Page 22 - KIPP NYC 2022 Benfits Summary

Supplemental Employee and Dependent Life and AD&D Insurance
In addition to the basic life insurance paid by KIPP NYC, you may purchase supplemental life insurance, insured by Prudential, to be paid to your beneficiaries in the event of your death. If you do not purchase coverage when you are first eligible as a new hire, or when you are newly eligible due to an employment status change, you must complete a medical questionnaire (Evidence of Insurability form). A physical examination may be required, prior to being approved by Prudential for the full benefit amount.
You may purchase supplemental life insurance in increments of $10,000, up to a maximum benefit of the lesser of 5x base salary or $500,000. During annual enrollment, any increase to your current benefit level will be subject to Evidence of Insurability. This benefit is paid in full by the employee on a post-tax basis.
Portability and/or conversion are available upon termination of employment or an employment status change which results in a loss or reduction of benefits. Benefits reduce to 65% of the original amount at age 65; to 50% of original amount at
age 70.
EMPLOYEE & SPOUSE LIFE RATE CHART
Age
Monthly Rate per $1,000
<25 $0.05
25–29 $0.06
30–34 $0.07
35–39 $0.09 40–44 $0.10 45–49 $0.15 50–54 $0.23
55–59 $0.42 60–64 $0.62 65–69 $1.00 70–74 $1.50
75+ $2.00
Example
Salary: $49,500
Elected Benefit (increment of $10,000): $50,000 Age: 27
$0.06 / $1,000 X $50,000 = $3.00
$3.00 would be your monthly premium. To calculate your semi-monthly (per pay) premium, divide your monthly premium by two.
(Supplemental Life Maximum: $500,000) (Guaranteed issue: $200,000)
NOTE: Your premium will change as of the first of the month following your birthday, should you enter the next age bracket. Use the rate chart above to calculate your new premium, to be deducted from your paycheck on a post-tax basis.
Supplemental Life Premium Calculation:
Rate/$1,000 x Elected Benefit Amount = Monthly Premium
In addition to buying supplemental life insurance over and above the basic life insurance provided by KIPP NYC, through Prudential, you have the option to buy AD&D insurance for yourself and life and AD&D insurance for your spouse and dependent children. You must purchase coverage for yourself to be eligible to purchase coverage for your dependents. You must also purchase supplemental life to be eligible to purchase supplemental AD&D. If you do not purchase dependent life coverage when you are first eligible, your dependent must complete a medical questionnaire (Evidence of Insurability form). A physical examination may be required, prior to being approved by Prudential for the full benefit amount. You have the option to purchase the benefits on the following page.
22 KIPP NYC PUBLIC SCHOOLS