UNDERWRITING GUIDELINES

Transcription

1 UNDERWRITING GUIDELINES Western Reserve Life WRL Freedom ChoiceTerm II WRL Freedom Index Universal Life WRL Freedom Global Index Universal Life WRL Freedom Elite Builder II WRL Freedom Asset Advisor For Agent use only. Not for use with the public. AG /10-WFG

2 WRL Life Insurance Underwriting Guidelines Table of Contents Medical Requirements Underwriting Criteria Class Availability Underwriting Policies and Procedures Authorized Paramedical Companies Trial Applications Confidential Financial Questionnaire Inspection Reports Personal Hisry Question Interviews Mor Vehicle Reports Cash with Application Illustrations Juvenile Coverage Cover Letter (What Include) Retention and Reinsurance Aumatic Issue Limits Jumbo Limit Definition APS Requirements Male Build Table Term Products Female Build Table Term Products General Financial Underwriting Guidelines

3 Medical Requirements In calculating the coverage amount that requires these tests, be sure include the tal amount applied for with WRL during six months. KEY: A B C D E Non-medical Paramed Exam, BCP, HOS Paramed Exam, BCP, HOS, Resting ECG Medical Exam, BCP, HOS, Resting ECG Medical Exam, BCP, HOS, TRD PARAMED Basic Paramedical Exam. Includes medical hisry questions, measured height and weight, pulse, and blood pressure. MED EXAM Medical Docr Exam. Must be arranged through approved paramed companies. HOS (Home Office Urine Specimen) An HOS is required with all medical and paramedical exams. Specimens are good for 1 year up age 70 and good for 6 months for ages 71 and older. Issue Age $25,000 $50,000 $50,001 $75,000 $75,001 $100,000 $100,001 $250,000 $250,001 $500, * A A A A A BCP Testing is performed by ExamOne, Clinical Reference Labs and Heritage Labs. Appointed paramedical services can obtain the Blood Chemistry Profile. The BCP is a venous blood draw. BCP is good for 1 year up age 70 and good for 6 months for ages 71 and older. Resting Electrocardiagram (ECG) & Treadmill (TRD) If resting ECG and TRD records are available from a test conducted within the last 12 months, the test need not be repeated. Treadmill (TRD): The facility performing the test should submit the actual tracing our office for review by our Medical Direcr. A treadmill ECG should not be arranged for any applicant with a hisry of heart disease without receiving authorization from the Underwriting Department. MCAS (Minnesota Cognitive Acuity Screen) Proposed insureds age 71 and older will complete the Minnesota Cognitive Acuity Screen which screens for cognitive deficits. The MCAS is a simple, short telephone interview, conducted by registered nurses (RNs) trained administer the test. The MCAS will be good for 6 months. *Juvenile applications will not be considered until the child is at least 1month old. Standalone term not available. Note - When the Inflation Fighter Rider is added, the medical and financial requirements will be based on the 150% of the face amount $500,001 $1,000,000 $1,000,001 $2,000,000 $2,000,001 $3,500,000 $3,500,001 $5,000,000 $5,000,001 $10,000,000 Call Home Office $10,000,001 and Higher A A A B B B B B B B D A A A B B B B C C C D A A B B B C C C C C E B B B B C C C C C C E B B B C C C C D D D D B B B C D D D D D D D D D D D D D D D D D D 3 4

4 Underwriting Criteria Class Elite Plus Non- SMOKING STATUS Not available Not available Available Not available Not available Available Nonsmoker (no bacco or nicotine use for): 5 years (60 months) 2 years (24 months) Not available 2 years (24 months) 2 years (24 months) Not available Incidental Cigar Usage Not available Available subject : Admitted on app and/or exam HOS neg for cotinine No more than 1 per month Available Available subject : Admitted on app and/or exam HOS neg for cotinine No more than 1 per month Available subject : Admitted on app and/or exam HOS neg for cotinine No more than 1 per month Available BUILD Refer appropriate build table. There are no weight allowances. Refer appropriate build table. There are no weight allowances. Refer appropriate build table. There are no weight allowances. Refer appropriate build table. There are no weight allowances. Refer appropriate build table. There are no weight allowances. Refer appropriate build table. There are no weight allowances. CHOL/HDL With or without treatment Up and age 70: 5.0 or less; age 71+: 5.5 or less Up and age 70: 5.5 or less; age 71+: 6.0 or less Up and age 70: 5.5 or less; age 71+: 6.0 or less Up and age 70: 6.2 or less; age 71+: 6.7 or less Up and age 70: 7.0 or less; age 71+: 7.5 or less Up and age 70: 7.0 or less; age 71+: 7.5 or less CHOLESTEROL With or without treatment 230; disregard if ratio 4.0 or less or less No limit No limit 5 6

