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BASIC LIFE/ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) - MUTUAL OF OMAHA
• Employee: One times annual salary up to $300,000.
• CPI pays the premium for employee coverage. The coverage amount is based on salary. Coverage amounts above
$50k per year are subject to imputed income tax.
• AD&D coverage is equal to your life insurance coverage and provides benefits in certain accidental events.
LONG TERM DISABILITY (LTD) - MUTUAL OF OMAHA
• 60% of your monthly before tax salary, up to $5,000.
• CPI pays the premium for employee coverage. The coverage amount is based on salary.
• Elimination period is 180 days after the date of your disability and will continue until normal Social Security
retirement age (provided qualification continues).
VOLUNTARY LIFE/AD&D - MUTUAL OF OMAHA
Voluntary Life may be purchased by the employee through payroll deduction. The employee, spouse, and/or dependents
(child(ren) age 14 days to 26 years) may need to qualify for benefits.
Employee Only:
7X annual salary, up to $350,000 coverage maximum
Guarantee Issue:
Up to $100,000 (for new hires)
Spouse:
50% of employee benefit, up to $100,000 in $5,000 increments
Guarantee Issue:
Up to $30,000 (for new hires)
Child(ren):
50% of employee benefit, up to $10,000 in $2,000 increments
Guarantee Issue:
Up to $10,000 (for new hires)
SEMI-MONTHLY PREMIUM RATE TABLE
ATTAINED AGE
EMPLOYEE PER
$10,000
SPOUSE PER
$5,000
CHILD PER
$2,000
Less than 25
$0.43
$0.21
$0.20
regardless of number of
children
25-29
$0.43
$0.21
30-34
$0.43
$0.21
35-39
$0.58
$0.29
40-44
$0.83
$0.41
45-49
$1.33
$0.66
50-54
$1.88
$0.94
55-59
$2.73
$1.36
60-64
$4.43
$2.21
65-69
$7.93
$3.96
70-74
$11.13
75-79
$23.88
80+
$23.88
Note: Spouse rates are based on spouse’s birth date.