Voluntary Life and Accidental Death and Dismemberment (AD&D) coverage allows you to purchase additional financial security for your family. This optional coverage is also available for your spouse and/or child(ren), if you purchase it for yourself.
Employee Life / AD&D Coverage
- Elect Increments of $10,000
- Maximum coverage: $500,000
- Guaranteed Issue, if under age 60: $150,000
If you wish to elect voluntary Life/AD&D coverage for you and/or your dependents, your monthly rate is calculated based on your age and the amount of coverage.
Coverage amounts | Employee Age |
||||||
|---|---|---|---|---|---|---|---|
| 0-19 | 20-24 | 25-29 | 30-34 | 35-39 | 40-44 | 45-49 | |
| $10,000 | $0.44 | $0.44 | $0.51 | $0.63 | $0.88 | $1.21 | $1.94 |
| $20,000 | $0.88 | $0.88 | $1.02 | $1.26 | $1.76 | $2.42 | $3.88 |
| $30,000 | $1.32 | $1.32 | $1.53 | $1.89 | $2.64 | $3.63 | $5.82 |
| $40,000 | $1.76 | $1.76 | $2.04 | $2.52 | $3.52 | $4.84 | $7.76 |
| $50,000 | $2.20 | $2.20 | $2.55 | $3.15 | $4.40 | $6.05 | $9.70 |
| $60,000 | $2.64 | $2.64 | $3.06 | $3.78 | $5.28 | $7.26 | $11.64 |
| $70,000 | $3.08 | $3.08 | $3.57 | $4.41 | $6.16 | $8.47 | $13.58 |
| $80,000 | $3.52 | $3.52 | $4.08 | $5.04 | $7.04 | $9.68 | $15.52 |
| $90,000 | $3.96 | $3.96 | $4.59 | $5.67 | $7.92 | $10.89 | $17.46 |
| $100,000 | $4.40 | $4.40 | $5.10 | $6.30 | $8.80 | $12.10 | $19.40 |
| $110,000 | $4.84 | $4.84 | $5.61 | $6.93 | $9.68 | $13.31 | $21.34 |
| $120,000 | $5.28 | $5.28 | $6.12 | $7.56 | $10.56 | $14.52 | $23.28 |
| $130,000 | $5.72 | $5.72 | $6.63 | $8.19 | $11.44 | $15.73 | $25.22 |
| $140,000 | $6.16 | $6.16 | $7.14 | $8.82 | $12.32 | $16.94 | $27.16 |
| $150,000 | $6.60 | $6.60 | $7.65 | $9.45 | $13.20 | $18.15 | $29.10 |
| $160,000 | $7.04 | $7.04 | $8.16 | $10.08 | $14.08 | $19.36 | $31.04 |
| $170,000 | $7.48 | $7.48 | $8.67 | $10.71 | $14.96 | $20.57 | $32.98 |
| $210,000 | $9.24 | $9.24 | $10.71 | $13.23 | $18.48 | $25.41 | $40.74 |
| $250,000 | $11.00 | $11.00 | $12.75 | $15.75 | $22.00 | $30.25 | $48.50 |
| $290,000 | $12.76 | $12.76 | $14.79 | $18.27 | $25.52 | $35.09 | $56.26 |
| $330,000 | $14.52 | $14.52 | $16.83 | $20.79 | $29.04 | $39.93 | $64.02 |
| $370,000 | $16.28 | $16.28 | $18.87 | $23.31 | $32.56 | $44.77 | $71.78 |
| $410,000 | $18.04 | $18.04 | $20.91 | $25.83 | $36.08 | $49.61 | $79.54 |
| $450,000 | $19.80 | $19.80 | $22.95 | $28.35 | $39.60 | $54.45 | $87.30 |
| $500,000 | $22.00 | $22.00 | $25.50 | $31.50 | $44.00 | $60.50 | $97.00 |
Coverage amounts | Employee Age |
||||||
|---|---|---|---|---|---|---|---|
| 50-54 | 55-59 | 60-64 | 65-69 | 70-74 | 75-79 | 80-84 | |
| $10,000 | $2.98 | $4.86 | $7.76 | $13.61 | $49.73 | $49.73 | $49.73 |
| $20,000 | $5.96 | $9.72 | $15.52 | $27.22 | $99.46 | $99.46 | $99.46 |
| $30,000 | $8.94 | $14.58 | $23.28 | $40.83 | $149.19 | $149.19 | $149.19 |
| $40,000 | $11.92 | $19.44 | $31.04 | $54.44 | $198.92 | $198.92 | $198.92 |
| $50,000 | $14.90 | $24.30 | $38.80 | $68.05 | $248.65 | $248.65 | $248.65 |
| $60,000 | $17.88 | $29.16 | $46.56 | $81.66 | $298.38 | $298.38 | $298.38 |
| $70,000 | $20.86 | $34.02 | $54.32 | $95.27 | $348.11 | $348.11 | $348.11 |
| $80,000 | $23.84 | $38.88 | $62.08 | $108.88 | $397.84 | $397.84 | $397.84 |
| $90,000 | $26.82 | $43.74 | $69.84 | $122.49 | $447.57 | $447.57 | $447.57 |