5 Underwriting Criteria Class Elite Plus Non- SUBSTANDARD No ratable impairments. No ratable impairments. Flat extras allowed for aviation. (Available on Term and UL only) No ratable impairments. Flat extras allowed for aviation. (Available on Term and UL only) Flat extras allowed for aviation. (Available on Term and UL only) Table ratings and flat extras allowed. Table ratings and flat extras allowed. BLOOD PRESSURE No current treatment for hypertension. Prior treatment OK if discontinued more than 2 years ago: Up and age 70: 135/85; age 71+: 145/85 With or without treatment, up and age 70: 145/85; age 71+: 150/90 With or without treatment, up and age 70: 145/85; age 71+: 150/90 With or without treatment, up and age 70: 148/88; age 71+: 152/88 With or without treatment, up and age 70: 150/90; age 71+: 155/90 With or without treatment, up and age 70: 150/90; age 71+: 155/90 FAMILY HISTORY No family deaths before age 65 of heart or vascular disease or cancer of either parent or any sibling. Disregard if PI is age 65 or older. No death due heart or vascular disease or cancer of either parent before age 60. Disregard if PI is age 60 or older. No death due heart or vascular disease or cancer of either parent before age 60. Disregard if PI is age 60 or older. No death due heart or vascular disease or cancer of either parent before age 60. Disregard if PI is age 60 or older. No death due heart or vascular disease or cancer of both parents before age 60. Disregard if PI is age 60 or older. No death due heart or vascular disease or cancer of both parents before age 60. Disregard if PI is age 60 or older. PERSONAL HISTORY No heart or vascular disease, diabetes, or cancer (except some skin cancers). No heart or vascular disease, diabetes, or cancer (except some skin cancers). No heart or vascular disease, diabetes, or cancer (except some skin cancers). No heart or vascular disease, diabetes, or cancer (except some skin cancers). No ratable impairments. No ratable impairments. 7 8

6 Underwriting Criteria Class Elite Plus Non- DRIVING HISTORY No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in the past 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in the past 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in the past 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in the past 5 years. PRIVATE AVIATION Available with Aviation Exclusion Rider. Ages 71 and over not available. Available with Aviation Exclusion Rider. (May qualify for special no-flat rates as determined by Underwriting.) Flat extra available. (Available on Term and UL only) Available with Aviation Exclusion Rider. (May qualify for special no-flat rates as determined by Underwriting.) Flat extra available. (Available on Term and UL only) Available as qualifies. (Available on Term and UL only) Available as qualifies. Available as qualifies. AVOCATION* No participation in recreational activities listed No participation in recreational activities listed No participation in recreational activities listed No participation in recreational activities listed No participation in recreational activities listed No participation in recreational activities listed * Avocation: Prohibited activities involving aeronautics (e.g., hang-gliding, ultralight, soaring, skydiving, ballooning, etc.), powered racing, competitive vehicles, mountain climbing, rodeos, competitive skiing, or scuba/skin diving at a depth greater than 75 feet. 9 10

7 Underwriting Criteria Class Elite Plus Non- DRIVING HISTORY No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in the past 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in the past 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in the past 5 years. No more than 2 moving violations in 3 years AND no convictions for operating a mor vehicle while under the influence of alcohol or other drugs, or reckless driving in the past 5 years. PRIVATE AVIATION Available with Aviation Exclusion Rider. Ages 71 and over not available. Available with Aviation Exclusion Rider. (May qualify for special no-flat rates as determined by Underwriting.) Flat extra available. (Available on Term and UL only) Available with Aviation Exclusion Rider. (May qualify for special no-flat rates as determined by Underwriting.) Flat extra available. (Available on Term and UL only) Available as qualifies. (Available on Term and UL only) Available as qualifies. Available as qualifies. AVOCATION* No participation in recreational activities listed No participation in recreational activities listed No participation in recreational activities listed No participation in recreational activities listed No participation in recreational activities listed No participation in recreational activities listed * Avocation: Prohibited activities involving aeronautics (e.g., hang-gliding, ultralight, soaring, skydiving, ballooning, etc.), powered racing, competitive vehicles, mountain climbing, rodeos, competitive skiing, or scuba/skin diving at a depth greater than 75 feet

