Product: Instant Decision IUL
Product Type: Simplified Issue Indexed Universal Life
Issue Ages: 18–65
Face Amounts: $50,000–$450,000
Target Market: Permanent life with cash value growth (IUL)
Americo’s Instant Decision IUL is a simplified issue, permanent life insurance product offering indexed cash value growth based on the S&P 500®. It is designed to provide lifelong coverage with potential for premium flexibility and policy loans. All underwriting is instant and completed via Americo's online eApplication system. No paramed exams, lab work, or APSs are required for underwriting.
Issue Ages: 18–65 (age last birthday)
Minimum Face Amount: $50,000
Maximum Face Amount (Non-Medical): $450,000
Risk Classes: Non-nicotine and Nicotine (based on 24-month tobacco/nicotine abstinence)
Indexed Universal Life with 1-year index periods
Two Indexed Interest Strategies:
S&P 500 Point-to-Point with a Cap
S&P 500 Point-to-Point with a Participation Rate
Sweep and declared interest accounts have a guaranteed 2% minimum
Indexed accounts have a 0% guaranteed minimum annual crediting rate
Option A (Level) death benefit at issue; Option B (Increasing) available after year 1
Death benefit options may be changed after policy year 1 (subject to face amount restrictions)
Premium load: 7%
Monthly per-policy charge: $5.00 (current), $7.00 (guaranteed)
Unit-based charges vary by class, gender, and age
Deductions follow order: Sweep > Declared > Indexed Account (LIFO if multiple indexed)
5-year No-Lapse Guarantee if minimum premium is paid
Can be reinstated by paying missed premiums
Keeps policy in force even with negative accumulation value (within guarantee limits)
Standard Loan:
Interest: 4% (first 10 years), 2% (thereafter)
Drawn from declared account
Index Loan:
Interest up to 8%; continues to receive index crediting
Drawn from indexed account, with default to declared if indexed values are insufficient
Partial Surrenders:
Not allowed in first policy year
Minimum: $500
One per year
Reduces face amount and subject to partial surrender charges
No exams, labs, or APSs
Underwriting via eApp with:
MIB check
Prescription history check
Application questions (Sections 4–13 are knockout questions)
Drill-down required for any “Yes” answers
Health changes before approval must be reported
| Height | Weight Range (lbs) |
|---|---|
| 4’8” | 80–188 |
| 4’9” | 82–195 |
| 4’10” | 85–202 |
| 4’11” | 88–209 |
| 5’0” | 91–216 |
| 5’1” | 95–223 |
| 5’2” | 97–231 |
| 5’3” | 100–238 |
| 5’4” | 103–246 |
| 5’5” | 107–254 |
| 5’6” | 110–262 |
| 5’7” | 113–270 |
| 5’8” | 117–278 |
| 5’9” | 120–286 |
| 5’10” | 123–295 |
| 5’11” | 127–303 |
| 6’0” | 131–312 |
| 6’1” | 134–321 |
| 6’2” | 138–330 |
| 6’3” | 142–339 |
| 6’4” | 145–348 |
| 6’5” | 149–357 |
| 6’6” | 153–366 |
| 6’7” | 157–376 |
No formal exclusion list provided
Rx history reviewed in underwriting
Agents must provide full medical history and exam results
Critical Illness Accelerated Death Benefit Rider (Series 2195):
ALS, End Stage Renal Failure, Invasive Cancer, Major Organ Failure, Heart Attack, Stroke
Chronic Illness Accelerated Death Benefit Rider (Series 2196):
Must be unable to perform 2 of 6 ADLs or have cognitive impairment
Terminal Illness Accelerated Death Benefit Rider (Series 2197):
Life expectancy 12 months or less
All riders are lump-sum only; once exercised, policy and riders terminate
Must be a legal U.S. resident (Green Card or I-551)
Not available for temporary visitors or B1/B2 visa holders
U.S. citizens can travel abroad for up to 4 weeks
Military sales prohibited on bases; deployment disclosure required
Allowed within 3 years of lapse
Requires proof of insurability and payment of back premiums
No-lapse guarantee may be reinstated with back premium
External replacements allowed via eApp only
Internal replacements not allowed
Indexed accounts reset annually
Surrender charges apply for 14 years
Partial surrender charge = % of full surrender charge; minimum $50
Transfers only allowed on sweep dates or at end of index period
This content is based on Americo’s full May 2025 Instant Decision IUL Agent Guide and is intended for use in internal AI Assistant training and Joomla menu integration only.
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Product: Instant Decision Term Series
Product Types: Term 125, Term 100, CBO 100, CBO 50, ADB Term, Payment Protector
Issue Ages: Varies by term (20–75 overall range)
Face Amounts: $25,000–$450,000 (non-med)
Target Market: Term life, mortgage protection, return-of-premium, or income payout benefits
The Americo Instant Decision Term Series is a simplified issue term life insurance suite offering a variety of death benefit and cash-back designs. These products are issued with no medical exams required and deliver an instant underwriting decision via electronic application (eApp). Each plan supports specific income replacement goals, mortgage protection strategies, or return-of-premium benefits. Non-medical underwriting is available up to $450,000 across the series.
