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.
| Age Bands | Rates 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:
- Enter the amount of coverage
- Divide by 1,000 (for the number of units of $1,000)
- 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
- Calculate the Units: $100,000 (Amount of Coverage) divided by $1,000 = 100 Units.
- 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.