Government of the District of Columbia

Basic Life insurance is equal to one times your Annual Earnings plus $2,000 and the amount of AD&D coverage is equal to the amount of life coverage. Basic Life coverage has a minimum of $10,000. To calculate your estimated bi-weekly* premium for Basic Life and AD&D, fill out the form below:

Plan 1 Basic Life and AD&D - 1x Annual Salary + $2000
Enter Annual Base Salary:
	Calculate     Clear
Estimated bi-weekly premium:

Eligible employees enrolled in the Basic Life and AD&D (Plan 1) may also elect any or all of the following insurance options, A, B and C. Use the calculator(s) below to determine your estimated bi-weekly* premium(s):

Optional Life Insurance Option A - Flat $10,000
Enter Employee Age as of Last January 1:
	Calculate     Clear
Estimated bi-weekly premium:

Optional Life Insurance Option B - 1, 2, 3, 4 or 5 times annual salary
Enter Employee Age as of Last January 1:
Enter Annual Base Salary:
Select 1, 2, 3, 4 or 5 times annual salary:	Select One 1 x Salary 2 x Salary 3 x Salary 4 x Salary 5 x Salary
	Calculate     Clear
Estimated bi-weekly premium:

Dependents Life Insurance
Select a benefit option	Select One Option C1 – Spouse $10,000 and Children $10,000 Option C2 – Spouse $25,000 and Children $10,000 Option C3 – Spouse $50,000 and Children $10,000
Enter Employee Age as of Last January 1:
		Calculate     Clear
Estimated bi-weekly premium:

Total Optional Life Insurance Options A, B and C
Estimated total bi-weekly premiums for selected options noted below:	Clear All

*Some departments within the Government District of the District of Columbia pay on a monthly basis. Please check with your human resources representative for the monthly rates.

Before enrolling, review the Coverage Highlights, Group Life Insurance Booklet and Certificate of Insurance for answers to commonly asked questions, costs, exclusions, limitations and reductions.