| $100,000 | $29.80 | $48.60 | $77.60 | $136.10 | $497.30 | $497.30 | $497.30 |
| $110,000 | $32.78 | $53.46 | $85.36 | $149.71 | $547.03 | $547.03 | $547.03 |
| $120,000 | $35.76 | $58.32 | $93.12 | $163.32 | $596.76 | $596.76 | $596.76 |
| $130,000 | $38.74 | $63.18 | $100.88 | $176.93 | $646.49 | $646.49 | $646.49 |
| $140,000 | $41.72 | $68.04 | $108.64 | $190.54 | $696.22 | $696.22 | $696.22 |
| $150,000 | $44.70 | $72.90 | $116.40 | $204.15 | $745.95 | $745.95 | $745.95 |
| $160,000 | $47.68 | $77.76 | $124.16 | $217.76 | $795.68 | $795.68 | $795.68 |
| $170,000 | $50.66 | $82.62 | $131.92 | $231.37 | $845.41 | $845.41 | $845.41 |
| $210,000 | $62.58 | $102.06 | $162.96 | $285.81 | $1,044.33 | $1,044.33 | $1,044.33 |
| $250,000 | $74.50 | $121.50 | $194.00 | $340.25 | $1,243.25 | $1,243.25 | $1,243.25 |
| $290,000 | $86.42 | $140.94 | $225.04 | $394.69 | $1,442.17 | $1,442.17 | $1,442.17 |
| $330,000 | $98.34 | $160.38 | $256.08 | $449.13 | $1,641.09 | $1,641.09 | $1,641.09 |
| $370,000 | $110.26 | $179.82 | $287.12 | $503.57 | $1,840.01 | $1,840.01 | $1,840.01 |
| $410,000 | $122.18 | $199.26 | $318.16 | $558.01 | $2,038.93 | $2,038.93 | $2,038.93 |
| $450,000 | $134.10 | $218.70 | $349.20 | $612.45 | $2,237.85 | $2,237.85 | $2,237.85 |
| $500,000 | $149.00 | $243.00 | $388.00 | $680.50 | $2,486.50 | $2,486.50 | $2,486.50 |
Spouse Life / AD&D Coverage
- Available if you, as an employee, enroll in the Voluntary Life / AD&D Coverage
- Elect Increments of $5,000
- Maximum coverage: Up to 50% of the Employee amount, i.e., $250,000
- Guaranteed Issue: $5,000
If you wish to elect voluntary Life/AD&D coverage for your spouse, your monthly rate is calculated based on your spouse’s age and the amount of coverage.
Coverage amounts | Spouse Age |
|||||
|---|---|---|---|---|---|---|
| 0-19 | 20-24 | 25-29 | 30-34 | 35-39 | 40-44 | |
| $5,000 | $0.31 | $0.31 | $0.35 | $0.44 | $0.64 | $0.92 |
| $10,000 | $0.61 | $0.61 | $0.70 | $0.88 | $1.28 | $1.83 |
| $15,000 | $0.92 | $0.92 | $1.05 | $1.32 | $1.92 | $2.75 |
| $20,000 | $1.22 | $1.22 | $1.40 | $1.76 | $2.56 | $3.66 |
| $25,000 | $1.53 | $1.53 | $1.75 | $2.20 | $3.20 | $4.58 |
| $30,000 | $1.83 | $1.83 | $2.10 | $2.64 | $3.84 | $5.49 |
| $35,000 | $2.14 | $2.14 | $2.45 | $3.08 | $4.48 | $6.41 |
| $40,000 | $2.44 | $2.44 | $2.80 | $3.52 | $5.12 | $7.32 |
| $45,000 | $2.75 | $2.75 | $3.15 | $3.96 | $5.76 | $8.24 |
| $50,000 | $3.05 | $3.05 | $3.50 | $4.40 | $6.40 | $9.15 |
| $55,000 | $3.36 | $3.36 | $3.85 | $4.84 | $7.04 | $10.07 |
| $60,000 | $3.66 | $3.66 | $4.20 | $5.28 | $7.68 | $10.98 |
| $65,000 | $3.97 | $3.97 | $4.55 | $5.72 | $8.32 | $11.90 |
| $70,000 | $4.27 | $4.27 | $4.90 | $6.16 | $8.96 | $12.81 |
| $75,000 | $4.58 | $4.58 | $5.25 | $6.60 | $9.60 | $13.73 |
| $80,000 | $4.88 | $4.88 | $5.60 | $7.04 | $10.24 | $14.64 |
| $85,000 | $5.19 | $5.19 | $5.95 | $7.48 | $10.88 | $15.56 |
| $105,000 | $6.41 | $6.41 | $7.35 | $9.24 | $13.44 | $19.22 |
| $125,000 | $7.63 | $7.63 | $8.75 | $11.00 | $16.00 | $22.88 |
| $145,000 | $8.85 | $8.85 | $10.15 | $12.76 | $18.56 | $26.54 |
| $165,000 | $10.07 | $10.07 | $11.55 | $14.52 | $21.12 | $30.20 |
| $185,000 | $11.29 | $11.29 | $12.95 | $16.28 | $23.68 | $33.86 |
| $205,000 | $12.51 | $12.51 | $14.35 | $18.04 | $26.24 | $37.52 |
