Page 12 - 2018 USI Enrollment
P. 12
Additional Life Insurance
Evidence of Insurability (EOI) or proof The University offers an additional life insurance with competitive group
of good health is required under the rates so you can purchase additional inancial protection you need for
following circumstances. you and your family. This voluntary beneit is available to regular (non-
X Late entrant: you have temporary) full-time employees.
previously waived the opportunity
to elect this coverage and are For Yourself
now electing coverage for the irst Beneit Amount $10,000 increments
time Beneit Up to $500,000
Guarantee Issue Amount* Up to $200,000
X Current participant: you For Your Spouse
currently have this coverage and Beneit Amount $5,000 increments
are requesting an increase to Beneit Up to $200,000 not to exceed 50% of employee’s elected
your current coverage amount amount
Guarantee Issue Amount* Up to $50,000
X New hires: you are electing For Your Child(ren)
this coverage within the irst 30 Beneit Amount $10,000 not to exceed 50% of employee’s elected
days of employment and you are amount
requesting coverage over the
guarantee issue amount How Much Your Additional Life Coverage Will Cost Per
Month
Age Employee and Spouse Rate Per $1,000 of Coverage
Cost of Coverage <25 $0.039
Your premium rate will depend on 25–29 $0.040
$0.041
30–34
your age. Spouse rates will be based 35–39 $0.047
on the spouse’s age. 40–44 $0.070
45–49 $0.101
50–54 $0.171
55–59 $0.281
60–64 $0.382
65–69 $0.680
70+ $1.484
Child Monthly Cost Per $1,000 of Coverage
$10,000 $0.05
Cost Calculation Example
Rate Per $1,000 Beneit Amount Estimated Monthly Cost
Employee Age 33 $0.041 × $100,000 ÷ 1,000 = $4.10
Coverage will not take effect until approved by the carrier. Age reductions will apply to beneit amounts and guarantee issue amounts.
* The guarantee issue amount is available for new hires only. If you do not elect this coverage within the irst 31 days of becoming irst eligible,
you will be required to submit evidence of insurability (EOI) or proof of good health to enroll at a later date.
12 2018 Benefits Enrollment
Evidence of Insurability (EOI) or proof The University offers an additional life insurance with competitive group
of good health is required under the rates so you can purchase additional inancial protection you need for
following circumstances. you and your family. This voluntary beneit is available to regular (non-
X Late entrant: you have temporary) full-time employees.
previously waived the opportunity
to elect this coverage and are For Yourself
now electing coverage for the irst Beneit Amount $10,000 increments
time Beneit Up to $500,000
Guarantee Issue Amount* Up to $200,000
X Current participant: you For Your Spouse
currently have this coverage and Beneit Amount $5,000 increments
are requesting an increase to Beneit Up to $200,000 not to exceed 50% of employee’s elected
your current coverage amount amount
Guarantee Issue Amount* Up to $50,000
X New hires: you are electing For Your Child(ren)
this coverage within the irst 30 Beneit Amount $10,000 not to exceed 50% of employee’s elected
days of employment and you are amount
requesting coverage over the
guarantee issue amount How Much Your Additional Life Coverage Will Cost Per
Month
Age Employee and Spouse Rate Per $1,000 of Coverage
Cost of Coverage <25 $0.039
Your premium rate will depend on 25–29 $0.040
$0.041
30–34
your age. Spouse rates will be based 35–39 $0.047
on the spouse’s age. 40–44 $0.070
45–49 $0.101
50–54 $0.171
55–59 $0.281
60–64 $0.382
65–69 $0.680
70+ $1.484
Child Monthly Cost Per $1,000 of Coverage
$10,000 $0.05
Cost Calculation Example
Rate Per $1,000 Beneit Amount Estimated Monthly Cost
Employee Age 33 $0.041 × $100,000 ÷ 1,000 = $4.10
Coverage will not take effect until approved by the carrier. Age reductions will apply to beneit amounts and guarantee issue amounts.
* The guarantee issue amount is available for new hires only. If you do not elect this coverage within the irst 31 days of becoming irst eligible,
you will be required to submit evidence of insurability (EOI) or proof of good health to enroll at a later date.
12 2018 Benefits Enrollment