Personal tools

Dependent Life Insurance Worksheet (Food Services)

Determine life insurance coverage for your spouse and/or children.

Twice a Month Payroll Deductions

Deductions for your non-medical insurance premium will come out of your paycheck on the 10th and 25th of each month. The amount you see below is what will be taken out of your paycheck. Please note that the salary bands have been adjusted.

Dependent Life Plan 1: Spouse and/or Children

Provides coverage for your Spouse and/or Children for the amount of $5,000 each. The cost of this coverage is $0.70 twice monthly.

Dependent Life Plan 2: Spouse

Coverage available in increments of $10,000 from $10,000 up to $300,000.

Dependent Life Plan 2 Coverage Rates
Age BandsRates per $1,000 Coverage
<29 $0.029
30-34 $0.043
35-39 $0.051
40-44 $0.059
45-49 $0.100
50-54 $0.138
55-59 $0.261
60-64 $0.406
65-69 $0.775
>69 $1.259
Costs listed are twice monthly payroll deductions.

How to Calculate Rates

To calculate your Dependent Life bimonthly payroll deduction for a spouse, follow these steps: 

  1. Enter the amount of coverage
  2. Divide by 1,000 (for the number of units of $1,000)
  3. Multiply by the rate for the Spouse's age group to get the Dependent Life Insurance total twice monthly premium

For example: $100,000 Coverage, Age 37

  1. Calculate the Units: $100,000 (Amount of Coverage) divided by $1,000 = 100 Units.
  2. Calculate the Premium: 100 Units x $0.051 (Rate for the Dependent Life Plan 2, Ages 35-39) = $5.10 bimonthly

Dependent Life Plan 3: Children

Provides coverage for your Child(ren) for the amount of $10,000 each at a cost of $1.27 twice monthly.