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Supplemental Life & AD&D for Eligible Employees and Dependents - Mutual of Omaha
Voluntary Life is available at a cost to the employee through payroll deduction. The employee and/or dependents may
need to qualify for benefits. (Children up to age 26.)
Employee Only:
$10,000
up to
7x annual
salary up to $350,000 - *
Guarantee Issue
: 7x annual salary up to
$100,000
Spouse:
$5,000
up to
$100,000
not to exceed 50% of employee benefit - *
Guarantee Issue
:
$30,000
Child(ren):
$2,000
up to
$10,000
not to exceed 50% of employee benefit - *
Guarantee Issue:
$10,000
*Guarantee Issue Amount means the amount of life insurance Mutual of Omaha will issue without requiring Evidence of Insurability.
EMPLOYEE PER PAYCHECK PREMIUM RATE TABLE
AGE
$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
0-34
$0.43
$0.86
$1.29
$1.72
$2.15
$2.58
$3.01
$3.44
$3.87
$4.30
35-39
$0.58
$1.16
$1.74
$2.32
$2.90
$3.48
$4.06
$4.64
$5.22
$5.50
40-44
$0.83
$1.66
$2.49
$3.32
$4.15
$4.98
$5.81
$6.64
$7.47
$8.30
45-49
$1.33
$2.66
$3.99
$5.32
$6.65
$7.98
$9.31 $10.64
$11.97
$13.30
50-54
$1.88
$3.76
$5.64
$7.52
$9.40 $11.28 $13.16 $15.04
$16.92
$18.80
55-59
$2.73
$5.46
$8.19
$10.92
$13.65 $16.38 $19.11 $21.84
$24.57
$27.30
60-64
$4.43
$8.86
$13.29
$17.72
$22.15 $26.58 $31.01 $35.44
$39.87
$44.30
65-69
$7.93
$15.86
$23.79
$31.72
$39.65 $47.58 $55.51 $63.44
$71.37
$79.30
70-74
$11.13
$22.26
$33.39
$44.52
$55.65 $66.78 $77.91 $89.04 $100.17
$111.30
75+
$23.88
$47.76
$71.64
$95.52 $119.40 $143.28 $167.16 $191.04 $214.92
$238.80
SPOUSE PER PAYCHECK PREMIUM RATE TABLE
AGE
$5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000
$50,000
0-34
$0.21
$0.43
$0.64
$0.85
$1.06
$1.28
$1.49
$1.70
$1.91
$2.13
35-39
$0.29
$0.58
$0.87
$1.16
$1.45
$1.74
$2.03
$2.32
$2.61
$2.90
40-44
$0.41
$0.83
$1.24
$1.65
$2.06
$2.48
$2.89
$3.30
$3.71
$4.13
45-49
$0.66
$1.33
$1.99
$2.65
$3.31
$3.98
$4.64
$5.30
$5.96
$6.63
50-54
$0.94
$1.88
$2.82
$3.76
$4.70
$5.64
$6.58
$7.52
$8.46
$9.40
55-59
$1.36
$2.73
$4.09
$5.45
$6.81
$8.18
$9.54 $10.90
$12.26
$13.63
60-64
$2.21
$4.43
$6.64
$8.85
$11.06 $13.28 $15.49 $17.70
$19.91
$22.13
65-69
$3.96
$7.93
$11.89
$15.85
$19.81 $23.78 $27.74 $31.70
$35.66
$39.63
ALL CHILDREN PER PAYCHECK PREMIUM RATE TABLE*
RATE
$2,000
$3,000
$4,000
$5,000 $6,000 $7,000 $8,000
$9,000
$10,000
$0.20
$0.30
$0.40
$0.50
$0.60
$0.70
$0.80
$0.90
$1.00
* Regardless of how many children you have, the premium is not a per child premium and is the same for one or all children.
Employee Premium Spouse Premium
Child(ren) Premium
Total Semi-Monthly Premium
+
+
=
Premium Calculations: Please note that the premium amounts presented above may vary slightly from the amounts provided on your enrollment form
due to rounding.
Employer Paid Life & AD&D - Mutual of Omaha
(full time employees working 30+ hours)
Southwest Network provides Basic Employee Term Life and Accidental Death and Dismemberment benefits in the amount
of 1 times your salary to a maximum of $100,000 at no cost to you.
Employer Paid Disability Insurance - Mutual of Omaha
(full time employees working 30+ hours)
Coverage
Benefits Begin
Weekly Benefit
Duration
Short Term Disability
Day 15
60% of salary to a maximum
of $1,000 per week
11 Weeks
Long Term Disability
Day 91
60% of salary to a maximum
of $5,000 per month
Social Security Normal
Retirement Age