Minimum Face Amount: $25,000
Maximum Face Amount (Non-Medical): $450,000
By Product Type and Term Length:
CBO 100 & CBO 50
Terms: 30, 25, and 20 years
Issue Ages:
30-Year: 20–55 (Non-nicotine); 20–50 (Nicotine)
25-Year: 20–55 (Non-nicotine); 20–50 (Nicotine)
20-Year: 20–60 (Non-nicotine); 20–52 (Nicotine)
Term 125 & Term 100
Terms: 30-, 25-, 20-, and 15-year level terms
Issue Ages:
30-Year: 20–60
25-Year: 20–65
20-Year: 20–70
15-Year: 20–75
ADB Term (Low-Cost Accidental Term)
Terms: 30 years (ages 20–50); 20 years (ages 51–60)
Death Benefit: $1,000 all-cause, plus Accidental Death Benefit (ADB): $100k, $150k, $200k, or $250k
Payment Protector & Continuation 10/25
Term Durations: 30, 25, 20, 15 years, or to Age 70
Issue Ages (Payment Protector): 20–60 (30 yr); 20–65 (25 yr); 20–70 (20 yr); 20–75 (15 yr); 20–50 (To Age 70)
Issue Ages (Continuation 10): up to 60 depending on term length
CBO 100 / CBO 50: Return of 100% or 50% of base premiums paid via Enhanced Surrender Value Rider
Term 125 / Term 100: Guaranteed level term with optional riders
ADB Term: Low-cost option with small all-cause benefit and larger ADB
Payment Protector: Monthly income payout to beneficiaries (lump sum optional)
Continuation Series: Whole life with reduced benefit (10% or 25%) after initial term
| Height | Standard Range | DI Rider Range | ADB Range |
|---|---|---|---|
| 4’8” | 80 - 188 | 74 - 178 | 74 - 211 |
| 4’9” | 82 - 195 | 77 - 184 | 77 - 219 |
| 4’10” | 85 - 202 | 79 - 191 | 79 - 227 |
| 4’11” | 88 - 209 | 82 - 198 | 82 - 235 |
| 5’0” | 91 - 216 | 85 - 204 | 85 - 243 |
| 5’1” | 95 - 223 | 88 - 211 | 88 - 251 |
| 5’2” | 97 - 231 | 91 - 218 | 91 - 259 |
| 5’3” | 100 - 238 | 94 - 225 | 94 - 268 |
| 5’4” | 103 - 246 | 97 - 233 | 97 - 276 |
| 5’5” | 107 - 254 | 100 - 240 | 100 - 285 |
| 5’6” | 110 - 262 | 103 - 247 | 103 - 294 |
| 5’7” | 113 - 270 | 106 - 255 | 106 - 303 |
| 5’8” | 117 - 278 | 109 - 263 | 109 - 312 |
| 5’9” | 120 - 286 | 112 - 270 | 112 - 321 |
| 5’10” | 123 - 295 | 115 - 278 | 115 - 331 |
| 5’11” | 127 - 303 | 119 - 286 | 119 - 340 |
| 6’0” | 131 - 312 | 122 - 294 | 122 - 350 |
| 6’1” | 134 - 321 | 126 - 303 | 126 - 360 |
| 6’2” | 138 - 330 | 129 - 311 | 129 - 369 |
| 6’3” | 142 - 339 | 133 - 320 | 133 - 380 |
| 6’4” | 145 - 348 | 136 - 328 | 136 - 390 |
| 6’5” | 149 - 357 | 140 - 337 | 140 - 400 |
| 6’6” | 153 - 366 | 143 - 346 | 143 - 411 |
| 6’7” | 157 - 376 | 147 - 355 | 147 - 421 |
All products are simplified issue with instant decision via eApp
No medical exams; may depend on answers to medical and personal history questions
Risk classification: Standard Nicotine or Standard Non-nicotine (24-month non-use required for Non-nicotine)
Unisex premium rates
Build chart used internally (not publicly listed)
Knockout Conditions:
No specified list provided, but products may decline based on:
Personal history questions
Health disclosures in application
MIB, Rx checks, and motor vehicle history
No height/weight chart publicly available.
Living Benefit Riders (included at no cost): Critical Illness, Chronic Illness, Terminal Illness (varies by product)
Enhanced Surrender Value Rider (CBO products only): Returns 50% or 100% of premiums at end of term
Accidental Death Benefit (ADB) Rider
Additional Insured Term Rider (not available on “To Age 70”)
Children’s Term Rider (up to $15,000/child)
Disability Income Rider
Income Term Rider (Term 125 only)
Involuntary Unemployment Waiver of Premium
Waiver of Monthly Specified Premium (on UL plans)
Waiver of Premium Rider (varies by term and product)
ADB Rider Note: Pays 25% of base death benefit upon accidental death; doubles if death occurs as a fare-paying passenger on a common carrier.
No guaranteed conversion to permanent products is outlined for core term plans
Some riders (e.g. Children’s Term Rider) include conversion privileges at age 22 or upon death of base insured
Available in most states (check Americo state availability chart)
eApplication available 24/7 with instant decision
Fully commissionable $90 policy fee
Modal factors: Monthly EFT (0.095), Annual (1.00)
Policy issue age is based on age last birthday
Premium modes: Annual or Monthly EFT
This guide is based on Americo's February 2024 Term Series agent materials and is intended for internal use and Assistant training only.
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Category: Agent AI
Tags: Agent Mortgage Protection, Product Matching, Underwriting, AgentAI
Purpose: This guide helps Coach Kelly recommend the most appropriate Mortgage Protection product based on age, health, coverage amount, loan structure, and client preferences. Kelly should reference the carrier-specific articles for plan rules, state availability, and underwriting exceptions.
Coach Kelly should use product tags and carrier articles to filter options by eligibility and strengths.
