Group Life Insurance: Schedule of Benefits
Benefit Schedule
$16 Monthly Contribution
| MEMBER | DEPENDENT | |||||||
| Member's Age at Time of Claim | Group Term Life Insurance | Group Accidental Death & Dismemberment Insurance | TotalBenefit For Accidental Death | Group Term Life Insurance | ||||
| Spouse/ Domestic Partner |
Child(ren) | |||||||
| < 25 | $225,000 | $100,000 | $325,000 | $20,000 | $4,000 (live birth to age 26) | |||
| 25-29 | $170,000 | $100,000 | $270,000 | $20,000 | ||||
| 30-39 | $100,000 | $100,000 | $200,000 | $20,000 | ||||
| 40-44 | $ 65,000 | $100,000 | $165,000 | $18,000 | ||||
| 45-49 | $ 40,000 | $100,000 | $140,000 | $15,000 | ||||
| 50-54 | $ 30,000 | $100,000 | $130,000 | $10,000 | ||||
| 55-59 | $ 18,000 | $100,000 | $118,000 | $ 7,000 | ||||
| 60-64 | $ 12,000 | $100,000 | $112,000 | $ 5,000 | ||||
| 65+ | $ 7,500 | $7,500 | $15,000 | $ 4,000 | ||||
| The total cost of coverage for the member, their spouse/domestic partner and eligible children is $16 per month. Payment is made by payroll deduction. Domestic partners may not be recognized in all states. | ||||||||
Benefit Schedule
$17 Monthly Contribution
| MEMBER | DEPENDENT | |||||||
| Member's Age at Time of Claim | Group Term Life Insurance | Group Accidental Death & Dismemberment Insurance | TotalBenefit For Accidental Death | Group Term Life Insurance | ||||
| Spouse/ Domestic Partner |
Child(ren) | |||||||
| <25 | $225,000 | $100,000 | $325,000 | $20,000 | $4,000 (live birth to age 26) | |||
| 25-29 | $170,000 | $100,000 | $270,000 | $20,000 | ||||
| 30-39 | $100,000 | $100,000 | $200,000 | $20,000 | ||||
| 40-44 | $65,000 | $100,000 | $165,000 | $18,000 | ||||
| 45-49 | $40,000 | $100,000 | $140,000 | $15,000 | ||||
| 50-54 | $30,000 | $100,000 | $130,000 | $10,000 | ||||
| 55-59 | $18,000 | $100,000 | $118,000 | $7,000 | ||||
| 60-64 | $12,000 | $100,000 | $112,000 | $5,000 | ||||
| 65-69 | $7,000 | $7,000 | $14,000 | $4,000 | ||||
| 70-74 | $6,000 | $6,000 | $12,000 | $3,000 | ||||
| 75-79 | $5,000 | $5,000 | $10,000 | $2,000 | ||||
| 80-84 | $4,000 | $4,000 | $8,000 | $2,000 | ||||
| 85+ | $3,000 | $3,000 | $6,000 | $2,000 | ||||
| The total cost of coverage for the member, their spouse/domestic partner and eligible children is $17 per month. Direct payment billed to you at home or pension deduction for retirees (as determined by plan sponsor). Domestic partners may not be recognized in all states. | ||||||||