| $225,000 | $13.73 | $13.73 | $15.75 | $19.80 | $28.80 | $41.18 |
| $250,000 | $15.25 | $15.25 | $17.50 | $22.00 | $32.00 | $45.75 |
Coverage amounts | Spouse Age |
|||||
|---|---|---|---|---|---|---|
| 50-54 | 55-59 | 60-64 | 65-69 | 70-74 | 75-84 | |
| $5,000 | $2.24 | $3.43 | $5.86 | $10.01 | $17.83 | $35.70 |
| $10,000 | $4.47 | $6.85 | $11.71 | $20.01 | $35.65 | $71.40 |
| $15,000 | $6.71 | $10.28 | $17.57 | $30.02 | $53.48 | $107.10 |
| $20,000 | $8.94 | $13.70 | $23.42 | $40.02 | $71.30 | $142.80 |
| $25,000 | $11.18 | $17.13 | $29.28 | $50.03 | $89.13 | $178.50 |
| $30,000 | $13.41 | $20.55 | $35.13 | $60.03 | $106.95 | $214.20 |
| $35,000 | $15.65 | $23.98 | $40.99 | $70.04 | $124.78 | $249.90 |
| $40,000 | $17.88 | $27.40 | $46.84 | $80.04 | $142.60 | $285.60 |
| $45,000 | $20.12 | $30.83 | $52.70 | $90.05 | $160.43 | $321.30 |
| $50,000 | $22.35 | $34.25 | $58.55 | $100.05 | $178.25 | $357.00 |
| $55,000 | $24.59 | $37.68 | $64.41 | $110.06 | $196.08 | $392.70 |
| $60,000 | $26.82 | $41.10 | $70.26 | $120.06 | $213.90 | $428.40 |
| $65,000 | $29.06 | $44.53 | $76.12 | $130.07 | $231.73 | $464.10 |
| $70,000 | $31.29 | $47.95 | $81.97 | $140.07 | $249.55 | $499.80 |
| $75,000 | $33.53 | $51.38 | $87.83 | $150.08 | $267.38 | $535.50 |
| $80,000 | $35.76 | $54.80 | $93.68 | $160.08 | $285.20 | $571.20 |
| $85,000 | $38.00 | $58.23 | $99.54 | $170.09 | $303.03 | $606.90 |
| $105,000 | $46.94 | $71.93 | $122.96 | $210.11 | $374.33 | $749.70 |
| $125,000 | $55.88 | $85.63 | $146.38 | $250.13 | $445.63 | $892.50 |
| $145,000 | $64.82 | $99.33 | $169.80 | $290.15 | $516.93 | $1,035.30 |
| $165,000 | $73.76 | $113.03 | $193.22 | $330.17 | $588.23 | $1,178.10 |
| $185,000 | $82.70 | $126.73 | $216.64 | $370.19 | $659.53 | $1,320.90 |
| $205,000 | $91.64 | $140.43 | $240.06 | $410.21 | $730.83 | $1,463.70 |
| $225,000 | $100.58 | $154.13 | $263.48 | $450.23 | $802.13 | $1,606.50 |
| $250,000 | $111.75 | $171.25 | $292.75 | $500.25 | $891.25 | $1,785.00 |
Child Life / AD&D Coverage
- Available if you, as an employee, enroll in the Voluntary Life / AD&D Coverage
- Coverage amount of a child from 15 days to 6 months of age: $1,000
- Coverage amount of a child from 15 days to 26 years: Elect Increments: $1,000
- Maximum coverage: $10,000
- Guaranteed Issue: $10,000
If you wish to elect voluntary Life/AD&D coverage for your children, your monthly rate is calculated based on your children’s age and the amount of coverage.
Coverage Amount | Premium |
|---|---|
| $1,000 | $0.34 |
| $2,000 | $0.68 |
| $3,000 | $1.03 |
| $4,000 | $1.37 |
| $5,000 | $1.71 |
| $6,000 | $2.05 |
| $7,000 | $2.39 |
| $8,000 | $2.74 |
| $9,000 | $3.08 |
| $10,000 | $3.42 |
Designate Your Beneficiary
Please designate a beneficiary for your life insurance coverage including voluntary elections. If a beneficiary is not designated, benefits will be paid according to the carrier policy
Evidence of Insurability
You may be asked to provide Evidence of Insurability (EOI) form, if:
- You do not enroll for coverage during your initial eligibility period as a new hire.
- You want to increase your coverage during company’s open enrollment or a qualifying event after your initial enrollment.
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