Page 15 - 2019 CareHere Enrollment Guide
P. 15
CAREHERE
Voluntary Life Insurance Post-Tax If you elected coverage when
Contributions (Full-Time Employees Only) initially eligible, each year at
Voluntary Employee and Spouse Life Rates open enrollment, you may
Based on amount elected and employee age. Divide amount elected for increase your coverage amount
each plan by $1,000 and multiply by the following amount, based on your by $10,000 or $20,000 up to
age as of January 1, 2019 to calculate your monthly rate. For your bi-weekly the guaranteed issue amount of
rate, multiply that number by 12 and divide by 26. $200,000 without completing
Age Per $1,000 Age Per $1,000 an evidence of insurability (EOI)
20-24 $0.063 50-54 $0.419 form. If you elected coverage
25-29 $0.072 55-59 $0.684 for your spouse when he/she
30-34 $0.089 60-64 $1.092 was initially eligible, you may
35-39 $0.123 65-69 $1.915 increase your spouse’s coverage
40-44 $0.171 70-74 $3.457 amount by $5,000 or $10,000
45-49 $0.273 75+ $6.999 up to the guaranteed issue
Child(ren) Voluntary Life Rates amount of $35,000. Each year at
Based on amount elected. Divide amount elected $1,000 and multiply by open enrollment, you may elect
$0.400 to calculate the monthly rate. For the bi-weekly rate, multiply that coverage for your dependent
number by 12 and divide by 26.
children without completing an
EOI form.
ADP will calculate your bi-weekly post-tax pay
period deductions based on your election If you do not elect coverage
for yourself or your spouse
when initially eligible, you must
complete an EOI form and be
approved for coverage.
15
Voluntary Life Insurance Post-Tax If you elected coverage when
Contributions (Full-Time Employees Only) initially eligible, each year at
Voluntary Employee and Spouse Life Rates open enrollment, you may
Based on amount elected and employee age. Divide amount elected for increase your coverage amount
each plan by $1,000 and multiply by the following amount, based on your by $10,000 or $20,000 up to
age as of January 1, 2019 to calculate your monthly rate. For your bi-weekly the guaranteed issue amount of
rate, multiply that number by 12 and divide by 26. $200,000 without completing
Age Per $1,000 Age Per $1,000 an evidence of insurability (EOI)
20-24 $0.063 50-54 $0.419 form. If you elected coverage
25-29 $0.072 55-59 $0.684 for your spouse when he/she
30-34 $0.089 60-64 $1.092 was initially eligible, you may
35-39 $0.123 65-69 $1.915 increase your spouse’s coverage
40-44 $0.171 70-74 $3.457 amount by $5,000 or $10,000
45-49 $0.273 75+ $6.999 up to the guaranteed issue
Child(ren) Voluntary Life Rates amount of $35,000. Each year at
Based on amount elected. Divide amount elected $1,000 and multiply by open enrollment, you may elect
$0.400 to calculate the monthly rate. For the bi-weekly rate, multiply that coverage for your dependent
number by 12 and divide by 26.
children without completing an
EOI form.
ADP will calculate your bi-weekly post-tax pay
period deductions based on your election If you do not elect coverage
for yourself or your spouse
when initially eligible, you must
complete an EOI form and be
approved for coverage.
15
