Page 41 - 2021 Team Member Benefit Guide - English

What happens to those you love if something
happens to you?

Optional Life and Voluntary AD&D Coverage – Employee, Spouse & Child
Amount Available
Employee Minimum of $10,000 up to 8X annual base pay (rounded to the
next $10K)
(Maximum combined limit of $2 million for basic + optional life)
Spouse Spouse Life I: $5,000 to $45,000 (in increments of $5,000)
Note: Spouse Life cannot Spouse Life II: $50,000 to $250,000 (in increments of $25,000)
exceed Employee’s combined
Basic & Optional Life.
Child $15,000 or $20,000

Rates for both Employee Optional Life and Spouse Life are age-banded using the employee’s
age for Employee Optional Life and the Spouse’s age for Spouse Life.
Employee/Spouse Rates Child Rate
Age Monthly Rate per Age Monthly Rate per
$1,000 of Coverage $1,000 of Coverage
<25 .04 0-26 .125
25-29 .05
30-34 .07 Here is an example of how the cost for employee
35-39 .09 optional life (or Spouse Life) is calculated for an
individual (Employee or Spouse), age 42 who
40-44 .10 elects $100,000 of coverage.
45-49 .15 To determine cost per paycheck:
50-54 .23 ($100,000/1,000) x .10 = $10.00 per month. Then
55-59 .37 ($10.00 x 12) = $120 total annual cost.
60-64 .66
65-69 1.27 Then, 120 divided by 26 for biweekly or 52 for
weekly = $4.62 per biweekly paycheck or $2.31
70+ 2.06 per weekly check.

Voluntary AD&D – Employee, Spouse & Child
The same rate applies to anyone enrolled in these plans: .025 per $1,000 of coverage.
1. Enter number of units of coverage _____
2. Enter Rate .025
3. Multiply Line 1 X Line 2 _____
4. Multiply Line 2 times 12 _____
5. Divide Line 4 by 26 for bi-weekly or 52 for weekly rate.
This is the amount withheld from your paycheck - _____

*Reduction for age applies to Basic Life and AD&D at age 65 and 70. The benefit reduces to 65%
at age 65 and to 50% at age 70. Reduction for age does NOT apply to Optional Life and AD&D for
either the Employee or Spouse. 40