Western Insurance Specialties

Voluntary Supplemental Life Insurance for you and your family

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Welcome to Apply anytime throughout the year!

Simply complete the Application and short Medical Form and we will take care of the rest.

Once you have been approved, we will take care of setting it up on payroll deduction. It’s that easy!

Electronic Secure Fillable Form  
Application Form Apply Now - Click Here
Medical Form Apply Now - Click Here
Email US service@wisnv.com
Western Insurance Specialties
PO BOX 12910
Reno NV 89510
Mailing Address
(775) 826-2333
(702) 383-9187
(800) 342-0707
FAX (775) 826-2390
Phone & FAX
 
Paper and Print Forms
Summary of Benefits Brochure Download
Application Form Download
Medical Form Download
Beneficiary & Address Change Form Download
Life Insurance Policy Certificate Download

Monthly Premiums will be adjusted according to your pay cycle (20 or 24 Pay Periods) depending on your pay schedule. Employee and Spouse/Domestic Partner rates are the same in accordance with respective ages. Maximum amount of coverage Employee may apply for is 10 times your salary not to exceed $750,000 (minimum amount is $10,000). Maximum Sp/Dp may apply for is $380,000. Employee must carry coverage in order to apply for Sp/Dp Coverage and Accidental Death & Dismemberment (AD&D) coverage. AD&D Life Insurance can be added to base coverage up to $750,000 regardless of salary (monthly rates are listed on Application Form). AD&D covers you on or off the job--24/7! Child coverage: one premium covers all eligible children in the household. Please see Brochure Summary of Benefits for rates and terms above age 65 and further details regarding child coverage provisions.
 

AGE
BRACKET
COST PER MO
$50,000.00
COST PER MO
$100,000.00
COST PER MO
$150,000.00
UNDER 30 $ 4.25 $ 8.50 $ 12.75
30-34 $ 4.75 $ 9.50 $ 14.25
35-39 $ 6.25 $ 12.50 $ 18.75
40-44 $ 8.75 $ 17.50 $ 26.25
45-49 $ 14.75 $ 29.50 $ 44.25
50-54 $ 23.25 $ 46.50 $ 69.75
55-59 $ 36.25 $ 72.50 $ 108.75
60-64 $ 49.25 $ 98.50 $ 147.75