8 Class Availability (1). Base Face Amount (Not Including Rider) must fall in Medical Requirements Category B or higher (For all products except Term). (2) Base Amount is $100,001 and up (Term Only). (3). Age Limitation Product Specific: Classes may not be available over age 70. Please consult your promotional material. (4). Requirements listed are not all inclusive and other facrs could prevent qualification for a class. Final decision will be made by company underwriter for all classes. 13

9 Underwriting Policies and Procedures user is defined as using any bacco products (cigarettes, cigars, chewing bacco, etc.) within 24 months. Authorized Paramedical Companies The companies listed below are authorized perform paramedical and medical exams on behalf of Western Reserve Life Assurance Co. of Ohio (WRL). Paramedical and medical exams are good for 6 months. American Para Professional Systems (APPS) , Examination Management Services, Inc. (EMSI) , ExamOne, Inc , Insurance Medical Services, Inc , www. Imsparamed.com Portamedic , Superior Mobile Medics , www. superiorexams.com Trial Applications If a prospect has been highly rated or declined by any company in or if there is a serious health problem, submit a fully completed application, providing all pertinent information for underwriter review. Further requirements should not be ordered unless requested by the underwriter. Do not collect initial premium with application. If you need guidance determine if a trial application is appropriate or have any questions regarding the trial application process, call WRL Underwriting at Confidential Financial Questionnaire (U ) This is required at time of application and must be submitted with the application. Ages 18-70: Insurance amounts over $2,000,000 Ages 71+: Insurance amounts over $1,000,000 14

10 Inspection Reports Authorized Inspection Companies The home office will order inspection reports when necessary. The company listed below is authorized perform Inspection Reports (IRs) on behalf of WRL. Inspection Reports are good for 1 year. ExamOne, a Quest Diagnostic Company Personal Coverage Inspection Report required for: Ages 18 60: Insurance amounts over $5,000,000 Ages 61 85: Insurance amounts over $2,000,000 An Inspection report may be ordered at the discretion of the underwriter. Business Coverage Inspection Report required for: Ages 0 85: Insurance amounts over $2,500,000 A Business Beneficiary Report should be requested if the application amount is over $2,500,000. An Inspection Report may be ordered at the discretion of the underwriter. Personal Hisry Question Interviews Personal hisry interviews can be ordered at the discretion of the home office underwriter up the Inspection Report limits. Mor Vehicle Reports These reports are ordered by Underwriting: Ages 18 40: all amounts. Ages 41 70: $1,000,001 and Up Ages 71 and Up: all amounts Cash with Application Money may be taken with an application(s), provided the tal of all amounts applied for does not exceed $1,000,000. Even though we allow money be collected on applications up and $1,000,000, the Company s liability is limited the terms of the Conditional Receipt. The Conditional Receipt can be used only if payment is made at the time the application is signed. If money is not collected with the application, the blank Conditional Receipt must be submitted with the application. Illustrations A signed illustration is required be submitted with all applications in jurisdictions where the NAIC Model Illustration Regulation has been passed and the plan is illustratable. Please ask your WRL Representative for a list of WRL products that are illustratable and the states that have passed the regulation. 15

