Page 22 - 2022 Drive Open Enrollment Guide - Non Union

Benefit costs

Voluntary LTD – Empire

Age Rate per $100 How to calculate your LTD Cost: Take your monthly pre-disability base
of Coverage salary rounded to the nearest dollar and divide it by 100 then multiply the
monthly number by 12 and divide by 52 for weekly and 26 for biweekly.
Under 30 $0.14
30-34 $0.22 An employee earns $2,500 a month and is 35 years old: $2,500/100*$.37
35-39 $0.37 = $9.25 monthly cost; $9.25*12/52=$2.13 weekly cost
40-44 $0.56
An employee earns $20,000 a month and is 35 years old, the benefit is
45-49 $0.77
capped at $16,677: $16,677/100*$.37=$61.70; $61.70*12/52=$14.24
50-54 $0.99 weekly cost
55-59 $1.20
60-64 $1.07 Note: Earnings are based on your monthly pre-disability base salary (plus
commissions for sales associates only).
65-69 $0.85
70-74 $0.73 Voluntary STD – Empire
75+ $0.73
Age Rate per $10
of Coverage
How to calculate your STD Cost: Take STD Example:
your annual pre-disability base salary, An employee earns $25,000 per year Under 30 $0.240
divide by 52 and multiple by 60%. This and is 35 years old: 30-34 $0.228
amount can be no more than the benefit $25,000/52=$480.76 35-39 $0.222
max of $1,000. Round the amount to $480.76*60%=$288.46 40-44
the next $10 and divide by 10 and Round to the nearest $10=$290 $0.234
multiple by the rate that corresponds to $290/$10=29 45-49 $0.270
your age. 29*$0.228 = $6.61 monthly cost; 50-54 $0.312
$6.61*12/26=$3.05 biweekly cost; 55-59 $0.396
$6.61*12/52=$1.53 weekly cost
60-64 $0.480
65-69 $0.546
Voluntary Life/AD&D – Empire 70-74 $0.654

75+ $0.654
Age Rate per $1,000
of Coverage How To Calculate Your Voluntary Life Payroll Deduction
Under 30 $0.071 Step 1: Select Life Insurance benefit amount
Step 2: Choose rate corresponding with your specific age band for you or
30-34 $0.071
your spouse
35-39 $0.101
Step 3: Multiply the rate by the coverage amount chosen and divide by
40-44 $0.161 $1,000. This will give you the total monthly cost for the benefit amount
45-49 $0.241 selected
50-54 $0.451
EXAMPLE: Coverage selected: $100,000, Age: 34
55-59 $0.701
$0.071 (Rate) X $100,000 (Coverage amount),
60-64 $0.761 Then divide by $1,000 = $7.10 monthly cost; $7.10*12/52=$1.64 weekly cost
65-69 $1.391
70-74 $2.841
75+ $8.131
Child Life $2.00 per $10,000

Please note: If you are in sales and receive a commission/bonus, please contact HR to determine your pre- 22
disability earnings.