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Warm Up on the Beach

Thank you for submitting
your benefit elections!



 

If you elected HSA 2500 or Base 6750 medical plan, 
you may contact Optum Bank to establish an HSA:

Optum Bank

  Policy #924852  www.optumbank.com

or

www.myuhc.com Member Services 866-314-0335
 

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Scroll down for information about

VOLUNTARY LIFE

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THIS ENROLLMENT PAGE IS FOR EMPLOYEES WHO

WISH TO PURCHASE VOLUNTARY LIFE/AD&D

- In addition to the employer-paid Basic Life/AD&D -

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Voluntary Life /AD&D is available to purchase through your employer.

Pricing for both employee and spouse is

based on the employee's age.  

The per pay period deduction is calculated as follows using the

Age/Rate grid below:











 

Step 1:  Find EMPLOYEE Age Bracket and Rate

Step 2:  Consider COVERAGE AMOUNT you wish to purchase (max 5x Base Annual Earnings)

Step 3:  Multiply Employee COVERAGE AMOUNT by age-banded RATE  =  Gross amount

Step 4:  Divide GROSS AMOUNT by 1000 = Monthly Rate

Step 5:

Semi-Monthly Employees: 

Divide MONTHLY RATE by 2 = Pay Period Deduction (semi-monthly)

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Biweekly Employees:

Multiply MONTHLY RATE by .4615 = Pay Period Deduction (biweekly)

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Weekly Employees (TACO CABANA Employees):

Divide MONTHLY RATE by 52 = Pay Period Deduction (weekly)

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Should you have any questions, please contact your Benefits Manager, Amanda Garcia.

Age Rate Grid.png

ENROLL / Purchase Voluntary Life/AD&D:
Enter Information on our Secure Site 
*Required fields

EMPLOYEE

Gender

How much coverage do you wish to purchase? Increments of $10k not to exceed 5x Base Annual Earnings or $500,000 (Guarantee Issue Amount is $300k)

If desired coverage amount is over $300,000, you must complete and submit the Evidence of Insurability (EOI) Application.

YOU WILL BE REDIRECTED TO A PAGE AFTER SUBMITTING THIS FORM.

SPOUSAL COVERAGE

Spousal coverage up to $250,000 is available to purchase in increments of $5,000 not to exceed 50% of employee's coverage amount.  See pricing grid for cost.

NOTE: You can not get spousal coverage without employee coverage.

If desired coverage amount is over $20,000, you must complete and submit the Evidence of Insurability (EOI) Application.

YOU WILL BE REDIRECTED TO A PAGE AFTER SUBMITTING THIS FORM.

CHILD BENEFIT

A child benefit is available to purchase in increments of $2,500 not to exceed $10,000. The cost is $0.12 per $1000 of coverage. No EOI required.

VTL Child Rate Grid_MCTR Benefits.png
Select Child Benefit Amount you wish to purchase:
Who employs you?
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