OPTIONAL SPECIAL ACCIDENT INSURANCE

 

This optional coverage is available on a contributory basis for employees and dependents (spouse and children) and is in addition to the basic special accident death coverage.  Benefits will be paid for dismemberment if the loss occurs within 90 days of the accident, provided the employee or dependent was covered on the date of the accident and meets the established criteria.

                                          2010 Premiums

Salary                              Employee                          Family

Less than $3,000               $0.27                                 $0.41

$3,000-$3,999                    0.41                                   0.59

$4,000-$4,999                    0.54                                   0.79

$5,000-$5,999                    0.68                                   1.00

$6,000-$6,999                    0.81                                   1.20

$7,000-$7,999                    0.95                                   1.41

$8,000-$8,999                    1.08                                   1.61

$9,000-$9,999                    1.22                                   1.82

$10,000-$12,499                1.44                                   2.11

$12,500-$14,999                1.71                                   2.52

$15,000-$17,499                1.98                                   2.89

$17,500-$19,999                2.25                                   3.30

$20,000 and Over               2.70                                   3.96

Enrollment Application