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Voluntary Dependent Life and AD&D Insurance 2017 Beneits Enrollment

If you elect voluntary life coverage for yourself, you can also elect voluntary life
coverage for your spouse and dependent children. This coverage offers inancial
protection to you in the event of your covered family member’s death. You pay the
full cost of the premium with after-tax dollars.

Voluntary Dependent Life and AD&D Insurance At-a-Glance

X Spouse life/AD&D—increments of $5,000 up to $250,000
Z Spouses are guaranteed up to $30,000 without submitting EOI

X Child life only—$10,000

Note: you cannot elect spousal or child life insurance greater than your own total
voluntary life insurance value.

Voluntary Life Rates

Paid on an after-tax basis via payroll deduction.

Employee and Spouse Child(ren)
Voluntary Life & AD&D Rates Voluntary Life Rates
Benefit Amount Per Flat Amount Per Total
Age Per $1,000 Dependent Dependents
Under 25 $.095
25–29 $.095
30–34 $.115
35–39 $.125
40–44 $.175
45–49 $.255 $10,000 $2.00
50–54 $.385
55–59 $.615
60–64 $.915
65–69 $1.475
70–74 $3.815
75+ $3.815

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