Life and Accidental Death & Dismemberment Insurance, continued Bi-Weekly Voluntary Life and AD&D Insurance Premiums (per $1,000 of coverage) AGE EMPLOYEE AND SPOUSE/ DOMESTIC PARTNER* Under 25 $0.027 25-29 $0.031 30-34 $0.040 35-39 $0.044 40-44 $0.051 45-49 $0.074 50-54 $0.111 55-59 $0.203 60-64 $0.309 65-69 $0.563 70-74 $0.910 75+ $0.955 Children $0.026 Flat Rate *Premium based on team member’s age as of January 1, 2024 Calculating Your Voluntary Life and AD&D Cost Follow these steps to calculate your bi-weekly voluntary Life and AD&D insurance premium: Enter the amount of Voluntary Life and AD&D Insurance you want: $ ________(1) Employee: Increments of $10,000, up to the lesser of 8x your base annual pay or $500,000 Spouse/Domestic Partner: Increments of $10,000 up to $100,000 Divide the amount in Line 1 by 1,000 and enter: $ ________(2) Use the chart above to 昀椀nd the bi-weekly cost for employee’s age and enter: $ ________(3) Multiply the amount in Line 2 by the amount in Line 3 and enter: This is your bi-weekly cost for Voluntary Life and AD&D Insurance $ ________(4) Note: Your cost can change if your coverage amount changes, your age changes, or if the insurance rates change. | 24 |

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