What is a flat extra in life insurance? A flat extra is an additional premium charge added to a life insurance policy when an applicant has a higher-than-average risk that cannot be fully addressed with a standard rating class. Situations could include health history, scuba diving, sky diving or other hazardous occupations. Unlike a table rating (which increases the overall premium by a percentage), a flat extra adds a fixed dollar amount per $1,000 of coverage. At Diversified Insurance Brokers, we help clients understand, plan for, and often reduce flat extras by shopping across 75+ top-rated carriers and presenting your case in the best possible light.

For many clients, the idea of a “flat extra” is confusing and a little discouraging. It can feel like a penalty for living your life, pursuing a career you love, or having come through a serious medical event. In reality, a flat extra is simply one of the tools underwriters use to price risk more precisely. When you understand how it works—and when you have a broker advocating for you—it becomes something you can manage, negotiate, and sometimes eliminate over time rather than a permanent barrier to affordable coverage.

How a Flat Extra Works

When an underwriter assigns a flat extra, it’s expressed as a dollar amount per $1,000 of coverage. For example, a flat extra of $5 per $1,000 on a $500,000 policy equals an additional $2,500 in annual premiums. The base premium is calculated first from your rate class (Preferred, Standard, Table rating, etc.), and then the flat extra is added on top as a separate line item.

Flat extras may apply for a temporary period—often somewhere in the 2–10 year range—when the extra risk is expected to improve or become less significant over time. In some cases, such as certain chronic medical conditions or ongoing high-risk activities, the flat extra may be applied on a longer-term or even permanent basis. Once the flat extra period ends, the surcharge is typically removed, which can lead to a meaningful reduction in future premiums without having to replace the policy.

Flat Extra vs. Table Rating

It’s important to distinguish between a flat extra and a table rating because they affect your premium in different ways. A table rating increases your overall premium by a percentage relative to the Standard rate. For example, a Table B rating often adds roughly 50% to the base premium; a Table C rating adds more, and so on. The table rating applies across the entire policy, regardless of face amount.

A flat extra, by contrast, adds a set dollar amount per $1,000 of coverage. This means the impact of a flat extra scales directly with the size of your death benefit. A $5 flat extra has a very different effect on a $250,000 policy than it does on a $2,000,000 policy. Because of this, policy design—choosing the right coverage amount and structure—can be a powerful lever for managing cost when a flat extra is involved.

In many cases, insurers may use both tools at once: for example, assigning a Table B rating plus a $3 flat extra per $1,000 of coverage. This is where experienced guidance becomes essential. The combination of higher rate class and flat extra can dramatically increase the cost of coverage if not managed carefully, and it’s common for alternate carriers to offer a much more favorable combination or even remove the flat extra completely.

Common Situations That Trigger a Flat Extra

Flat extras are typically reserved for specific, clearly identifiable risks that sit on top of your general health profile. These often include medical issues, occupational hazards, and avocational (hobby-related) risks that go beyond standard underwriting.

On the medical side, recent cancer treatment, organ transplants, certain heart procedures, or significant complications from conditions like diabetes can all lead to a flat extra. From an occupational standpoint, high-risk roles—such as commercial pilots, offshore oil workers, loggers, or other hazardous jobs—may prompt underwriters to add extra cost to reflect the elevated day-to-day risk.

Dangerous hobbies are another common trigger. Activities such as skydiving, scuba diving, mountain climbing, or motor racing can all result in flat extras depending on frequency, training, and safety practices. Military service—especially deployment to combat zones or hazardous duty assignments—can also trigger a flat extra due to the nature of the risk.

Case Example

To see how impactful flat extra shopping can be, consider a 38-year-old client with a history of melanoma. He was initially quoted with a $10 per $1,000 flat extra on a $750,000 policy—adding $7,500 per year on top of his base premium. We obtained updated pathology reports, clarified the staging and margins, and demonstrated a clean, consistent follow-up history with no recurrence.

With that more complete picture, we approached carriers known for nuanced cancer underwriting and secured an alternative offer with only a $5 per $1,000 flat extra. This effectively cut the extra cost in half, saving the client $3,750 annually while still providing the full $750,000 of protection his family needed.

How We Reduce or Remove Flat Extras

The good news is that flat extras are not always set in stone. At Diversified Insurance Brokers, we use several strategies to reduce or remove them where possible. Carrier shopping is the first step. Each insurer treats risk differently; one company’s $7 flat extra might be $3—or even $0—at another carrier with a different appetite or more updated underwriting guidelines.

Documentation and narrative are equally important. We don’t simply dump medical records on an underwriter; we package them into a clear, concise brief that explains your history, current status, and risk trajectory. That might include specialist notes, test results, proof of remission or stability, and evidence of safety practices for hazardous hobbies or occupations.

Timing also plays a major role. Many flat extras are driven by recency—a recent diagnosis, surgery, or change in activity. As time passes and your risk profile improves, we can request re-underwriting or a policy review to reduce or remove the extra. In some cases, we may design the policy from the start with the expectation that we will revisit it in a few years when the extra is more likely to be removed.

Finally, we look at policy design: coverage amount, term length, and product type. Sometimes splitting coverage across multiple policies or adjusting term lengths can keep the overall cost manageable while still protecting your most important financial obligations.

Client Checklist: What to Gather Before We Shop

To put you in the best possible position, we’ll want a clear, organized snapshot of your health and risk profile. The more complete and current your information, the stronger your case will look to underwriters.

• Most recent specialist/primary care notes (diagnoses, stability statements, restrictions).
• Recent labs and imaging summaries (if applicable).
• Medication list with dosages and adherence notes.
• Activity logs or safety certifications for scuba, skydiving, racing, etc.
• Any correspondence showing improvement over time (e.g., stable results, decreased frequency of follow-ups).

Smart Ways to Offset a Flat Extra—Without Overpaying

Even if a flat extra can’t be removed immediately, there are smart planning strategies to keep your coverage affordable. Right-sizing the benefit is one of the most effective. You can prioritize essential needs—such as mortgage payoff, income replacement for a set number of years, or college funding—and focus coverage there while avoiding excess death benefit that multiplies the flat extra unnecessarily.

Laddering terms is another strategy. By splitting your coverage across multiple term policies with different durations, you can ensure that short-term needs don’t carry the same extra cost for 20 or 30 years. Blending term and permanent coverage can also provide a stable lifelong foundation while using more cost-efficient term insurance for temporary obligations.

Most importantly, don’t treat the flat extra as permanent. We encourage clients to revisit their coverage regularly. If your health improves, your hazardous hobby becomes less frequent, or you leave a high-risk occupation, we can re-shop and renegotiate with carriers to seek a better offer.

Why Work with Diversified Insurance Brokers?

Since 1980, we’ve specialized in high-risk life insurance and helped thousands of clients secure coverage despite medical, occupational, or avocational challenges. With access to 75+ carriers and an advocacy-first approach, we work for you—not the insurance companies. Our role is to understand your story, translate it into underwriting language, and push for the most cost-effective coverage that still meets your goals.

Whether you’re facing a temporary flat extra after a recent diagnosis or a complex, multi-factor risk profile, our team can help you navigate your options and build a clear strategy. That might mean optimizing your current offer, re-shopping the market, or designing a long-term plan to reduce costs as your risk changes over time.