“Because your client is 42 years old, healthy, and prefers a 30-year return of premium option, Americo CBO 100 is a strong match. It offers full ROP at term-end, day-one coverage, and includes living benefits. If cost is a concern, SBLI Quility Term with ROP Rider is also worth quoting.”
Coach Kelly should include a link to the most relevant product article or multiple options for quoting and comparison. If unsure, direct the agent to the quote tool or agent portal to explore options in more detail.
When clients have health challenges, Coach Kelly should prioritize products that offer lenient underwriting or guaranteed issue options. Use this table to guide general product matching based on common impairments. If multiple issues are present, Coach Kelly should default to the most restrictive and cross-check carrier articles.
| Condition | Recommended Carriers / Products | Notes |
|---|---|---|
| Insulin-dependent Diabetes (no complications) | Royal Neighbors Jet Term, Home Protector Term, UHL Term DLX | Americo CBO may decline; check Mutual of Omaha if no Rx flags |
| Heart Attack / Stents / Bypass (2+ yrs ago) | KCL SI Term, RNA Jet Term, Home Protector | SBLI may accept with full underwriting; avoid Americo Term 125 |
| Stroke (over 2 years ago, no ADLs) | RNA Jet Term, CICA Term, UHL Term DLX | Many carriers will downgrade to GI or graded; avoid ROP options |
| Recent Cancer (within 2 years) | CICA, UHL Term DLX | Most simplified term will decline; use GI fallback options |
| On Oxygen or ADL Assistance | CICA, UHL GI, no term options | Mortgage protection not viable — redirect to Final Expense GI suggesting covering mortgage payments |
Coach Kelly should use these real-world examples to guide plan recommendations and phrasing. These scenarios reflect common client profiles and can be used to generate confident responses.
Coach Kelly should avoid vague answers and instead reply with confident, field-ready phrasing like this:
“For a healthy 40-year-old client looking for mortgage protection, I’d recommend Americo’s CBO 100 or SBLI Level Term. Both are no-exam term options. The Americo CBO gives them all their money back at the end of the term, while SBLI keeps the premium lower with strong living benefits.”
“If your client is 60 and has type 2 diabetes plus tobacco use, you’ll likely need a more flexible plan. Look at UHL’s Simple Term 20-DXL or Americo Term 125. Both accept moderate risk and offer competitive pricing without requiring an exam.”
“When the client’s main goal is Return of Premium plus some living benefit protection, Americo CBO 100 is hard to beat. Just make sure they’re under age 60 and not rated too high medically.”
“A 65-year-old with a past heart issue might not qualify for simplified issue term with some carriers. In that case, check Mutual of Omaha’s Term Life Express for a no-exam option or Transamerica Trendsetter Super if they’re open to a full underwriting process.”
Coach Kelly should always:
| Carrier | Product | Term Lengths | Face Amounts | Issue Ages | ROP Available? | Underwriting |
|---|---|---|---|---|---|---|
| Americo | Instant Decision Term | 15, 20, 25, 30 | $25K–$450K | 20–75 | Yes (CBO 100 / CBO 50) | Simplified Issue MIB, Rx, MVR, eInterview |
| SBLI (via Quility) | Simple Issue Level Term | 10, 15, 20, 30 | $100K–$1M | 18–60 | No | Simplified Issue No Exam, Digital UW |
| Mutual of Omaha | Term Life Express | 10, 15, 20, 30 | $25K–$300K | 18–70 | Yes (via ROP rider) | Simplified Issue MIB, Rx, Height/Weight |
| Kansas City Life | Signature Term Express | 10, 15, 20, 30 | $50K–$300K | 18–64 | No | Simplified Issue No Exam, Rx, Build |
| Occidental / AmAm |
Term Made Simple / EZ Term / Home Protector |
10, 15, 20, 30 ROP (20 & 30) |
$25K–$500K | 18–70 | Yes (ROP options) | Simplified Issue Build, Rx, MIB |
| United Home Life | Simple Term Series | 20, 30, 20 ROP, 20 DLX | $25K–$300K | 20–60 | Yes (20 ROP option) | Simplified Issue Phone Interview, Rx |
Purpose: This guide helps Coach Kelly evaluate and recommend Mortgage Protection products using structured tag logic. Tag alignment ensures consistent product matching based on term length, health fit, ROP preference, underwriting style, and coverage amounts.
For Americo Instant Decision Term – CBO 100, use:
When asked to compare term options, match the agent’s client scenario to tagged products. Evaluate term length, ROP preference, face amount, and health fit. Recommend 1–2 products and link to their carrier articles for quoting or app guidance.
Purpose: This guide helps Coach Kelly evaluate and recommend Mortgage Protection products using structured tag logic. Tag alignment ensures consistent product matching based on term length, health fit, ROP preference, underwriting style, and coverage amounts.
For Americo Instant Decision Term – CBO 100, use:
When asked to compare term options, match the agent’s client scenario to tagged products. Evaluate term length, ROP preference, face amount, and health fit. Recommend 1–2 products and link to their carrier articles for quoting or app guidance.
]]>Carrier: Occidental/American Amicable (AmAm)
Product: EZ Term
Product Type: Simplified Issue Level Term Life Insurance
Issue Ages: 18–70 (varies by term duration and face amount)
Face Amounts: $25,000–$500,000 (based on age and product variant)
Available Term Durations: 10, 20, and 30-Year Level Term Periods
Target Market: Clients needing fast, no-exam term coverage with budget-friendly premiums and simplified underwriting — especially younger clients, mortgage protection, or income replacement cases.
