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SUPPLEMENTAL LIFE INSURANCE PREMIUM INFORMATION

Additional Employee Life Insurance

Coverage
Rate

Supplemental Term Life for Employee

Premium is per $1,000 of Coverage

Ex: $30,000 of coverage for employee 30 years of age:

$30,000 x $.08 = $2400

Since premium is per thousand = $2400/1000 = $2.40 per month or $1.20 per paycheck (24 payperiods).

Age Range
Premium
Under 30
$ . 06
30 - 34
$ .08
35 - 39
$ .09
40 - 44
$ .12
45 - 49
$ .20
50 - 54
$ .34
55 - 59
$ .51
60 - 64
$ .69
65 - 69
$1.27
70 or more
$2.06

Spousal and Dependent Life Insurance

Coverage
Rate

Supplemental Term Life for the Spouse*

Premium is per $1,000 of Coverage

Ex: $30,000 of coverage for employee 30 years of age:

$30,000 x $.08 = $2400

Since premium is per thousand = $2400/1000 = $2.40 per month or $1.20 per paycheck (24 payperiods).

Age Range
Premium
Under 30
$ . 06
30 - 34
$ .08
35 - 39
$ .09
40 - 44
$ .12
45 - 49
$ .20
50 - 54
$ .34
55 - 59
$ .51
60 - 64
$ .69
65 - 69
$1.27
70 or more
$2.06

Dependent life insurance is available at a level of $4,000 for dependents aged two weeks to 19 years of age. Children less than 14 days of age and/or those in full-time active military service are not eligible. Premium is a family rated monthly premium regardless of the number of eligible dependents covered. 2004 family rate is $ .60 per month.

* Employee must purchase 1x supplemental insurance in order to purchase spousal and/or dependent life insurance.

PLEASE NOTE

The benefit plans summarized on these web pages are guidelines only. Every effort has been made to make these descriptions as brief, accurate and easy to understand as possible. Therefore, all details may not be described here. If there is a difference between the information in this publication and the official plan documents, the official plan documents will govern. In addition, the Colleges retain the right to supplement, modify, amend or eliminate benefit policies and plans. For more specific information, please contact the Office of Human Resources.