Plan Documents / Forms
Plan administrator number 1119934
If you want to participate, you must elect or already have coverage for yourself under the voluntary term life insurance benefit.
Enrollment Note
Your dependent's benefit amount cannot exceed 100 percent of your benefit amount. For example, if your salary is $40,000 and you elect one-half times your salary in voluntary term life for yourself, you must elect $20,000 or less for your spouse.
Coverage
You may choose one of the following plans.
| Coverage Option | Coverage Amount | 2022 Monthly Rate |
|---|---|---|
| Spouse/partner only | $10,000 | $3.49 |
| $20,000 | $6.66 | |
| $40,000 | $12.71 | |
| Dependent only (per child) |
$5,000 per child | $1.02 |
| $10,000 per child | $1.94 | |
| $20,000 per child | $3.69 | |
|
Spouse/partner and dependent |
$10,000 spouse/partner; $5,000 per child | $4.51 |
| $20,000 spouse/partner; $10,000 per child | $8.60 | |
| $40,000 spouse/partner; $20,000 per child | $16.40 |
This premium may only be paid after-tax as a deduction from your net pay.
As noted, each selection gives your spouse and/or dependents life insurance. The employee will always be the beneficiary in the death of a spouse and/or dependent. The contingent beneficiary will always be the insured's estate.
Have a Question?
The information presented on our website describes only the highlights of the plans and does not constitute official plan documents. Additional terms and conditions may apply. If there are any discrepancies between the information contained herein and the official plan documents, the plan documents will govern.