Employee Supplemental Life

Each eligible employee can select additional coverage up to $500,000, not to exceed five (5) times annual earnings, in increments of $10,000. Accidental Death and Dismemberment can be selected, but cannot exceed $250,000.

Spouse Supplemental Life

Each eligible employee can select coverage on their spouse from $10,000 to $500,000, in increments of $10,000. Accidental Death and Dismemberment can be selected in the same amount of Spouse Life, but not to exceed $250,000.  Coverage terminates at age 70.


When first eligible, employees can apply for up to $100,000, on a guarantee issue basis. During each annual enrollment, employees can elect to increase existing coverage by $10,000 on a guarantee issue basis, up to a total of $100,000. All other amounts applied for at a later date require evidence of insurability acceptable to the insurance company.

To be eligible for Dependent Life, Employee or Spouse Life must be enrolled. This policy covers each eligible child for amount selected ($5,000 or $10,000). Eligible children are ages 14 days to age 19 or to age 25 if full-time student. Evidence of Insurability is waived for Dependent Children starting July 1, 2018.

Policy Provisions

An accelerated death benefit is payable, if insured is diagnosed with a terminal illness. This benefit is equal to 50% of the amount of life insurance in force, or $50,000, whichever is less. You must have a minimum of $20,000 to qualify.

Waiver of premium if insured becomes totally disabled prior to the age of 60

Portability – coverage can be continued upon termination of employment until age 70 at low group rates with proof of good health

Rates are based on insured’s attained age as of July 1st annually.

Employees may convert Employee, Spouse or Dependent Supplemental insurance to an individual life insurance policy if this insurance stops. Proof of good health is not required.

This plan is insured by:


Supplemental Life Rates

Employee or Spouse Age Rate/$10,000
Less than 30 $.80
30 but less than 35 $.90
35 but less than 40 $1.10
40 but less than 45 $1.70
45 but less than 50 $2.90
50 but less than 55 $4.90
55 but less than 60 $7.60
60 but less than 65 $11.90
65 but less than 70 $21.30
70 and over $38.20
AD&D $.40

Certificate of Coverage

Refer to the Supplemental Life Certificate for exact provisions and limitations.

Amendment List

Amendment for 12 month continuation

Amendment remove birth to 14 day limitation