Page 74 - Texas Rangers 2022 Front Office Flipbook

Term Life and Accidental Death & Dismemberment (AD&D) Insurance

How much coverage can I get?

Calculate your costs
1 2 3 4
1. Enter the coverage
amount you want. Employee $______,000 ÷ $10,000 = $________ X $______ = $_______
2. Divide by the amount Spouse $______,000 ÷ $5,000 = $________ X $______ = $_______
shown.
3. Multiply by the rate. Child $______,000 ÷ $10,000 = $________ X $______ = $_______
Use the rate table (at Total cost
right) to find the rate
based on age.
(Choose the age you will
be when your coverage
becomes effective on
01/01/2022. To determine Employee monthly rate Spouse monthly rate Child monthly rate
your spouse rate, choose
the age the employee will Per $10,000 Per $5,000 $2.000 per $10,000 of
be when coverage becomes Age of coverage of coverage coverage
effective on 01/01/2022.) Cost Cost
4. Enter your cost. 15-24 $0.660 $0.185
25-29 $0.620 $0.240
30-34 $0.770 $0.350
35-39 $1.160 $0.530
40-44 $1.710 $0.805
45-49 $2.860 $1.235
50-54 $4.640 $1.830
55-59 $7.630 $2.645
60-64 $9.940 $3.585
65-69 $15.610 $5.175
70-74 $27.489 $9.790
75+ $45.331 $30.265

1. Enter the AD&D AD&D 1 2 3 4
coverage amount
you want. Employee $______,000 ÷ $10,000 = $________ X $0.200 = $_______
2. Divide by the amount Spouse $______,000 ÷ $5,000 = $________ X $0.100 = $_______
shown.
Child $______,000 ÷ $10,000 = $________ X $0.100 = $_______
3. Multiply by the rate.
Use the AD&D rate Total cost
table (at right) to find
the rate.
4. Enter your cost.

AD&D monthly rates
Coverage amount Rate
Employee per $10,000 of coverage $0.200
Spouse per $5,000 of coverage $0.100
Child per $10,000 of coverage $0.100

Billed amount may vary slightly.
If you apply for coverage above the guaranteed issue amount, you will be asked health-related questions which may affect your ability to get the larger coverage amount. In order to
purchase coverage for your dependents, you must buy coverage for yourself. Coverage amounts cannot exceed 100% of your coverage amounts.
EN-1976 FOR EMPLOYEES (4-21) 656923