11 Juvenile Coverage Standalone Individual Juvenile (ages 0-17) policies are available on VUL or UL products. Juvenile applications will not be considered until the child is at least 1month old. Please see the General Financial Underwriting Guide for more information about juvenile coverage. Cover Letter (What Include) The writing producer is an important source of information. Through the cover letter, he or she can provide an explanation of the purpose of the coverage and the method used establish the requested face amount. Specific information should be included regarding the background of the sale and the purpose and need for the coverage. Be sure clarify any unusual aspects of the case. List all coverage amounts in force and the amount being replaced, if any. Copies of an estate planning analysis and available financial statements should accompany the cover letter. A cover letter should be sent on all cases over $5,000,000. This will help expedite handling and result in less inconvenience all parties. Retention and Reinsurance Reinsurance plays an important role in our business. WRL has developed valuable relationships with our reinsurers over the years that enable us meet and service the needs of our field representatives and clients effectively. The amount of life insurance retained by WRL varies by the age and rating class of the client. Amounts in excess of what we retain are reinsured with p-rated reinsurance companies through an aumatic reinsurance pool or facultative reinsurance. Under the aumatic arrangement, the reinsurers are aumatically bound accept our decision and do not review our underwriting papers. Facultative cases do not qualify for aumatic pool arrangements. These require the entire underwriting file be sent the reinsurance company for the reinsurer s review and decision. Aumatic Issue Limits The aumatic issue limit is the amount of life insurance coverage we can issue without seeking facultative coverage. It includes the amount we retain, as well as the amount we aumatically cede our reinsurers. Our limits are among the highest in the industry and have been made possible by the strength and integrity of WRL, our underwriting standards and practices, and the quality of our field underwriting. Jumbo Limit Definition The jumbo limit cannot be exceeded, or we must seek facultative coverage. It is defined as the sum of all in force coverage plus the sum of all face amounts applied for whether be placed or not. 16

12 Attending Physician Statements Providing complete information, telephone number, will expedite the APS process. APSs will only be ordered by WRL. APS Requirements Face Amounts Age Up and $1 million $1,000,001 $2,500,000 Over $2.5 million 0 50 NOT ROUTINELY (for cause or for exam within 3 months not marked within normal limits)* NOT ROUTINELY (for cause or for exam within 3 months not marked within normal limits)* YES Will be required on ALL applications** NOT ROUTINELY (for cause or for exam within 3 months not marked within normal limits)* NOT ROUTINELY (for cause or for exam within 3 months not marked within normal limits)* YES Will be required on ALL applications Yes If over 500k OR has seen an MD in the last 3 months (any amount)* Yes Within the last 3 years for preferred classes and has an established PCP Yes Within the last 3 years for preferred classes and has an established PCP 70 and older Yes*** Yes*** Yes * APSs not needed on annual female exams unless exam was noted as abnormal or regular annual exams that are marked within normal limits. (If it is determined that an APS is not needed on recent exams and not marked within normal limits, please amend noting normal results.) ** Individual consideration up and $5 Million (and under age 40) if applicant has not seen an MD for more than 3 years (manager referral if over $5 Million). *** Ages 70 79, normal underwriting guidelines if seen in the last 24 months by PCP. Age 80 should have seen an MD in the last 12 months for any consideration. 17

