Exhibit K - COM Life Insurance Information.pdf
PDF 609 KB Posted
- Attached to
- Life and Disability Insurance
- Solicitation number
- 15001-0-2026-BG
- Issued by
- Dane County, Wisconsin
About this file
This is a Life Insurance Information exhibit prepared by the City of Madison Human Resources Department in Wisconsin, detailing the structure and administration of the municipality's group term life insurance program for eligible employees. The document outlines enrollment procedures, coverage types, and benefit calculations for both active employees and retirees. New employees have 30 calendar days from their hire date to enroll in the group life insurance program without medical underwriting, while subsequent enrollment or coverage increases require evidence of insurability. The program offers Basic Coverage calculated as the employee's highest annual salary rounded to the next thousand dollar increment (with a minimum of $10,000 and maximum of $200,000), and Supplemental Coverage available at 50%, 100%, or 200% of annual salary with respective maximums of $100,000, $200,000, and $400,000. Dependent coverage is also available in units covering spouses to age 65 and children to age 26, with monthly costs of $1.75 for one unit or $3.50 for two units. Premiums are deducted from employees' first paycheck of each month on an after-tax basis and are recalculated annually in July based on prior-year gross earnings.
Employee costs for coverage vary by age group, ranging from $0.05 per $1,000 for basic coverage for employees under 25 to $0.57 per $1,000 for employees aged 60 and above, with supplemental coverage costs scaled proportionally lower. Employees retiring before age 65 may continue coverage by paying quarterly premiums until reaching age 65, after which basic coverage continues at no cost at reduced percentages (75% at age 65, 50% at age 66, and 25% at age 67 and beyond), while supplemental coverage cannot be continued past age 65. Dependent coverage may be maintained into retirement with premiums billed annually until dependents age out of eligibility. The program allows employees to change beneficiaries, cancel coverage, or adjust coverage amounts at any time through submission of appropriate forms to the Human Resources Department. Questions and additional information regarding the program can be directed to the City of Madison Human Resources Benefits team at (608) 266-4615 or benefits@cityofmadison.com.
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Human Resources Department Madison Municipal Building, Suite 261 215 Martin Luther King, Jr. Boulevard Madison, Wisconsin 53703 Phone: (608) 266-4615 Fax: (608) 267-1115 hr@cityofmadison.com www.cityofmadison.com/human-resources
LIFE INSURANCE INFORMATION
Type of Coverage: Group Term Life Insurance
Enrollment: New employees have 30 calendar days from initial date of hire in an eligible position to enroll in the group life insurance program without evidence of insurability (medical underwriting). After the initial enrollment period, an employee will be required to provide evidence of good health through the underwriting process to enroll or to increase the amount of coverage. Coverage may also be increased following an eligible qualifying life event (limitations and deadlines apply). Enrollment is voluntary, and coverage may be cancelled or reduced at any time. The form for enrollment/changes/cancellation must be returned to the Human Resources Department.
Amounts Available: Basic Coverage is the employee's highest annual salary of record rounded up to the next highest thousand. This coverage is subject to a minimum of $10,000 (for employees in certain classifications with less than $10,000 annual earnings) and a maximum of $200,000.
Supplemental Coverage is in addition to Basic Coverage. It is calculated by multiplying the employee’s highest annual salary of record (HAS) by a factor of 0.5, 1, or 2, and then rounding to the next highest thousand.
• 50% Supplemental = HAS x 0.5, rounded up to the next highest thousand; subject to a maximum of $100,000
• 100% Supplemental = HAS x 1, rounded up to the next highest thousand; subject to a maximum of $200,000
• 200% Supplemental = HAS x 2, rounded up to the next highest thousand; subject to a maximum of $400,000
Employee Cost:
Age Group
Cost Per $1000 Coverage (Basic)
Cost Per $1000 Coverage (Supplemental)
Under 25 $0.05 $0.035
25-29 $0.06 $0.042
30-34 $0.08 $0.056
35-39 $0.09 $0.063
40-44 $0.10 $0.07
45-49 $0.15 $0.105
50-54 $0.23 $0.161
55-59 $0.43 $0.301
60-64 $0.57 $0.399
65-69* $0.57 $0.399 over 69* Free (basic coverage only) $0.399
Dependent Coverage: Designed to help with final expenses for the death of a dependent. The employee is the beneficiary for eligible dependent(s). When an employee no longer has eligible dependents, it is their responsibility to submit a new life insurance form to remove dependent coverage.
Units Coverage Cost
1 unit $10,000, spouse to age 65 and
$10,000, each dependent child to age 26 $1.75/mo.
2 units $20,000, spouse to age 65 and
$15,000, each dependent child to age 26 $3.50/mo.
Exhibit K mailto:hr@cityofmadison.com http://www.cityofmadison.com/human-resources
Beneficiary: Benefits for loss of your life are payable to the beneficiary designated on the Enrollment Form.
To change beneficiaries, you must submit a new Life Insurance Change Form to Human Resources. The form is available online or from the Human Resources Department.
Premium Schedule: Premiums are deducted from the first paycheck of the month for current month’s coverage.
Premiums are deducted after tax.
Annual Update: In July of each year, premiums and insurance amounts are recalculated based on the prior year’s gross earnings. Changes are reflected on the first check in July. An employee’s Basic Coverage will be based on the employee’s highest annual salary of record.
Retirement Benefits: An employee who retires before age 65 may maintain their coverage into retirement by paying premiums billed from the City. Bills are sent quarterly for three months’ premiums at a time and continue until age 65.
If an employee retires at or after age 65 (or retires before age 65 and continues life insurance coverage after retirement by paying the premium costs to age 65), coverage would continue at no cost to the retiree at a reduced percentage of Basic Only (details below). Supplemental coverage cannot be continued beyond age 65.
A retiree who drops all life insurance coverage may not re-enroll.
• Dependent Coverage: An employee who is enrolled in unit(s) of dependent coverage and has eligible dependent(s) at retirement may opt to continue that coverage into retirement as well. Dependent coverage premiums are billed annually, and may be continued until the last eligible dependent ages out of eligibility (age 65 for spouses, age 26 for children). Coverage cannot be continued beyond this point.
Example: An employee’s highest annual salary of record is $54,125.54 and they are enrolled in Basic + 200% Supplemental coverage. They retire at age 57 and opt to continue coverage into retirement.
Age Basic Rate per
$1000 Supplemental
Rate per $1000
Monthly Cost
$54,125.54, rounded up = $55,000
$0.43 ($54,125.54 x 2), rounded up = $109,000
$0.301 $56.46
In this example, the retiree would be billed $169.38 ($56.46 x 3) each quarter until they turn 60 and enter a new age group for premium costs, at which point their premium would increase to $0.57 per $1000 coverage for Basic and $0.399 per $1000 coverage for Supplemental. They can elect to reduce coverage at any time by communicating with Human Resources and City Payroll.
If this retiree continues paying premiums to age 65, coverage would continue at no cost to the retiree at a reduced percentage of Basic Only, as outlined below:
Age Percentage of Former
Basic Coverage
Coverage (based on $55,000 Basic)
65 75% $41,250
66 50% $27,500
67+ 25% $13,750
If you would like additional information or have any questions, please contact the Human Resources Benefits team at
(608) 266-4615 or benefits@cityofmadison.com.
Page 2 of 2 Updated 7/1/2025
Exhibit K mailto:benefits@cityofmadison.com
File details come from the government source that posted it. Updated .