Health Tolerance: Moderate — Table 4 max, Rx & MIB check, telephone interview possible
Occidental Life Insurance Company of North Carolina (a member of American-Amicable Group)
Easy Term is a simplified issue level term life insurance policy designed to provide affordable, renewable coverage through age 95. The product offers level premium terms of 10, 20, and 30 years, with optional Return of Premium (ROP) benefits available on the 20- and 30-year plans. Premiums are guaranteed to remain level for the selected term period. The product includes several built-in accelerated benefit riders and offers a variety of optional riders for customization.
| Plan | Issue Ages (Age Nearest Birthday) | |||
|---|---|---|---|---|
| Non-Tobacco | Tobacco | |||
| 10-Year Level Premium | Ages 18–70 | Ages 18–70 | ||
| 20-Year Level Premium | Ages 18–65 | Ages 18–65 | ||
| 30-Year Level Premium | Ages 18–55 | Ages 18–55 | ||
| 20-Year Return of Premium | Ages 18–60 | Ages 18–60 | ||
| 30-Year Return of Premium | Ages 18–50 | Ages 18–50 | ||
| Minimum Issue Limit | $25,000 face amount or $15/mo premium (whichever is greater) | |||
| Maximum Face Amount |
|
|||
| Premium Bands |
|
|||
| Modal Factors |
|
|||
| Policy Fee | $60 Annually (fully commissionable) | |||
Easy Term uses simplified underwriting, including a Yes/No application, MIB and Rx report, Motor Vehicle Report (MVR), and a build chart. Telephone interviews may be required based on the coverage amount or rider selection. Underwriting may request medical records (APS) at their discretion. The company does not accept applications for applicants over or under the build chart limits, or with conditions flagged as automatic declines in the Medical Impairment Guide. Reapplication is not allowed if an individual has had three prior lapsed, surrendered, or canceled policies from the company.
| Height | Min Weight | Max Weight (Table 2) | Max Weight (Table 4) |
|---|---|---|---|
| HEIGHT | MINIMUM WEIGHT MUST BE AT LEAST | MAXIMUM WEIGHT WITHIN TABLE 2 | MAXIMUM WEIGHT WITHIN TABLE 4 |
| 4’10” | 86 | 182 | 199 |
| 4’11” | 88 | 188 | 205 |
| 5’ | 90 | 195 | 212 |
| 5’1” | 93 | 201 | 220 |
| 5’2” | 95 | 208 | 227 |
| 5’3” | 99 | 215 | 234 |
| 5’4” | 101 | 221 | 242 |
| 5’5” | 104 | 228 | 249 |
| 5’6” | 106 | 235 | 257 |
| 5’7” | 110 | 243 | 265 |
| 5’8” | 113 | 250 | 273 |
| 5’9” | 117 | 257 | 281 |
| 5’10” | 120 | 265 | 289 |
| 5’11” | 125 | 272 | 298 |
| 6’ | 129 | 280 | 306 |
| 6’1” | 133 | 288 | 315 |
| 6’2” | 136 | 296 | 323 |
| 6’3” | 140 | 304 | 332 |
| 6’4” | 143 | 312 | 341 |
| 6’5” | 146 | 320 | 350 |
| 6’6” | 149 | 329 | 359 |
| 6’7” | 153 | 337 | 368 |
| 6’8” | 157 | 346 | 378 |
| 6’9” | 160 | 355 | 387 |
| EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) |
|---|---|---|---|
| Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. |
| MEDICATION | COMMON USE OF CONCERN | RX FILL WITHIN | PLAN ELIGIBILITY |
| Betapace | Heart Arrhythmia | N/A | Decline |
| Betapace | CHF | N/A | Decline |
| Betaseron | Multiple Sclerosis | N/A | Decline |
| Betaxolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Betaxolol HCL | CHF | N/A | Decline |
| BiDil | CHF | N/A | Decline |
| Bisoprolol Fumarate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Bisoprolol Fumarate | CHF | N/A | Decline |
| Bromocriptine Mesylate | Parkinson’s | N/A | Decline |
| Bumetanide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Bumetanide | CHF | N/A | Decline |
| Bumex | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Bumex | CHF | N/A | Decline |
| Buprenex | Alcohol / Drugs | 4 years | Decline |
| Bystolic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Bystolic | CHF | N/A | Decline |
| Calan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Calcium Acetate | Kidney Dialysis | N/A | Decline |
| Calcium Acetate | Renal Insufficiency/Failure | N/A | Decline |
| Calcium Acetate | Diabetic Nephropathy | N/A | Decline |
| Campath | Cancer | 8 years > 8 years | Decline Standard |
| Campral | Alcohol / Drugs | 4 years | Decline |
| Capoten | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Capoten | CHF | N/A | Decline |
| Capozide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Capozide | CHF | N/A | Decline |
| Captopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Captopril | CHF | N/A | Decline |
| Carbamazepine | Seizures | N/A | See Impairment Guide |
| Carbatrol | Seizures | N/A | See Impairment Guide |
| Carbidopa | Parkinson’s | N/A | Decline |
| Cardizem | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Cardura | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Cartia | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Carvedilol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Carvedilol | CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Medication | Use | RX Fill Within | Plan Eligibility |
|---|---|---|---|
| Digoxin | Irregular Heartbeat | N/A | Decline |
| Digoxin | CHF | N/A | Decline |
| Dilacor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Dilantin | Seizures | N/A | See Impairment Guide |
| Dilatrate SR | Angina / CHF | N/A | Decline |
| Dilor | Asthma | N/A | See Impairment Guide |
| Dilor | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Diovan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Diovan | CHF | N/A | Decline |
| Disulfiram | Alcohol / Drugs | 4 years | Decline |
| Dolophine | Opioid Dependence | 4 years | Decline |
| Donepezil HCL | Alzheimer’s / Dementia | N/A | Decline |
| Duoneb | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Dyazide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Dyazide | CHF | N/A | Decline |
| Dynacirc | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Dyrenium | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Dyrenium | CHF | N/A | Decline |
| Edecrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Edecrin | CHF | N/A | Decline |
| Edurant | AIDS | N/A | Decline |
| Eldepryl | Parkinson’s | N/A | Decline |
| Emtriva | AIDS | N/A | Decline |
| Enalapril Maleate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Enalapril Maleate | CHF | N/A | Decline |
| Enalaprilat | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Enalaprilat | CHF | N/A | Decline |
| Epitol | Seizures | N/A | See Impairment Guide |
| Epivir | AIDS | N/A | Decline |
| Eplerenone | CHF | N/A | Decline |
| Eskalith | Bi-Polar / Schizophrenia | N/A | Decline |
| Esmolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Esmolol HCL | CHF | N/A | Decline |
| Exforge | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Exforge | CHF | N/A | Decline |
| Felodipine | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Femara | Cancer | 8 years > 8 years | Decline Standard |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Foscavir | AIDS | N/A | Decline |
| Fosinopril Sodium | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Fosinopril Sodium | CHF | N/A | Decline |
| Fosrenol | Kidney Dialysis | N/A | Decline |
| Fosrenol | Renal Insufficiency / Failure | N/A | Decline |
| Fosrenol | Diabetic Nephropathy | N/A | Decline |
| Furosemide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Furosemide | CHF | N/A | Decline |
| Gabapentin | Seizures | N/A | See Impairment Guide |
| Gabapentin | Restless Leg Syndrome | N/A | Standard |
| Gleevec | Cancer | 8 years > 8 years | Decline Standard |
| Glipizide | Diabetes | N/A | See ‘#’ Below |
| Glucophage | Diabetes | N/A | See ‘#’ Below |
| Glucotrol | Diabetes | N/A | See ‘#’ Below |
| Glyburide | Diabetes | N/A | See ‘#’ Below |
| Glynase | Diabetes | N/A | See ‘#’ Below |
| Haldol | Schizophrenia | N/A | Decline |
| Haloperidol | Schizophrenia | N/A | Decline |
| HCTZ/Triamterene | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| HCTZ/Triamterene | CHF | N/A | Decline |
| Hectoral | Kidney Dialysis | N/A | Decline |
| Hectoral | Renal Insufficiency / Failure | N/A | Decline |
| Hectoral | Diabetic Nephropathy | N/A | Decline |
| Heparin | Blood Clot / Deep Vein Thrombosis | N/A | See Impairment Guide |
| Hepsera | Liver Disorder / Hepatitis | N/A | Decline |
| Hizentra | Immunodeficiency | N/A | Decline |
| Humalog | Diabetes | N/A | Decline |
| Humulin | Diabetes | N/A | Decline |
| Hydralazine HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Hydralazine HCL | CHF | N/A | Decline |
| Hydroxychloroquine | Systemic Lupus (SLE) | N/A | Decline |
| Hydroxychloroquine | Rheumatoid Arthritis | N/A | Decline |
| Hydroxyurea | Cancer | 8 years > 8 years | Decline Standard |
| Hytrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Hyzaar | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Hyzaar | CHF | N/A | Decline |
| Imdur | Angina / CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Imuran | Organ / Tissue Transplant | N/A | Decline |
| Imuran | Rheumatoid Arthritis | N/A | Decline |
| Imuran | Systemic Lupus (SLE) | N/A | Decline |
| Inamrinone | CHF | N/A | Decline |
| Inderal | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Inderal | CHF | N/A | Decline |
| Inderide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Inderide | CHF | N/A | Decline |
| Inspra | CHF | N/A | Decline |
| Insulin | Diabetes | N/A | Decline |
| Intron-A | Cancer | 8 years > 8 years | Decline Standard |
| Intron-A | Hepatitis C | N/A | Decline |
| Invirase | AIDS | N/A | Decline |
| Ipratropium Bromide | Allergies | N/A | Standard |
| Ipratropium Bromide | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Isoptin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Isordil | Angina / CHF | N/A | Decline |
| Isosorbide Dinitrate/ Mononitrate | Angina / CHF | N/A | Decline |
| Janumet | Diabetes | N/A | See ‘#’ Below |
| Januvia | Diabetes | N/A | See ‘#’ Below |
| Kaletra | AIDS | N/A | Decline |
| Kemadrin | Parkinson’s | N/A | Decline |
| Kerlone | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Kerlone | Glaucoma | N/A | Standard |
| Labetalol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Labetalol | Angina | N/A | Decline |
| Lamictal | Seizures | N/A | See Impairment Guide |
| Lamictal | Bi-polar / Major depression | N/A | Decline |
| Lamotrigine | Seizures | N/A | See Impairment Guide |
| Lamotrigine | Bi-polar / Major depression | N/A | Decline |
| Lanoxicaps | Irregular Heartbeat | N/A | Decline |
| Lanoxicaps | CHF | N/A | Decline |
| Lanoxin | Irregular Heartbeat | N/A | Decline |
| Lanoxin | CHF | N/A | Decline |
| Lantus | Diabetes | N/A | Decline |
| Larodopa | Parkinson’s | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Lasix | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Lasix | CHF | N/A | Decline |
| Leukeran | Cancer | 8 years > 8 years | Decline Standard |
| Levatol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Levatol | Angina | N/A | Decline |
| Levemir | Diabetes | N/A | Decline |
| Levocarnitine | Kidney Dialysis | N/A | Decline |
| Levocarnitine | Renal Insufficiency / Failure | N/A | Decline |
| Levocarnitine | Diabetic Nephropathy | N/A | Decline |
| Levodopa | Parkinson’s | N/A | Decline |
| Lexiva | AIDS | N/A | Decline |
| Lipitor | Cholesterol | N/A | Standard |
| Lisinopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Lisinopril | CHF | N/A | Decline |
| Lithium | Bi-Polar / Schizophrenia | N/A | Decline |
| Lodosyn | Parkinson’s | N/A | Decline |
| Lopressor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Losartan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Losartan | CHF | N/A | Decline |
| Lotensin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Lotensin | CHF | N/A | Decline |
