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Life and Accidental Death and Dismemberment (AD&D) Premiums

2012 Premiums

Basic Life and AD&D Insurance for Employees

Employees

$4.08 per month (employer-paid)

Supplemental Life Insurance for Employees and Supplemental Spouse* Life Insurance

Your premium rate changes to the next higher rate as you reach each new age bracket.

Employee's age	Monthly cost for each $1,000 of coverage
	Non-smoker	Smoker
Under 25	$0.024	$0.031
25-29	0.026	0.037
30-34	0.029	0.049
35-39	0.036	0.056
40-44	0.054	0.063
45-49	0.078	0.095
50-54	0.122	0.145
55-59	0.228	0.270
60-64	0.350	0.411
65-69	0.646	0.792
70+	0.964	1.287

Basic Life Insurance for Dependents

An employee pays $0.50 per family per month, regardless of the number of dependents.

Supplemental Accidental Death and Dismemberment Insurance

Employee AD&D benefit	Cost to cover employee only	Cost to cover employee & dependents	Coverage for spouse*		Coverage for children
			With no children	With children	With spouse*	With no spouse*
$ 25,000	$0.20	$0.30	$ 12,500	$ 10,000	$ 1,250	$ 2,500
50,000	0.40	0.60	25,000	20,000	2,500	5,000
75,000	0.60	0.90	37,500	30,000	3,750	7,500
100,000	0.80	1.20	50,000	40,000	5,000	10,000
125,000	1.00	1.50	62,500	50,000	6,250	12,500
150,000	1.20	1.80	75,000	60,000	7,500	15,000
175,000	1.40	2.10	87,500	70,000	8,750	17,500
200,000	1.60	2.40	100,000	80,000	10,000	20,000
225,000	1.80	2.70	112,500	90,000	11,250	22,500
250,000	2.00	3.00	125,000	100,000	12,500	25,000

*or qualified/Washington State-registered domestic partner