Critical PROVIDER FIELD UNDERWRITING GUIDE & RATE BOOK

Transcription

1 G T L Critical PROVIDER FIELD UNDERWRITING GUIDE & RATE BOOK 10 OR 20 YEAR RENEWABLE TERM LIFE INSURANCE WITH A CRITICAL ILLNESS ACCELERATED BENEFIT RIDER WHICH PROVIDES CASH BENEFITS FOR 18 CRITICAL CONDITIONS FOR AGENT USE ONLY Underwritten by Guarantee Trust Life Insurance Company ADL5-10 (Rev. 9/10) 16T354

2 Table of CONTENTS Product Details, Underwriting and Application Processes...Pg 4 Rider Information...Pg 5 Height and Weight Chart...Pg 6 Medical Conditions Not Eligible...Pg 7 10 Year Term Premium Rates...Pg 8 20 Year Term Premium Rates...Pg 9 Notes 2

3 Agent INFORMATION GTL s Critical Provider product can be submitted through our online Agent Portal, by mail, fax or . For more details, see page 4. Note: these submission methods only apply to the Critical Provider product. When submitting new business to GTL, you must also complete and include a New Business Transmittal form with each application submission. You can download the transmittal form from GTLink by searching for form number 15T054, or you can order it on any product supply requisition. New business and commissions will be delayed if business is not accompanied by this form. Methods of Submitting Business Agent Portal: Mail: Log in to the Agent Portal at to submit business online. If you do not have a login and password, contact our Life and Health Sales Department at (800) or agency@gtlic.com. Guarantee Trust Life Insurance Company Attn: New Business 1275 Milwaukee Ave. Glenview, IL Underwriting Fax: (847) und@gtlic.com Contact Us Sales Support: (800) agency@gtlic.com Underwriting: (800) und@gtlic.com Web Site: Quoting Software: 3

4 Product DETAILS Critical Provider is a level, renewable and convertible 10 or 20 year term life insurance policy with a critical illness accelerated benefit rider. ISSUE AGES: 0 60 years (age at last birthday). AGES 0-19: Benefit limited to $5,000 or $10,000. Renewable to age 70 and convertible to age 65. (Cannot be sold stand alone; child applications must be submitted with a parent application). POLICY FEE: $75 annual policy fee (except for ages 0-19). Policy fee is not commissionable. LIMITED COVERAGE AVAILABLE: Select this option and the policy will provide coverage equal to one half (50%) of the covered conditions. INSURANCE AMOUNTS: Minimum face amount is $10,000 or $20 monthly premium ($240 annual), whichever is higher (except for ages 0-19). Maximum face amount is $100,000. In Washington State, minimum face amount is $25,000 for ages 20 and above. For ages 0 months to 19 face amount is $25,000 only. In certain situations, additional life insurance from GTL may be obtained. Contact the Underwriting Department for more information. RIDERS: Return of Premium, Accidental Death Benefit, and Waiver of Premium available. Critical Illness Accelerated Benefit Rider is included in the policy. See page 5 for detailed rider information. Underwriting Submission Process This product has a simplified issue, yes/no application. When an application is received in the home office, an MIB search will be run. + Coverage is issued on a non-medical basis. If the client elects bank draft, you must include bank draft information when you mail, fax or us the application. Can be list billed with a minimum of four lives. + If medical records are required due to MIB information, the Proposed Insured will need to provide these records at no expense to the Company in order to reconsider the application. Application Process A maximum of two (2) Proposed Insured s can be written on one application. If the answer to any of the medical questions is YES or the Proposed Insured does not meet the build guidelines, that person is not eligible for the plan. If the owner of the policy is different than the Proposed Insured, we must have the Social Security Number of both written on the application. Replacement form is required, where applicable. Monthly bank draft (PAC) business: If the premium payor is different than the Proposed Insured, the payer s information must be recorded on the bank draft form. 4

5 Rider INFORMATION CRITICAL ILLNESS ACCELERATED BENEFIT This rider is included as part of the term life insurance policy. 100% BENEFIT PAID FOR: Heart Attack, Stroke, Life Threatening Cancers, Major Organ Transplant, Coronary Bypass Surgery, Kidney Failure, Coma, Paralysis, or Blindness. 75% BENEFIT PAID IF: Insured as diagnosed by a physician, has a life expectancy of 12 months or less ($75,000 maximum). Insured is permanently confined to a nursing home due to a non-correctable medical condition ($75,000 maximum). 25% BENEFIT PAID FOR: Benign Brain Tumor, Alzheimer s Disease, HIV Infection From Blood Transfusion, Parkinson s Disease, Aorta Graft Surgery, or Heart Valve Replacement or Repair. 10% BENEFIT PAID FOR: Coronary Angioplasty Surgery (payable one time). MAXIMUM CRITICAL ILLNESS RIDER BENEFIT The maximum critical illness rider benefit is the policy s face amount or $100,000, whichever is lower. Subsequent claims payments, where applicable, will be based upon the benefit percentage times the remaining death benefit. Each benefit paid will reduce the policy s face amount proportionately. The rider terminates after the maximum benefit is paid. All listed benefit conditions are payable one time only and may vary by state. Accelerated benefits are payable after a 30 day waiting period (not applicable in TX). 100% Death Benefit is payable if no other benefit listed has been paid. RETURN OF PREMIUM The ROP Rider rewards long-term policyholders by returning 100% of paid base policy annual premiums at the end of the policy term, less any benefits paid or fees submitted. If the plan ends due to non-payment of premiums prior to the end of the term period, the cashsurrender value then available may be taken as cash or used to purchase a reduced amount of insurance that is paid up to age 95. ISSUE AGES: years (Not available with the 10-year plan). ACCIDENTAL DEATH BENEFIT If the Accidental Death Benefit Rider is purchased, it will provide an additional death benefit in the event of accidental death. The accidental death benefit amount will equal the face amount of the policy. ISSUE AGES: years WAIVER OF PREMIUM If the Waiver of Premium Rider is purchased, the plan will waive all of the policyholder s premiums if they are continually, totally disabled for at least 90 days, until the policy monthly anniversary falls on or directly follows their 60th birthday or through the end of the base policy while the rider is in force. ISSUE AGES: years Term plans and riders are subject to state availability. Benefits payable are subject to the terms, conditions, definitions and limitations as stated in the policy and benefit rider(s). 5

