Employee Benefits
Life Insurance 2005
Who’s Eligible?
Permanent Employees, Part-time Faculty teaching 50% or more for two consecutive
quarters, Lawful Spouse or Qualified Same Sex Domestic Partner (SSDP), Dependent
Children.
Effective Date of Coverage
*If you’re eligible, your coverage begins on the first of the month following
the date of employment (if the date of employment is on the first working day of
a month, coverage begins on the date of employment).
NOTE: (Part A - Basic Term Life and AD&D only)
*If you apply for Part B, C and/or D coverage within 60 days after your date of
eligibility, coverage becomes effective the first of the month following the
signature date on the enrollment form.
*Part E shall become effective on the first day of the calendar month following
the month in which such application is made.
Program Summary
Part A – Basic Term Life and Accidental Death & Dismemberment Insurance for
Employees ($25,000 Life and $5000 AD&D) Employer Provided
Part B - Basic Dependent Term Life Insurance ($2500 per dependent)
Part B – Supplemental Spouse Term Life Insurance
Part C – Optional Term Life Insurance for Employees
Part D – Supplemental Term Life Insurance for Employees
Part E – Voluntary Accidental Death & Dismemberment Insurance
Rates
Part A Basic
|
Retirees |
Employees |
Self-pay |
|
$2.19
|
$2.75
(employer-paid) |
$2.75
|
Part B Supplemental, Part C Optional, and Part D Supplemental Insurance
|
Employee's age |
Cost per $1,000 per month |
|
Non-smoker |
Smoker |
|
Under 25 |
$0.030 |
$0.036 |
|
25-29 |
0.032 |
0.040 |
|
30-34 |
0.034 |
0.054 |
|
35-39 |
0.042 |
0.068 |
|
40-44 |
0.062 |
0.068 |
|
45-49 |
0.088 |
0.102 |
|
50-54 |
0.138 |
0.162 |
|
55-59 |
0.258 |
0.302 |
|
60-64 |
0.382 |
0.462 |
|
65-69 |
0.726 |
0.890 |
|
70+ |
1.058 |
1.444 |
(Your premium rate changes to the next higher rate as you reach each new age
bracket.)
Please note: Part B Basic for dependents is $.48.
Part E - Accidental Death and Dismemberment
|
Employee AD&D benefit |
Cost to cover only yourself |
Cost to cover you
& your dependents |
Coverage your spouse/
SSDP
would have: |
Coverage your children would
have: |
|
With no children |
With children |
If you have a spouse/
SSDP |
If you have no spouse/
SSDP |
|
$ 25,000 |
$0.30 |
$0.40 |
$ 12,500 |
$ 10,000 |
$ 1,250 |
$ 2,500 |
|
50,000 |
.60 |
.80 |
25,000 |
20,000 |
2,500 |
5,000 |
|
75,000 |
0.90 |
1.20 |
37,500 |
30,000 |
3,750 |
7,500 |
|
100,000 |
1.20 |
1.60 |
50,000 |
40,000 |
5,000 |
10,000 |
|
125,000 |
1.50 |
2.00 |
62,500 |
50,000 |
6,250 |
12,500 |
|
150,000 |
1.80 |
2.40 |
75,000 |
60,000 |
7,500 |
15,000 |
|
175,000 |
2.10 |
2.80 |
87,500 |
70,000 |
8,750 |
17,500 |
|
200,000 |
2.40 |
3.20 |
100,000 |
80,000 |
10,000 |
20,000 |
|
225,000 |
2.70 |
3.60 |
112,500 |
90,000 |
11,250 |
22,500 |
|
250,000 |
3.00 |
4.00 |
125,000 |
100,000 |
12,500 |
25,000 |
|
