Page 13 - 2021 Dreyer's Benefits Guide

VOLUNTARY LIFE INSURANCE – FOR YOUR DEPENDENTS

Voluntary Life insurance for your dependents can help protect VOLUNTARY LIFE RATES FOR
your family during difficult times. Employees must purchase EMPLOYEE/SPOUSE
Voluntary Life coverage for themselves in order to purchase AGE MONTHLY RATES PER $1,000
Voluntary Life coverage for their spouse and/or child(ren). Child Rate $0.10
Under 25 $0.040
VOLUNTARY LIFE INSURANCE – FOR YOUR DEPENDENTS 25–29 $0.050
30–34 $0.060
EVIDENCE OF
COVERAGE LEVEL COVERAGE AMOUNT INSURABILITY/PROOF 35–39 $0.080
OF GOOD HEALTH
40–44 $0.090
Increments of $5,000 up to $250,000 – 45–49 $0.115
Spouse $25,000
not to exceed 50% of Employee coverage 50–54 $0.210
55–59 $0.375
Child Benefit < 6 months = $1,000
Child(ren) None 60–64 $0.585
Child Benefit > 6 months = $10,000
65–69 $0.950
70+ $1.750

VOLUNTARY AD&D INSURANCE – FOR YOUR DEPENDENTS

Employees must purchase Voluntary AD&D coverage for themselves in order to purchase Voluntary AD&D
coverage for their spouse and/or child(ren).

VOLUNTARY AD&D INSURANCE – FOR YOUR DEPENDENTS

COVERAGE LEVEL COVERAGE AMOUNT EVIDENCE OF INSURABILITY/PROOF OF GOOD HEALTH
Increments of $5,000 up to $250,000 –
Spouse not to exceed 50% of Employee coverage None

Child Benefit < 6 months = $1,000
Child(ren) None
Child Benefit > 6 months = $10,000

Voluntary AD&D is optional for Employee, Spouse and Child, and the rate is $0.020 per $1,000 of coverage.

GUARANTEED ISSUE AND EVIDENCE OF INSURABILITY

Employees and spouses who elect coverage when first eligible can elect up to the Guaranteed Issue (GI)
amount without Evidence of Insurability (EOI). If the amount requested is more than GI, you will need to
provide EOI before the amount over GI becomes effective.
IMPUTED INCOME

Under current tax laws, imputed income is the value of your Basic Life insurance that exceeds $50,000 and
is subject to federal income, Social Security, and state income taxes, if applicable. This imputed income
amount will be included in your paycheck and shown on your W-2 statement.

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LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) INSURANCE