4.1 FY 2020-21 VOLUNTARY INSURANCE EXHIBIT A RATES.DOCX
Extracted text (via pymupdf_layout)
1627 characters
Employee Benefits – Plan Year 2021 Premium Rates - Exhibit A FY 20-21 Short Term Disability Pay Period Premium = (Multiplier X Annual Base Salary) /24 pay periods Employee Only Multiplier 40% 0.0018 50% 0.0029 60% 0.0055 FY 20-21 Employee Assistance Program Monthly Monthly Eligible Monthly Total Employer Participant Premium Premium Premium Employee Assistance 2.98 2.98 0.00 FY 20-21 Life Insurance Monthly Monthly Monthly Total Employee Employer Premium per Premium Premium Per Life Insurance $1000 Per $1000 $1000 Basic Life 1X Salary 0.030 0.030 Basic AD&D 1X Salary 0.015 0.015 Employee Additional ADD 1X Salary/$1000 0.020 0.020 Family Additional ADD 2X Salary/$1000 0.035 0.035 Dependent Child Life /$5,000 0.100 0.100 Additional - Non-Smoker Under 25 0.029 0.029 Additional - Non-Smoker 25-29 0.035 0.035 Additional - Non-Smoker 30-34 0.046 0.046 Additional - Non-Smoker 35-39 0.051 0.051 Additional - Non-Smoker 40-44 0.067 0.067 Additional - Non-Smoker 45-49 0.109 0.109 Additional - Non-Smoker 50-54 0.167 0.167 Additional - Non-Smoker 55-59 0.284 0.284 Additional - Non-Smoker 60-64 0.480 0.480 Additional - Non-Smoker 65-69 0.692 0.692 Additional - Non-Smoker 70 and older 1.281 1.281 Additional - Smoker Under 25 0.047 0.047 Additional - Smoker 25-29 0.051 0.051 Additional - Smoker 30-34 0.058 0.058 Additional - Smoker 35-39 0.099 0.099 Additional - Smoker 40-44 0.141 0.141 Additional - Smoker 45-49 0.280 0.280 Additional - Smoker 50-54 0.516 0.516 Additional - Smoker 55-59 0.526 0.526 Additional - Smoker 60-64 0.815 0.815 Additional - Smoker 65-69 0.997 0.997 Additional - Smoker 70 and older 1.638 1.638