Please be sure to note that coverage is effective on the hire date or the benefit eligibility date and premiums are paid one month in advance (i.e. deductions for March premiums are taken in February). Premiums become due for the first full month after your date of hire or your eligibility date. Depending on when the enrolment form is received, you may have an intial deduction greater than a one month period.
| Employee | Employee & Spouse | Employee & Child/ren | Employee, Spouse & Child/ren | |
|---|---|---|---|---|
| UM Choice Health Care Program |
$106.94 |
$236.26 |
$181.12 |
$308.86 |
| Catastrophic Program |
$46.14 |
$108.06 |
$64.56 |
$129.66 |
| Employee Only | Employee & Spouse | Employee & Child/ren | Employee, Spouse & Child/ren |
|---|---|---|---|
|
14.76 |
29.52 |
35.82 |
50.58 |
| Employee Only | Employee & Spouse | Employee & Child/ren | Employee, Spouse & Child/ren |
|---|---|---|---|
|
6.00 |
12.00 |
13.00 |
20.60 |
| Plan A | Plan B |
|---|---|
|
$0.00 |
$.21 |
| Coverage Amount | Employee Only | Employee & Family |
|---|---|---|
|
$25,000 |
$.53 |
$.73 |
|
$50,000 |
$1.05 |
$1.45 |
|
$75,000 |
$1.58 |
$2.18 |
|
$100,000 |
$2.10 |
$2.90 |
|
$125,000 |
$2.63 |
$3.63 |
|
$150,000 |
$3.15 |
$4.35 |
Call MetLife at 800-438-6388 for individual quote
| Plan A: | Plan B: |
|---|---|
|
$0.00 |
$.03 |
| Supplemental Life Insurance * – Per $1,000 of Coverage | Spouse Life Insurance – Per $1,000 of Coverage | |||
|---|---|---|---|---|
| Employee Age (Age as of January 1 of the Plan year) |
Amount | Spouse Age (Age as of December 1 preceding the Plan year) |
Amount | |
|
<30 |
$.04 |
<30 |
$.07 |
|
|
30-34 |
$.04 |
30-34 |
$.09 |
|
|
35-39 |
$.06 |
35-39 |
$.12 |
|
|
40-44 |
$.10 |
40-44 |
$.18 |
|
|
45-49 |
$.17 |
45-49 |
$.27 |
|
|
50-54 |
$.29 |
50-54 |
$.41 |
|
|
55-59 |
$.48 |
55-59 |
$.63 |
|
|
60-64 |
$.63 |
60-64 |
$.99 |
|
|
65-69 |
$.99 |
65-69 |
$1.56 |
|
|
70 |
$1.66 |
70-74 |
$2.49 |
|
|
71 |
$2.33 |
75-79 |
$4.07 |
|
|
72 |
$2.80 |
80-84 |
$6.33 |
|
|
73 |
$3.11 |
85-89 |
$9.92 |
|
|
74 |
$3.44 |
90-94 |
$14.56 |
|
|
75 |
$3.79 |
Coverage Amounts Available $10,000 $20,000 ** $30,000 $40,000 $50,000 |
||
|
76 |
$4.17 |
|||
|
77 |
$4.55 |
|||
|
78 |
$4.98 |
|||
|
79 |
$5.42 |
|||
|
80 |
$5.91 |
|||
|
81 |
$6.46 |
Dependent Child Life Insurance – Per Coverage Amount Listed | ||
|
82 |
$7.10 |
|||
|
83 |
$7.80 |
$5,000** |
$.35 |
|
|
84 |
$8.57 |
$10,000 |
$.70 |
|
|
85 |
$9.39 |
$15,000 |
$1.05 |
|
|
86 |
$10.25 |
$20,000 |
$1.40 |
|
|
87 |
$11.13 |
$25,000 |
$1.75 |
|
|
88 |
$12.05 |
|||
|
89 |
$13.01 |
|||
|
90 |
$14.02 |
|||
|
91 |
$15.12 |
|||
|
92 |
$16.36 |
|||
|
93 |
$17.87 |
|||
|
94 |
$19.97 |
|||
* Contact your Campus Benefits Representative for the appropriate enrollment forms.
** Evidence of Insurability is required for any amount chosen over this coverage amount. Contact your Campus Benefits Representative for the appropriate forms.
