Coverage Amounts (BN17.3)

Use Coverage Amounts (BN17.3) to define the method for determining coverage amounts, coverage limits, and coverage defaults.

Examples of coverage amounts include a life insurance plan offering coverage as a multiple of employee salary, flat amount, or supplemental; or a disability plan that is a percent of an employee's salary.

If the plan does not offer coverage that is unique to particular employee groups, you only need to complete this form once for the plan by leaving the Employee Group field blank. If the plan offers different coverage amounts for different groups of employees, complete this form for each employee group for which coverage is unique. When you leave the Employee Group field blank, the application uses the coverage table for employees who do not meet the criteria for a specific employee group coverage record.

Any amount fields use the currency associated with the plan on BN15.1 (Benefit Plan).

Use this form only if the Coverage Type field is Coverage Amounts in BN15.1 (Benefit Plan) for the plan.