Dependent Life Insurance
Schedule of Benefits - Quarterly Premiums

Coverage Amount $10,000 - $250,000 in $10K increments
(Premiums for Dependent Group Life Insurance are based on the applicant/member's age) 		 
Coverage Amount $10,000 - $150,000 Spouse Life
Insurance 
Member's Age - One low premium (below) covers all dependents, including spouse. 
Level    1    2    3    4    5    6    7    8    9    10    11    12    13    14    15
Spouse Life
Insurance 		 $10,000  $20,000  $30,000  $40,000  $50,000  $60,000  $70,000  $80,000  $90,000  $100,000  $110,000  $120,000  $130,000  $140,000  $150,000 
Children    
2wks - 2yrs  1,000  2,000  3,000  4,000  5,000  6,000  7,000  8,000  9,000  10,000  10,000  10,000  10,000  10,000  10,000 
2yrs - 5yrs  2,000  4,000  6,000  8,000  10,000  12,000  14,000  16,000  18,000  20,000  20,000  20,000  20,000  20,000  20,000 
5yrs - 19yrs*  2,500  5,000  7,500  10,000  12,500  15,000  17,500  20,000  22,500  25,000  25,000  25,000  25,000  25,000  25,000 
   * to age 23 if full-time student 
Under 25  1.50  3.00  4.50  6.00  7.50  9.00  10.50  12.00  13.50  15.00  16.50  18.00  19.50  21.00  22.50 
25-29  2.00  4.00  6.00  8.00  10.00  12.00  14.00  16.00  18.00  20.00  22.00  24.00  26.00  28.00  30.00 
30-34  2.25  4.50  6.75  9.00  11.25  13.50  15.75  18.00  20.25  22.50  24.75  27.00  29.25  31.50  33.75 
35-39  3.00  6.00  9.00  12.00  15.00  18.00  21.00  24.00  27.00  30.00  33.00  36.00  39.00  42.00  45.00 
40-44  4.00  8.00  12.00  16.00  20.00  24.00  28.00  32.00  36.00  40.00  44.00  48.00  52.00  56.00  60.00 
45-49  5.50  11.00  16.50  22.00  27.50  33.00  38.50  44.00  49.50  55.00  60.50  66.00  71.50  77.00  82.50 
50-54  8.00  16.00  24.00  32.00  40.00  48.00  56.00  64.00  72.00  80.00  88.00  96.00  104.00  112.00  120.00 
55-59  12.00  24.00  36.00  48.00  60.00  72.00  84.00  96.00  108.00  120.00  132.00  144.00  156.00  168.00  180.00 
60-64  18.50  37.00  55.50  74.00  92.50  -  -  -  -  -  -  -  -  -  - 
65-69  47.50  95.00  142.50  190.00  237.50  -  -  -  -  -  -  -  -  -  - 
70-74  98.00  196.00  -  -  -  -  -  -  -  -  -  -  -  -  - 


Coverage Amount $160,000 - $250,000
Level       16       17       18       19       20       21       22       23       24       25 
Spouse Life
Insurance 		 $160,000  $170,000  $180,000  $190,000  $200,000  $210,000  $220,000  $230,000  $240,000  $250,000 
Children    
2wks - 2yrs  10,000  10,000  10,000  10,000  10,000  10,000  10,000  10,000  10,000  10,000 
2yrs - 5yrs  20,000  20,000  20,000  20,000  20,000  20,000  20,000  20,000  20,000  20,000 
5yrs - 19yrs*  25,000  25,000  25,500  25,000  25,000  25,000  25,000  25,000  25,000  25,000 
       * to age 23 if full-time student 

Member's Age - One low premium (below) covers all dependents, including spouse. 
Under 25  24.00  25.50  27.00  28.50  30.00  31.50  33.00  34.50  36.00  37.50 
25-29  32.00  34.00  36.00  38.00  40.00  42.00  44.00  46.00  48.00  50.00 
30-34  36.00  38.25  40.50  42.75  45.00  47.25  49.50  51.75  54.00  56.25 
35-39  48.00  51.00  54.00  57.00  60.00  63.00  66.00  69.00  72.00  75.00 
40-44  64.00  68.00  72.00  76.00  80.00  84.00  88.00  92.00  96.00  100.00 
45-49  88.00  93.50  99.00  104.50  110.00  115.50  121.00  126.50  132.00  137.50 
50-54  128.00  136.00  144.00  152.00  160.00  168.00  176.00  184.00  192.00  200.00 
55-59  192.00  204.00  216.00  228.00  240.00  252.00  264.00  276.00  288.00  300.00 
IMPORTANT INFORMATION FOR LEVELS 16 - 25:
  • At member's age 60, the maximum spouse coverage under Level 16 through Level 25 is $120,000 for $222.00 quarterly.
  • At the member's age 65, the maximum spouse coverage under Level 16 through Level 25 is $60,000 for $285.00 quarterly.
  • At member's age 70, the maximum spouse coverage under Level 16 through Level 25 is $30,000 for $294.00 quarterly.


IMPORTANT INFORMATION FOR ALL LEVELS:
  • Premiums for Dependent Group Life Insurance are based on the applicant/member's age. However, your spouse's insurance coverage will terminate on your spouse's 75th birthday. The maximum amount of insurance for a spouse of a member age 60-69 is $50,000. The maximum amount of insurance for a spouse of a member age 70 and over is $20,000.
  • If your dependent group insurance coverage exceeds the amount permitted when the member reaches a new age group, your dependent group life insurance coverage will automatically reduce to the amount permitted as shown in the schedule of benefits.
  • A spouse's insurance coverage may not be greater than 50% of the member's life insurance.
  • You may reduce your dependent coverage at any time upon written notification to WAEPA. All dependent coverage terminates at the spouse's age 75.

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