Employee:

1 or 2  times annual base salary, not to exceed a coverage amount of $250,000

Spouse:
(age 64 or younger)

$20,000

Children:

$10,000

Employee:

A coverage amount of 3 times annual base salary or $260,000 to $500,000

Spouse:
(age 64 or younger)

$30,000 to $100,000 not to exceed 2 times employee’s annual base salary

Spouse:
(age 65-69)

All coverage

Employee:

4, 5 or 6 times or coverage amount of $510,000 to $1,000,000

Increased
Coverage Amount:

Any increase in coverage amount, except for automatic increases caused by salary increases.  However, automatic increases greater than $100,000 will require full evidence of good health.

Late entrant:^†

All coverage