6 Critical PROVIDER Height and Weight Chart Note: If the Proposed Insured s height and weight fall outside of the parameters, they are not eligible for the plan. Height Minimum Weight Maximum Weight 4' 8" ' 9" ' 10" ' 11" ' 0" ' 1" ' 2" ' 3" ' 4" ' 5" ' 6" ' 7" ' 8" ' 9" ' 10" ' 11" ' 0" ' 1" ' 2" ' 3" ' 4" ' 5" ' 6" Questions? Contact the New Business Underwriting Department at und@gtlic.com or (800)

7 Medical CONDITIONS NOTE: If two or more of the Proposed Insured s natural parent(s), sister(s) or brother(s) were diagnosed with diabetes, cancer, stroke, heart disease, kidney disease, paralysis, or any hereditary disease before the age of 60, the proposed insured does not qualify for the plan. The following are the most common medical conditions/histories that are not eligible for the Critical Provider Plan. Adenocarcinoma AIDS Alcoholism within 10 years Alzheimer Disease Aneurysms Angina Angioplasty Aortic Insufficiency Aortic Regurgitation Aortic Stenosis Aplastic Anemia Atrial Fibrillation Atrial Flutter Blindness Brain Tumor Build - See build table listed on page 6 Cancer/Carcinoma Cerebral Vascular Accident (CVA) Cholesterol over 270mg/dl Chronic Hepatitis, all types Chronic Obstructive Pulmonary Disease Cirrhosis Congestive Heart Failure Coronary Artery Spasm Coronary Bypass Coronary Insufficiency Crohn s Disease Cystic Fibrosis Dementia Diabetes Mellitus, Insulin dependent Diabetes Mellitus, oral or diet: Diagnosed before age 35 or Diagnosed over 10 years ago Dialysis Down s Syndrome Drug Use, other than occasional marijuana Epilepsy within 5 years of diagnosis Esophageal Varices Heart Attack Hemophilia Hepatitis C HIV Positive Hodgkin s Disease Huntington s Chorea or Disease Hydrocephalus Leukemia Lymphoma Malignant Melanoma Mitral Insufficiency Mitral Regurgitation Mitral Stenosis Mixed Connective Tissue Disease Motor Neuron Disease Multiple Myeloma Multiple Sclerosis Muscular Dystrophy Myasthenia Gravis Myocardial Infarction Non-Hodgkin s Disease Pacemaker Paralysis Parkinson s Disease Peripheral Vascular Disease Polycystic Disease Prostrate Specific Antigen (PSA) 4 mg/ml or greater Pulmonary Insufficiency Renal/Kidney Failure Rheumatoid Arthritis, on treatment Sarcoma Sickle Cell Anemia Squamous Cell Carcinoma, recurrent Stroke Surgical treatment for obesity: within 1 year or with complications Systemic Lupus Erythematosus (SLE) Transient Ischemic Attack (TIA) Transitional Cell Carcinoma Transplantation (other than corneal) Ulcerative Colitis Valve Replacement 7

8 Critical PROVIDER Annual Rate is per $1,000 of Base Benefit Amount 10 Year Term ROP is not available on the 10 Year Term. Waiver of Premium Full (100%) Limited (50%) Full (100%) Limited (50%) Full (100%) Limited (50%) Policy Fee: $75.00 (Not included in rates). 8

9 Critical PROVIDER Annual Rate is per $1,000 of Base Benefit Amount Waiver of Premium Full (100%) Limited (50%) Full (100%) Limited (50%) Full (100%) Limited (50%) 20 Year Term Term-to-70 for Ages ROP NS Non Smoker ROP Smoker SM Policy Fee: $75.00 (Not included in rates). 9

10 Critical PROVIDER FIELD UNDERWRITING GUIDE & RATE BOOK GUARANTEE TRUST LIFE INSURANCE COMPANY WITH MORE THAN SEVENTY YEARS OF EXPERIENCE IN THE INSURANCE INDUSTRY, GUARANTEE TRUST LIFE INSURANCE COMPANY HAS A PROUD HERITAGE OF PROVIDING EXCELLENT SERVICE AND SUPERIOR INSURANCE PRODUCTS. GUARANTEE TRUST LIFE INSURANCE IS A MUTUAL LEGAL RESERVE COMPANY LOCATED IN GLENVIEW, IL, AND LICENSED TO CONDUCT BUSINESS IN 49 STATES AND THE DISTRICT OF COLUMBIA. FORM 99RTNP, RIDER FORMS R07CTAB, R20W0P, R09R0P, R95ADB G T L Guarantee Trust Life Insurance Company 1275 Milwaukee Ave. Glenview, IL gtlic.com agency@gtlic.com (800)