20-Pay Premium Table Voluntary Life Insurance

Reliance Standard Plans Supplemental and Dependent Life Insurance Premium Table Plan Holder: Goshen Community Schools Scheduled Benefit: Each eligible employee may elect for himself/herself and/or his/her eligible spouse an amount of insurance shown in the table below. For employees age 65 and older: Benefit amounts are reduced according to the age-based reduction chart shown in the Supplemental Life brochure. Employee/Spouse Premiums: To find you and your spouse's premium:  Determine your age band: Your age = your age at your last birthday.  Select a benefit amount (employees age 65 and older: see above comment).  Spouse premium: Repeat the steps above for your spouse at your age at your last birthday.  Employee and spouse rates change as insured moves from one age bracket to the next. Employee 20 Payment Periods Premiums Page 1 of 3