| Loxapine | Schizophrenia | N/A | Decline |
| Loxitane | Schizophrenia | N/A | Decline |
| Lozol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Lupron | Cancer | 8 years > 8 years | Decline Standard |
| Lyrica | Seizures | N/A | See Impairment Guide |
| Mavik | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Mavik | CHF | N/A | Decline |
| Maxzide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Maxzide | CHF | N/A | Decline |
| Mellaril | Schizophrenia | N/A | Decline |
| Metformin | Diabetes | N/A | See ‘#’ Below |
| Methadone | Opioid Dependence | 4 years | Decline |
| Methadose | Opioid Dependence | 4 years | Decline |
| Methotrexate | Cancer | 8 years > 8 years | Decline Standard |
| Methotrexate | Rheumatoid Arthritis | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Metoprolol HCTZ | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Metoprolol HCTZ | CHF | N/A | Decline |
| Metoprolol Tartrate / Succinate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Metoprolol Tartrate / Succinate | CHF | N/A | Decline |
| Micardis | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Micardis | CHF | N/A | Decline |
| Micronase | Diabetes | N/A | See ‘#’ Below |
| Milrinone | CHF / Cardiomyopathy | N/A | Decline |
| Minipress | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Minitran | Angina / CHF | N/A | Decline |
| Mirapex | Parkinson’s | N/A | Decline |
| Mirapex | Other Use | N/A | Standard |
| Moban | Schizophrenia | N/A | Decline |
| Moduretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Moduretic | CHF | N/A | Decline |
| Moexipril HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Moexipril HCL | CHF | N/A | Decline |
| Monoket | Angina / CHF | N/A | Decline |
| Monopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Monopril | CHF | N/A | Decline |
| Mysoline | Seizures | N/A | See Impairment Guide |
| Nadolol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Nadolol | CHF | N/A | Decline |
| Naloxone | Alcohol / Drugs | 4 years | Decline |
| Naltrexone | Alcohol / Drugs | 4 years | Decline |
| Narcan | Alcohol / Drugs | 4 years | Decline |
| Natrecor | CHF | N/A | Decline |
| Navane | Schizophrenia | N/A | Decline |
| Neurontin | Seizures | N/A | See Impairment Guide |
| Nifedipine | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Nimodipine | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
| Nimotop | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
| Nitrek | Angina / CHF | N/A | Decline |
| Nitro-bid | Angina / CHF | N/A | Decline |
| Nitro-dur | Angina / CHF | N/A | Decline |
| Nitroglycerine / Nitrotab / Nitroquick/Nitrostat | Angina / CHF | N/A | Decline |
| Nitrol | Angina / CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Normodyne | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Norpace | Irregular Heartbeat | N/A | Decline |
| Norvir | AIDS | N/A | Decline |
| Novolin | Diabetes | N/A | Decline |
| Novolog | Diabetes | N/A | Decline |
| Pacerone | Irregular Heartbeat | N/A | Decline |
| Pancrease | Chronic Pancreatitis | N/A | Decline |
| Parcopa | Parkinson’s | N/A | Decline |
| Parlodel | Parkinson’s | N/A | Decline |
| Pegasys | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Peg-Intron | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Pentam 300 | AIDS | N/A | Decline |
| Pentamidine Isethionate | AIDS | N/A | Decline |
| Pergolide Mesylate | Parkinson’s | N/A | Decline |
| Permax | Parkinson’s | N/A | Decline |
| Phenobarbital | Seizures | N/A | See Impairment Guide |
| Phoslo | Kidney Dialysis | N/A | Decline |
| Phoslo | Renal Insufficiency / Failure | N/A | Decline |
| Phoslo | Diabetic Nephropathy | N/A | Decline |
| Plaquenil | Systemic Lupus (SLE) | N/A | Decline |
| Plaquenil | Malaria | N/A | Standard |
| Plaquenil | Rheumatoid Arthritis | N/A | Decline |
| Plavix | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
| Plendil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Prandin | Diabetes | N/A | See ‘#’ Below |
| Prazosin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Primacor | CHF | N/A | Decline |
| Prinivil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Prinivil | CHF | N/A | Decline |
| Prinzide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Prinzide | CHF | N/A | Decline |
| Procardia | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Prograf | Organ / Tissue Transplant | N/A | Decline |
| Proleukin | Cancer | 8 years > 8 years | Decline Standard |
| Prolixin | Schizophrenia | N/A | Decline |
| Propranolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Propranolol HCL | CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Proventil | Asthma | N/A | See Impairment Guide |
| Proventil | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Prozac | Depressive Disorder | N/A | Standard |
| Quinapril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Quinapril | CHF | N/A | Decline |
| Quinaretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Quinaretic | CHF | N/A | Decline |
| Ramipril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Ramipril | CHF | N/A | Decline |
| Ranexa | Angina / CHF | N/A | Decline |
| Rapamune | Organ / Tissue Transplant | N/A | Decline |
| Rebetol | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Rebetron | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Rebif | Multiple Sclerosis | N/A | Decline |
| Renagel | Kidney Dialysis | N/A | Decline |
| Renagel | Renal Insufficiency / Failure | N/A | Decline |
| Renagel | Diabetic Nephropathy | N/A | Decline |
| Renvela | Kidney Dialysis | N/A | Decline |
| Renvela | Renal Insufficiency / Failure | N/A | Decline |
| Renvela | Diabetic Nephropathy | N/A | Decline |
| Requip | Parkinson’s | N/A | Decline |
| Requip | Restless Leg Syndrome | N/A | Standard |
