15 Your monthly payroll contributions for life, accident, critical illness, and hospital indemnity insurance are shown below. See the Human Resource department for specific rate contributions. Voluntary Life and AD&D Insurance Monthly Cost per $1,000 of Coverage Age Employee Spouse 15 - 29 $0.107 $0.107 30 - 34 $0.111 $0.111 35 - 39 $0.133 $0.133 40 - 44 $0.185 $0.185 45 - 49 $0.277 $0.277 50 - 54 $0.430 $0.430 55 - 59 $0.664 $0.664 60 - 64 $0.950 $0.950 65 - 69 $1.595 $1.595 70 - 99 $3.181 $3.181 Voluntary Life and AD&D Child(ren) Rates Child(ren) $0.132 Accident Insurance Basic Plan Employee $5.45 Employee + Spouse $8.90 Employee + Child(ren) $9.27 Family $12.72 Critical Illness Employee Spouse Age Monthly Rate Preferred (non - smoker) $10,000 benefit Monthly Rate Non - Preferred (smoker) $10,000 benefit Monthly Rate Preferred (non - smoker) $5,000 benefit Monthly Rate Non - Preferred (smoker) $5,000 benefit 15 - 29 $3.90 $5.80 $1.95 $2.90 30 - 39 $6.20 $10.30 $ 3.10 $5.15 40 - 49 $11.20 $22.30 $ 5.60 $11.15 50 - 59 $21.80 $50.90 $ 10.90 $25.45 60 - 69 $37.90 $99.40 $ 18.95 $49.70 70 - 99 $63.80 $167.50 $ 31.90 $83.75 Hospital Indemnity Insurance (age 15 - 99) Employee Only $7.69 Employee + Spouse $19.61 Employee + Child(ren) $14.23 Family $26.15 Benefit Costs