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VOLUNTARY LIFE / AD&D
INSURANCE
During your initial enrollment period, you have the
opportunity to purchase additional life insurance with
Cigna for yourself, your spouse, and/or dependent
children. You cannot cover your spouse or dependent
children unless you elect coverage for yourself. You may
elect coverage up to the guaranteed issue amount
without providing evidence of insurability (EOI), which is a
statement of health. Coverage above the guaranteed
issue and coverage for those who did not make an
election when initially eligible, must complete an EOI and
be approved by Cigna before it goes into effect. Benefit
reductions apply at age 65.
EMPLOYEE COVERAGE
Employees may elect coverage in increments of $10,000
up to the lesser of $300,000 or 5 x Salary. Guaranteed
Issue: $120,000
SPOUSE COVERAGE
Spousal coverage is available in $5,000 increments not to
exceed 100% of the employee amount up to a maximum
of $150,000. You must use your spouse’s age and the
spouse rate to calculate the monthly premium.
Guaranteed Issue: $50,000.
CHILDREN
Coverage is available for your children up to age 26
whether or not they are a full-time student. You can elect
coverage of $5,000 or $10,000. The amount you select is
for each child you cover. The cost is based upon the
family unit and not
each child.
Guarantee issue
does not apply to
child coverage and
there is a $1,000
maximum on
children under 14
days.
ACCIDENTAL
DEATH &
DISMEMBERMENT
(AD&D)
When voluntary life
is elected, AD&D
coverage will be
included.
Accidental death &
dismemberment is
only available for
employee and spouse coverage.
EMPLOYEE MONTHLY COST
Age Band
Employee
Rate per
$1,000
Spouse
Rate per
$1,000
Under 30
$.08
$.08
30-34
$.10
$.10
35-39
$.12
$.16
40-44
$.21
$.23
45-49
$.31
$.36
50-54
$.57
$.68
55-59
$1.12
$1.25
60-64
$1.64
$1.87
65-69
$2.76
$3.07
70-74
$4.97
$5.67
AD&D
$.023
$.023
Child
$.20 Per
$1,000 of
Coverage
$50,000
Elected
Coverage
÷ 1,000 =
50
Units
X
$0.33 Rate
* See Note
=
$16.65
Monthly Cost
*The premium calculation is
based upon the life rate for an
employee age 45.
HOW TO CALCULATE
VOLUNTARY PREMIUM
REMEMBER:
You must add the life rate and the AD&D rate to calculate the total monthly premium.
When calculating the monthly premium, be sure to use the appropriate Employee or Spouse rate.