| Ribavirin | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Rilutek | ALS / Motor Neuron Disease | N/A | Decline |
| Risperdal | Bi-Polar / Schizophrenia | N/A | Decline |
| Risperidone | Bi-Polar / Schizophrenia | N/A | Decline |
| Rituxan | Cancer | 8 years > 8 years | Decline Standard |
| Rituxan | Rheumatoid Arthritis | N/A | Decline |
| Ropinirole | Parkinson’s | N/A | Decline |
| Ropinirole | Restless Leg Syndrome | N/A | Standard |
| Rythmol | Irregular Heartbeat | N/A | Decline |
| Serevent | Asthma | N/A | See Impairment Guide |
| Serevent | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Seroquel | Bi-Polar / Schizophrenia | N/A | Decline |
| Sinemet/Sinemet CR | Parkinson’s | N/A | Decline |
| Sodium Edecrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Sodium Edecrin | CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Sotalol Hydrochloride | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Sotalol Hydrochloride | CHF | N/A | Decline |
| Sotalol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Sotalol HCL | CHF | N/A | Decline |
| Spiriva | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Spironolactone | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Spironolactone | CHF | N/A | Decline |
| Sprycel | Cancer | 8 years > 8 years | Decline Standard |
| Stalevo | Parkinson’s | N/A | Decline |
| Starlix | Diabetes | N/A | See ‘#’ Below |
| Suboxone | Alcohol / Drugs | 4 years | Decline |
| Subutex | Alcohol / Drugs | 4 years | Decline |
| Sustiva | AIDS | N/A | Decline |
| Symbicort | Asthma | N/A | Standard |
| Symbicort | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Symmetrel | Parkinson’s | N/A | Decline |
| Tambocor | Irregular Heartbeat | N/A | Decline |
| Tamoxifen | Cancer | 8 years > 8 years | Decline Standard |
| Tarka | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tarka | CHF | N/A | Decline |
| Tasmar | Parkinson’s | N/A | Decline |
| Tegretol | Seizures | N/A | See Impairment Guide |
| Tenex | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tenoretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tenoretic | CHF | N/A | Decline |
| Tenormin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tenormin | CHF | N/A | Decline |
| Theo-Dur | Asthma | N/A | See Impairment Guide |
| Theo-Dur | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Theophylline | Asthma | N/A | See Impairment Guide |
| Theophylline | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Thioridazine | Schizophrenia | N/A | Decline |
| Thiothixene | Schizophrenia | N/A | Decline |
| Thorazine | Schizophrenia | N/A | Decline |
| Tiazac | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tolazamide | Diabetes | N/A | See ‘#’ Below |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Tolbutamide | Diabetes | N/A | See ‘#’ Below |
| Tolinase | Diabetes | N/A | See ‘#’ Below |
| Toprol XL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Toprol XL | CHF | N/A | Decline |
| Torsemide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Torsemide | CHF | N/A | Decline |
| Trandate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Trandate | CHF | N/A | Decline |
| Triamterene | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Triamterene | CHF | N/A | Decline |
| Tribenzor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tribenzor | CHF | N/A | Decline |
| Trihexyphenidyl HCL | Parkinson’s | N/A | Decline |
| Tresiba (Insulin) | Diabetes | N/A | Decline |
| Truvada | AIDS | N/A | Decline |
| Tyzeka | Liver Disorder / Hepatitis | N/A | Decline |
| Uniretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Uniretic | CHF | N/A | Decline |
| Univasc | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Univasc | CHF | N/A | Decline |
| Valcyte | AIDS | N/A | Decline |
| Valproic Acid | Seizures | N/A | See Impairment Guide |
| Valstar | Cancer | 8 years > 8 years | Decline Standard |
| Valturna | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Valturna | CHF | N/A | Decline |
| Vascor | Angina | N/A | Decline |
| Vaseretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Vaseretic | CHF | N/A | Decline |
| Vasotec | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Vasotec | CHF | N/A | Decline |
| Ventolin | Asthma | N/A | See Impairment Guide |
| Ventolin | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Verapamil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Viaspan | Organ / Tissue Transplant | N/A | Decline |
| Viracept | AIDS | N/A | Decline |
| Viramune | AIDS | N/A | Decline |
| Viread | AIDS | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Visken | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Visken | CHF | N/A | Decline |
| Vivitrol | Alcohol / Drugs | 4 years | Decline |
| Warfarin | Blood Clot / Deep Vein Thrombosis | N/A | See Impairment Guide |
| Warfarin | Stroke / Heart or Circulatory Disease or Disorder / Heart Valve Disease | N/A | Decline |
| Xeloda | Cancer | 8 years > 8 years | Decline Standard |
| Xopenex | Asthma | N/A | See Impairment Guide |
| Xopenex | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Zelapar | Parkinson’s | N/A | Decline |
| Zemplar | Kidney Dialysis | N/A | Decline |
| Zemplar | Renal Insufficiency / Failure | N/A | Decline |
| Zemplar | Diabetic Nephropathy | N/A | Decline |
| Zestoretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Zestoretic | CHF | N/A | Decline |
| Zestril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Zestril | CHF | N/A | Decline |
| Ziac | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Ziac | CHF | N/A | Decline |
| Zyprexa | Bi-Polar / Schizophrenia | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Note: The Critical Illness Rider cannot be issued with Waiver of Premium – Disability. DIR and AODIR cannot be issued together.
