Page 21 - Dawson 2021 New Hire Guide
P. 21
2021 Benefits Guide
Rates apply to both employee and spouse—spouse rate Evidence of Insurability
based on spouse age. Children under 26 $0.145/$1,000 If you do not elect coverage for yourself or your
per month. spouse during your new hire enrollment period and
The ADP/WFN enrollment system will automatically want to elect coverage at a later date, you will be
calculate the cost per pay period of your elected required to complete evidence of insurability (EOI).
voluntary life and AD&D coverage as follows. If you elect coverage for yourself and/or your spouse
1. You select the amount of additional insurance you during your new hire eligibility period, each year at
want to purchase open enrollment you may increase your coverage by
2. Using the rate based on your age two $10,000 increments and your spouse’s coverage
by two $5,000 increments (up to the guaranteed issue
3. And the following formula to calculate your level shown on page 20), without completing EOI.
monthly premium amount: Any increase above $20,000 for employee coverage or
Coverage amount/1,000 × rate = monthly $10,000 for spouse coverage requires completion of
premium evidence of insurability.
Example: 45 year old elects to purchase an
additional $100,000 of voluntary life and
AD&D insurance
$100,000/1,000 × $0.14 = $14.00; the
amount of premium equals $14.00 per
month. The bi-weekly per pay period cost is
$7.00. The weekly pay period cost is $3.23.
Your premium is paid for on an after-tax basis. If you
have a birthday during the plan year which takes you to
a higher rate, your premium rate will not change until
January 1 following your birthday.
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Rates apply to both employee and spouse—spouse rate Evidence of Insurability
based on spouse age. Children under 26 $0.145/$1,000 If you do not elect coverage for yourself or your
per month. spouse during your new hire enrollment period and
The ADP/WFN enrollment system will automatically want to elect coverage at a later date, you will be
calculate the cost per pay period of your elected required to complete evidence of insurability (EOI).
voluntary life and AD&D coverage as follows. If you elect coverage for yourself and/or your spouse
1. You select the amount of additional insurance you during your new hire eligibility period, each year at
want to purchase open enrollment you may increase your coverage by
2. Using the rate based on your age two $10,000 increments and your spouse’s coverage
by two $5,000 increments (up to the guaranteed issue
3. And the following formula to calculate your level shown on page 20), without completing EOI.
monthly premium amount: Any increase above $20,000 for employee coverage or
Coverage amount/1,000 × rate = monthly $10,000 for spouse coverage requires completion of
premium evidence of insurability.
Example: 45 year old elects to purchase an
additional $100,000 of voluntary life and
AD&D insurance
$100,000/1,000 × $0.14 = $14.00; the
amount of premium equals $14.00 per
month. The bi-weekly per pay period cost is
$7.00. The weekly pay period cost is $3.23.
Your premium is paid for on an after-tax basis. If you
have a birthday during the plan year which takes you to
a higher rate, your premium rate will not change until
January 1 following your birthday.
21
