Personal tools

Dependent Life Insurance Worksheet (Food Services)

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

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 bimonthly.

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 bimonthly 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 bimonthly 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 bimonthly.