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For Active Employees

As an employee, you are automatically enrolled in Plan A of the Basic Life Plan because it is 100% employer paid. You may opt out of this coverage if you wish. Coverage is available at 1x (Plan A) or 2x (Plan B) your annual base salary to a maximum of $1,700,000. With both options, the coverage amount begins to decrease once you reach age 55. In addition, you must be actively at work on the effective date of coverage; otherwise, coverage will begin when you return to active work.

For Retirees

As a retiree, Basic Life is available if you are eligible for retiree insurance benefits, have not yet reached age 70 and were enrolled in the plan before retiring. Your salary is based on the year in which you retired. You may not increase your coverage; however, you may decrease or cancel your coverage at any time by completing the instructions to change benefit/insurance elections. Please note, once you cancel your Basic Life coverage, you cannot re-enroll.

For Active Employees

Monthly premium cost* for active employees, per $1,000 of coverage**:

• Plan A- (1 x annual base salary & age graded): $0
• Plan B- (2 x annual base salary & age graded): $0.022

*Premiums for faculty on a nine-month contract paid over nine months are different. For more information, visit the Premiums for 9-month faculty paid over 9 months webpage.

**Learn more about the statement of health information required for enrolling in this plan.

For Retirees

Monthly premium cost for eligible retirees, per $1,000 of coverage:

• Plan A- (1 x annual base salary & age graded): $0
• Plan B- (2 x annual base salary & age graded): $0.0717

You may elect Basic Life Plan B at initial enrollment without providing a statement of health form provided you submit your enrollment within 31 days of your date of hire or eligibility date. If you elect Plan B during Annual Enrollment, you must submit a statement of health form.

Learn more about the statement of health information required for enrolling in this plan.

Coverage is available up to 8x your annual base salary to a maximum of $1,000,000, and a minimum of $20,000 even if you earn less. Monthly premiums vary by age. In addition, you must be actively at work on the effective date of coverage; otherwise, coverage will begin when you return to active work.

Employees/retirees may decrease Additional Life coverage at any time during the plan year by completing the appropriate instructions to change benefit/insurance elections.

Additional Life monthly premium cost* for active employees and retirees, per $1,000 of coverage**, by age as of January 1:

• < 25: $0.043
• 25 ¨C 29: $0.051
• 30 ¨C 34: $0.068
• 35 ¨C 39: $0.077
• 40 ¨C 44: $0.085
• 45 ¨C 49: $0.128
• 50 ¨C 54: $0.196
• 55 ¨C 59: $0.366
• 60 ¨C 64: $0.561
• 65 ¨C 69: $1.08
• 70 ¨C 71: $1.751
• 72: $1.785
• 73: $2.117
• 74: $2.346
• 75: $2.584
• 76: $2.839
• 77: $3.103
• 78: $3.392
• 79: $3.698
• 80: $4.029
• 81: $4.403
• 82: $4.837
• 83: $5.321
• 84: $5.840
• 85: $6.401
• 86: $6.987
• 87: $7.591
• 88: $8.211
• 89: $8.866
• 90: $9.554
• 91: $10.311
• 92: $11.152
• 93: $12.181
• 94+: $13.617

*Premiums for faculty on a nine-month contract paid over nine months are different. For more information, visit the Premiums for 9-month faculty paid over 9 months webpage.

**Statement of health requirements may apply.

As an employee, you may elect Additional Life (also sometimes called "Optional Life") at initial enrollment without providing a statement of health form (up to 2x annual base salary) provided you submit your enrollment within 31 days of your date of hire or eligibility date. If you waive this coverage, you will not be able to enroll until the next Annual Enrollment period. If you elect Additional Life during Annual Enrollment, a statement of health form is required for any enrollment or increase in coverage.

Learn more about the statement of health information required for enrolling in this plan.

Coverage is available in increments of $10,000 up to a maximum of $100,000.

Note: If your Spouse is confined at home under a Physician¡¯s care or hospitalized at the time coverage is scheduled to take effect, your Spouse's coverage will begin on the date your Spouse is no longer confined or hospitalized.