13 Male and Female Build Tables 18

14 Male Build Table Up and Age 70 Weight Height Elite Plus Standard

15 Male Build Table Ages 71+ Weight Height Elite Plus Standard

16 Female Build Table Up and Age 70 Weight Height Elite Plus Standard

17 Female Build Table Ages 71+ Weight Height Elite Plus Standard

18 23 General Financial Underwriting Guide The following financial guide is intended assist you in determining maximum coverage. Depending on the amount of coverage requested, WRL may need additional requirements. Inspection Reports and/or Personal Hisry Interviews may be required based on the applicant s age and the amount of coverage requested. When the amount requested exceeds $2,000,000 (Ages 18-70) or $1,000,000 (Ages 71+) a WRL Confidential Financial Questionnaire is required. Cover letters are helpful for all amounts, but should be included for amounts over $5,000,000, or whenever else indicated in this guide. Personal insurance needs should be a combination of income replacement and estate tax costs less personal coverage already inforce. Purpose Income Continuation Needs Formula and Requirements High Growth Potential/ Facr x Income Professional Ages Regular Limits Occupations To age Individual Consideration Individual Consideration The chart above is a useful guide for determining the maximum face amount for personal coverage income continuation needs. The income stated must be reasonable for the profession or occupation stated. The underwriter will consider the length and level of experience. The income source considered will be that of the proposed insured, not the household income or that of the owner. Remember that earned income includes salary, bonuses, commissions, and deferred compensation. It excludes income from investments. The unemployed spouse may be considered for a percentage of the employed spouse s income. The underwriter will analyze the sources of income, the tal financial situation of the client and the amount of coverage in force and applied for determine the maximum face amount WRL can approve. Purpose Key Person Compensation Ratio Purpose Juvenile Formula and Requirements AGE: To age 65 AMOUNT: 7 10 times income President/CEO AGE: Age 66+ AMOUNT: 5 times income A cover letter should be provided, for all amounts, explaining the keyperson s value the company, how the coverage amount was determined, whether the keyperson has ownership in the company and the percentage of ownership and a list of all other key persons, the amount of keyperson coverage and percentage of ownership of the company for each keyperson. Formula and Requirements The maximum tal line amount of coverage, inforce and applied for is $500,000. The parents or legal guardian should have a minimum of 2 times the amount requested on the juvenile. All siblings should have equal coverage. Parents or guardians must always witness the applications and complete the non-medical declarations. For amounts over $500,000 the underwriter will consider on an individual basis with a cover letter from the agent explaining the need and purpose and the overall family insurance estate planning program where the insurance needs of the parents are first covered and the amount of coverage on all family members is consistent with the financial picture of the parents. Income and net worth of the parents will be a facr in the decision as how much coverage will be issued. The cover letter should include the purpose of the coverage and how the amount was determined. Copies of the estate planning analysis should accompany the cover letter. Third party verification is required for amounts over $10,000,000. Third party verification is defined as atrney signature and supporting documentation and/or CPA or accountant verification and signed statement. Additionally, for amounts over $10,000,000 copies of the last two years financial statements are required. Purpose Credir or Business Loan Purpose Estate Tax Planning Purpose Business Continuation, Buy-Sell Sck Repurchase Formula and Requirements Coverage should be on key individuals only (owners, executives) and the face amount should be no more than 80% of the loan amount for individual coverage and tal loan coverage on all partners should not exceed 80% of the loan. A cover letter should include the purpose, duration of the loan, collateral pledged, it s value and the loan interest rate. The term of the loan must be 5 years or more. A copy of the loan agreement is needed for loans over $3,000,000. The business should be the owner of the policy Formula and Requirements This coverage is designed protect the value of an individual s estate at the time of their death. We need the purpose of the insurance, a current value of the applicant s estate, which includes a personal balance sheet listing all assets and liabilities, and an estate analysis. After calculating the applicant s net worth we use a base interest rate, times the applicant s life expectancy arrive at a face amount that should maintain the value of the estate. We can cover up 50% of the projected future value. AGE: To age 65 *Expected annual Interest: 7% **Maximum Number of Years: : *Expected annual Interest: 7% **Maximum Number of Years: : *Expected annual Interest: 7% **Maximum Number of Years: 7 *The 7% annual growth rate is used for illustration purposes. This estate appreciation rate should be adjusted, up or down, taking in consideration what is a reasonable growth facr in the current economic environment. Typically, this has been in the 5-10% range. ** Standard Risks only, otherwise the underwriter will use the maximum number of years or the remaining life expectancy projection, whichever is less. Formula and Requirements Coverage is designed protect the partners or sckholders in a business and allow for the continuation of that business after the loss of a partner. The amount is determined by the ownership percentage and the fair market value of the business. Premiums are paid by the company and the proceeds are used buy out the deceased partner s share of the business. A cover letter should be provided for all amounts explaining how the amount of insurance and the market value of the business were determined. A copy of the buy-sell agreement or the details of the buy-sell agreement should be provided. Please provide the applicant s ownership percentage, the number of other partners, their ownership percentage and the amount of buy-sell coverage on each partner and the amount and purpose of all in force business coverage. All partners must apply for or have in force buy/sell coverage. The underwriter will need the last two years corporate balance sheets and income statements, NOTES. 24

19 Life Insurance Products offered by: Western Reserve Life Assurance Co. of Ohio Home Office: Columbus, Ohio Administrative Office Address: P.O. Box 5068 Clearwater, Florida Cusmer Service: ext AG /10-WFG For Agent Use Only. Not For Use With The Public.