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(6 Martin County Board of County Commissioners I Employee Benefit Highlights 12021 �O LJ Voluntary Life Insurance Voluntary Employee Life Insurance Voluntary Spouse Life Insurance Eligible employee may elect to purchase additional Life insurance on a voluntary basis through The Standard.This coverage may be purchased in New Hires may purchase Voluntary Spouse Life insurance addition to the Basic Term Life and AD&D coverage.Voluntary Life insurance without being subject to Medical Underwriting, offers coverage for employee, spouse and/or child(ren) at different benefit also known as Evidence of Insurability(E0l), levels. up to the Guaranteed Issue amount of$25,000. New Hires may purchase Voluntary Employee Life insurance • Employee must participate in the Voluntary Employee Life plan for without being subject to Medical Underwriting, spouse to participate. also known as Evidence of Insurability(EOl), • Employee may elect Spouse Dependent Life coverage in the following up to the Guaranteed Issue amount of$50,000. amounts,not to exceed 100%of employee's Voluntary Life coverage amount: • Employee may elect coverage in the following amounts: Option 1:$25,000 Option 2:$50,000 Option 3:$75,000 Option 1:$25,000 Option 2:$50,000 Option 3:$75,000 • Benefit amounts are subject to the following age reduction schedule: • Benefit amounts are subject to the following age reduction schedule: g> Reduces to 65%of benefit amount at age 70 > Reduces to 50%of benefit amount at age 75 ag > Reduces to 65%of benefit amount at age 70 > Reduces to 50%of benefit amount at age 75 • Premium Calculation: • Premium Calculation: Elected Coverage_$1,000 x Employee Rate(see table)=Monthly Premium Elected Coverage-$1,000 x Employee Rate(see table)=Monthly Premium Voluntary Dependent Child(ren)Life Insurance Voluntary Life Insurance Rate Table • Employee must participate in the Voluntary Employee Life plan for Monthly Premium dependent child(ren)to participate. Age Bracket Employee/Spouse Cost • Coverage is$10,000 for eligible children,not to exceed 100%of the (Based On Employee Age) (Rate Per$1,000 of Benefit) employee's Voluntary Life coverage amount. Late applications are <30 $0.094 subject to medical underwriting approval. —��— — • Employee may cover unmarried dependent children from living birth 30-34 $0.096 through the end of the calendar year in which the child turns age 26. • 35-39 $0.127 • Cost for coverage is $2.00 a month regardless of the number of 40-44 $0.178 eligible children covered. 45-49 $0.269 • If employee did not enroll in the voluntary life plans for dependents when first eligible and now want to purchase this coverage or 50_54 $0.410 increase coverage, employee and/or dependent child will be 55-59 $0.663 required to complete The Standard's Medical History Statement form.The Medical History Statement form can be found on at www. 60-64 $0.8so - mybentek.com/martincounty. i 65-69^ $1.495 y y - --- E70-74 $2.656 The Standard I Customer Service:(800)247-6888 I www.standard.com 75+ -ry 510.072 Group Number:642407 98 16 ©2016,Gehring Group,Inc.,AD Rights Reserved