FINAL EXPENSE Must answer “no” to all questions in Section 6 and 7 Must answer “yes” to question 8aTWENTY PAY Must answer “no” to all questions in Section 6 and 7 Must answer “yes” to question 8aPREFERRED WHOLE LIFE Separate rates for non-tobacco/tobacco users Ages 0 to 70 0-50 $100,000 Minimum face: $10,000 51-60 $50,000 Must answer “no” to all questions in Section 6 and 7a 61-70 $30,000 Must answer “yes” to question 7b Prescription drug check Phone interview and/or APS Insured must be owner, spouse of owner or minor child of owner If face amount is $20,000 or more, signature of adult insured is required Insured’s social security number required10 YEAR LEVEL TERM Renewable to age 70 and convertible to age 80 Separate rates for non-tobacco/tobacco users 0-50 $100,000 Ages 0 to 70 51-60 $50,000 Minimum face: $10,000 61-70 $30,000 Must answer “no” to all questions in Section 6 and 7a Must answer “yes” to question 7b Prescription drug check Phone interview and/or APS Insured must be owner, spouse of owner or minor child of owner If face amount is $20,000 or more, signature of adult insured is required Insured’s social security number required Mississippi Only Ages 0-60 Renewable to age 60 and convertible to age 70 *Only if insured is owner, spouse of owner or minor child of owner.
3 YEAR MODIFIED DEATH BENEFIT 15 PAY Ages 0 to 39 Minimum face is whatever $15 per month will buy 0-39 $15,000 Must answer “no” to all questions in Section 6 Must answer “yes” to question 8a Death Benefit 1st Year - return of premiums paid plus 10% 2nd Year - return of premiums paid plus 20% 3rd Year - return of premiums paid plus 30% Thereafter - full benefit This plan is not available in AR, MA, MN, MT, NJ or NV2 YEAR MODIFIED DEATH BENEFIT 15 PAY Ages 40 to 85 Minimum face is whatever $15 per month will buy 40-85 $15,000 Must answer “no” to all questions in Section 6 Must answer “yes” to question 8a Death Benefit 1st Year - return of premiums paid plus 10% 2nd Year - return of premiums paid plus 20% Thereafter - full benefit New Jersey Only Ages 40-82 for females Ages 40-79 for malesFOR ALL: Use insured’s age as of sign date Policy fee (charged once per family) See additional face amount limits and signature guidelines on page 6.
The owner of the insurance policy may purchase a child rider on his/her child, stepchild orgrandchild who has not reached his or her 19th birthday at the time of the application.Each unit insures one child for $5,000 level term to age 25. A maximum of 5 units may bepurchased per child. Children that are 18 (15 in FL) need to sign the application. If insuringmultiple children, each child needs to have an equal number of units.Child rider applicants can qualify for the rider only if they are able to answer “no” to all healthquestions on the application and “yes” to the residency question. 15/20 Pay Plans All Other Plans * Maximum of 8 units *Not available in CT/NE
An existing policy form is required if the insured has existing life insurance coverage in thefollowing states, even if they are not replacing the business:AL, AK, AR, AZ, CO, HI, IA, KY, LA, MD, ME, MS, MT, NC, NH, NJ, NM, OH, OR, RI, SC, TX, UT,VA, VT, WI and WV Final Expense* Verify which, if any, significant health condition(s) the insured has by answering all of the questions listed in Section 7 on the application. in Section 6 are answered “no”. Preferred/Term* If the insureds answer “yes” to anything in Section 6, or question 7a, they are not eligible for Preferred or Term, but may be eligible for Final Expense coverage. Newborns may be insured 30 days from the date of birth provided all health questions in Section 6 are answered “no”. *See additional state requirements on page 6. We can only issue policies to insureds permanently residing in the United States. We do not insure foreign citizens temporarily in the United States. 6. A phone interview is attempted on each application. If you wish, you can have this interview done while in your insured’s home. After you have completed the application, please call our In-House Verification number at 800-218-5657. This is available during business hours. 7. Please visit our website for other helpful hints including faxing of applications. Go to the FAQ’s tab on www.lhlicagents.com/agents/
MAXIMUM FACE AMOUNTS PER RELATIONSHIP The maximum face amount applies to the total amount of coverage an insured has between all in force policies. All adult insureds must sign the application. $15,000 Maximum Final Expense Face Amount Parents insuring their children ages 18-21 Grandparents/great grandparents insuring grandchildren UNDER the age of 18 Children insuring their parents/in-laws 60 years and OVER The following are third party relationships and require a phone interview with the insured. $10,000 Maximum Final Expense Face Amount Parents or in-laws insuring their children OVER age 21 Adult children insuring either parents or in-laws that are UNDER the age of 60 Grandparents/great grandparents insuring grandchildren OVER the age of 18 Adult grandchildren insuring grandparents Anyone insuring their niece, nephew, uncle, aunt, cousin, sister or brotherSTATE SPECIFIC SIGNATURE GUIDELINES AK/AR/DE/HI/ID/KY/LA/MD/ME/MO/MT/NE/NM/NV/OR/SD/VA/WA/WI/WY: Unless insuring a spouse*, all proposed adult insureds must sign the application. (*Spouse’s signature still required for Preferred/Term applications $20,000 or more.) CA/CO/CT/DC/GA/IA/IL/IN/KS/MA/MS/ND/NH/NJ/OH/RI/SC/TN/TX/VT: In a parent-child relationship, if the adult insured is not available to sign or complete a consent call (if living in a different city), the policy can still be written, but only as a Modified Death Benefit. AL/AZ/OK/UT/WV: Signatures can be waived for parents insuring children (and vice-versa) living in different cities and parent-child Modified applications as long as we are able to conduct a phone interview with the insured. FL/NC: All proposed insureds must sign the application if age 15 and over. MI/PA: All proposed insureds must sign the application if age 18 and over. 1. We advance daily on checking account business if the initial premium is paid with a preprinted check from the account we are to draft. 2. We advance on checking account business when we draft the first premium and a preprinted voided check accompanies the application. The advance will be paid four business days after the first draft is processed. 3. We advance on post-dated CWA checks the first business day after the check is deposited. 4. We advance a maximum per household, payor, owner or insured. 5. Commission will be paid as earned on checking account business where the first premium is paid by money order or agent’s check. 6. We advance when insureds are not family members and an agent has no influence on the policy.
66 year old female who qualified for final expense non-tobacco rates wants a$10,000 policy with 3 units of AD&D on PAC.72 year old male who qualified for final expense non-tobacco rates wants a$5,000 policy with 1 unit of AD&D to be paid semi-annually.