• The total amount of insurance coverage for each month
• The employee's attained age at the end of the calendar year
• The amount the employee pays per month for insurance after taxes
• The number of months for which coverage has been in effect

1. Subtract $50,000 from the total amount of insurance coverage (the total benefit amount)
2. Divide that number by 1000
3. Multiply the total by the Table I amount, based on the employee's age
4. Multiply the total from Step 3 by the number of months the employee was covered (for which this information is valid)
5. Subtract the amount the employee has paid for coverage after tax

If There Is A Change Mid-Year

If the total benefit amount changes during the year, repeat steps 1-4 as many times as necessary. Add the totals together and subtract the amount the employee has paid (Step 5).  Example...

If There Is A Change Mid-Month

If there is a change to the total benefit amount mid-month, the total for that month is an average of the total on the first day of the month and the last day of the month.

Add the total amount of coverage for the first day of the month to the total amount of coverage for the last day of the month and divide by 2. Use this number for the total amount of insurance coverage for that month and begin with Step 1. Use this amount only for the month during which coverage has changed, and add it to the imputed income amount for the rest of the year. Example...

If The Insurance Becomes Effective Mid-Month

If the insurance becomes effective mid-month, the imputed income amount for that month is prorated. Divide the number of days the employee was covered during the month by the number of days in that month. Add the resulting decimal to the number of months you multiply by in Step 4. Example...

Table I