If your former Spouse no longer qualifies for this coverage, it is your responsibility to cancel your Spousal Life coverage. Retirees may decrease or cancel coverage at anytime by completing a form to instructions to change benefit/insurance elections. However, once you decrease of cancel your Dependent Life coverage(s) you cannot increase or re-enroll.

Dependent Life - Spouse monthly premium cost* for active employees and retirees, per $1,000 of coverage**, by age as of January 1:

• < 30: $0.064
• 30 ¨C 34: $0.073
• 35 ¨C 39: $0.10
• 40 ¨C 44: $0.155
• 45 ¨C 49: $0.228
• 50 ¨C 54: $0.346
• 55 ¨C 59: $0.537
• 60 ¨C 64: $0.837
• 65 ¨C 69: $1.32
• 70 ¨C 74: $2.11
• 75 ¨C 79: $3.449
• 80 ¨C 84: $5.36
• 85 ¨C 89: $8.399
• 90+: $12.977

*Premiums for faculty on a nine-month contract paid over nine months are different. For more information, visit the Premiums for 9-month faculty paid over 9 months webpage.

**Learn more about the statement of health information required for enrolling in this plan.

As an employee, your opportunities to elect dependent life for a spouse or sponsored adult dependent and the statement of health* requirements are as follows:

• New hire enrollment: You may elect coverage up to $20,000 without statement of health provided you do so within 31 days of your date of hire or benefit eligibility date.
• Annual enrollment: You may elect to enroll or change the amount of coverage for which you¡¯ve enrolled. Statement of health is required for newly elected coverage and increases in coverage. Statement of health is not required for decreases in coverage. 
• Mid-year qualifying event: You may elect coverage up to $20,000 without Statement of health provided you do so within 31 days of the date of marriage. Statement of health is required for existing spouses/sponsored adult dependents to enroll in any amount of coverage.
  • If your spouse/sponsored adult dependent was a UM benefit-eligible employee who lost their UM Basic Life Plan coverage and is newly eligible for UM spousal life coverage, you may elect up to $20,000 without statement of health provided you do so within 31 days of the date the UM employee coverage ended.

*Learn more about the statement of health information required for enrolling in this plan.

Coverage is available in increments of $5,000 up to a maximum of $25,000.

Dependent Life - Child Monthly premium cost* for active employees and retirees, per coverage amount listed:

• $5,000 coverage: $0.32
• $10,000 coverage: $0.64
• $15,000 coverage: $0.96
• $20,000 coverage: $1.28
• $25,000 coverage: $1.60

For more details on this plan, refer to the Dependent Life Insurance Summary Plan Description (SPD).

*Premiums for faculty on a nine-month contract paid over nine months are different. For more information, visit the Premiums for 9-month faculty paid over 9 months webpage.

Your opportunities to elect dependent life for a child are as follows:

• New hire enrollment: You may elect coverage up to $25,000 provided you do so within 31 days of your date of hire or benefit eligibility date; otherwise, you must wait until the next Annual Enrollment.
• Annual enrollment: You may elect to enroll or change the amount of coverage for which you¡¯ve enrolled.
• Mid-year qualifying event: You may elect coverage up to $25,000, provided you do so within 31 days of the date of birth or adoption.
  • If your dependent child was a UM benefit-eligible employee who lost their UM basic life coverage and is newly eligible for UM dependent life child coverage, in which case you may elect up to $25,000, provided you do so within 31 days of the date the UM employee coverage ended; otherwise, you must wait until the next Annual Enrollment.

If you enroll in coverage, then all of your children are covered. Children are eligible for Dependent Child Life insurance coverage until the end of the month in which they turn 26 years of age*. If your dependent(s) no longer qualify, it is your responsibility to cancel your Dependent Child Life coverage by completing instructions to change benefit/insurance elections.

*After exceeding this age limit, your child¡¯s coverage would normally end. However, your child will remain eligible for coverage after reaching the age limit if certain criteria is met regarding disability.