid below:











 

Step 1:  Find EMPLOYEE Age Bracket and Rate

Step 2:  Consider COVERAGE AMOUNT you wish to purchase (max 5x Base Annual Earnings)

Step 3:  Multiply Employee COVERAGE AMOUNT by age-banded RATE  =  Gross amount

Step 4:  Divide GROSS AMOUNT by 1000 = Monthly Rate

Step 5:

Semi-Monthly Employees: 

Divide MONTHLY RATE by 2 = Pay Period Deduction (semi-monthly)

Biweekly Employees:

Multiply MONTHLY RATE by .4615 = Pay Period Deduction (biweekly)

Should you have any questions, please contact your Benefits Manager, Sarah Rodriguez.

Age Rate Grid.png

ENROLL / Purchase Supplemental Life/AD&D:
Enter Information on our Secure Site 
*Required fields

EMPLOYEE

Gender

How much coverage do you wish to purchase? Increments of $10k not to exceed 5x Base Annual Earnings or $500,000 (Guranty Issue Amount is $300k)

If desired coverage amount is over $300,000, you must complete and submit the Evidence of Insurability (EOI) Application.

YOU WILL BE REDIRECTED TO A PAGE AFTER SUBMITTING THIS FORM.

SPOUSAL COVERAGE

Spousal coverage is available to purchase in increments of $5,000 not to exceed 50% of employee coverage amount.  See pricing grid for cost.   NOTE: You can not get spousal coverage without employee coverage.

If desired coverage amount is over $20,000, you must complete and submit the Evidence of Insurability (EOI) Application.

YOU WILL BE REDIRECTED TO A PAGE AFTER SUBMITTING THIS FORM.

CHILD BENEFIT

A child benefit is available to purchase in increments of $2,500 not to exceed $10,000  Per pay period deduction below. No EOI required.

Select Child Benefit Amount you wish to purchase (rates below):
Who employs you?