The policy is convertible without evidence of insurability. The new permanent policy must meet company minimums and may not exceed the face amount of the term policy being converted. Conversion must occur during the term period, prior to the insured reaching the maximum age as set by the carrier at the time of conversion.
Carrier: Occidental/American Amicable (AmAm)
Product: Home Protector Term
Product Types: 15, 20, and 30-Year Simplified Issue Term
Issue Ages: Varies by term and band (18–65 overall)
Face Amounts: $25,000–$500,000 (banded pricing structure)
Target Market: Mortgage protection or income replacement with simplified underwriting; includes built-in living benefits and optional return-of-premium
Occidental Life Insurance Company of North Carolina (a member of the American-Amicable Group)
Home Protector is a simplified issue level term life insurance product providing coverage to age 95. It is available in 15, 20, 25, and 30-year level premium options, with Return of Premium (ROP) available on the 20-, 25-, and 30-year terms. Premiums remain level during the selected term and coverage is renewable after the level period ends. This plan is designed to offer fast, simplified underwriting decisions and includes several built-in and optional riders.
Home Protector uses simplified issue underwriting. Policies are issued Standard through Table 4. There are no table ratings above Table 4. Eligibility is determined by application responses, MIB, prescription database, and optional telephone interview. Applicants exceeding weight/build chart limits or taking medications with disqualifying flags will be declined. APS (Attending Physician Statements) may be requested. A current mortgage is required for all applicants.
Applicants must fall within the acceptable range in the chart below. Applicants below minimum or above maximum are declined.
| BUILD CHART | BUILD CHART | BUILD CHART | BUILD CHART |
|---|---|---|---|
| HEIGHT | MINIMUM WEIGHT MUST BE AT LEAST | MAXIMUM WEIGHT WITHIN TABLE 2 | MAXIMUM WEIGHT WITHIN TABLE 4 |
| 4’10” | 86 | 182 | 199 |
| 4’11” | 88 | 188 | 205 |
| 5’ | 90 | 195 | 212 |
| 5’1” | 93 | 201 | 220 |
| 5’2” | 95 | 208 | 227 |
| 5’3” | 99 | 215 | 234 |
| 5’4” | 101 | 221 | 242 |
| 5’5” | 104 | 228 | 249 |
| 5’6” | 106 | 235 | 257 |
| 5’7” | 110 | 243 | 265 |
| 5’8” | 113 | 250 | 273 |
| 5’9” | 117 | 257 | 281 |
| 5’10” | 120 | 265 | 289 |
| 5’11” | 125 | 272 | 298 |
| 6’ | 129 | 280 | 306 |
| 6’1” | 133 | 288 | 315 |
| 6’2” | 136 | 296 | 323 |
| 6’3” | 140 | 304 | 332 |
| 6’4” | 143 | 312 | 341 |
| 6’5” | 146 | 320 | 350 |
| 6’6” | 149 | 329 | 359 |
| 6’7” | 153 | 337 | 368 |
| 6’8” | 157 | 346 | 378 |
| 6’9” | 160 | 355 | 387 |
The impairment guide outlines insurability based on specific medical conditions. Decisions reflect eligibility for the base plan, Disability Riders, AODIR, and Critical Illness Rider. Use the guide to identify automatic declines and conditions requiring special underwriting.
| EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) |
|---|---|---|---|
| Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. |
| MEDICATION | COMMON USE OF CONCERN | RX FILL WITHIN | PLAN ELIGIBILITY |
| Betapace | Heart Arrhythmia | N/A | Decline |
| Betapace | CHF | N/A | Decline |
| Betaseron | Multiple Sclerosis | N/A | Decline |
| Betaxolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Betaxolol HCL | CHF | N/A | Decline |
| BiDil | CHF | N/A | Decline |
| Bisoprolol Fumarate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Bisoprolol Fumarate | CHF | N/A | Decline |
| Bromocriptine Mesylate | Parkinson’s | N/A | Decline |
| Bumetanide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Bumetanide | CHF | N/A | Decline |
| Bumex | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Bumex | CHF | N/A | Decline |
| Buprenex | Alcohol / Drugs | 4 years | Decline |
| Bystolic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Bystolic | CHF | N/A | Decline |
| Calan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Calcium Acetate | Kidney Dialysis | N/A | Decline |
| Calcium Acetate | Renal Insufficiency/Failure | N/A | Decline |
| Calcium Acetate | Diabetic Nephropathy | N/A | Decline |
| Campath | Cancer | 8 years > 8 years | Decline Standard |
| Campral | Alcohol / Drugs | 4 years | Decline |
| Capoten | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Capoten | CHF | N/A | Decline |
| Capozide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Capozide | CHF | N/A | Decline |
| Captopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Captopril | CHF | N/A | Decline |
| Carbamazepine | Seizures | N/A | See Impairment Guide |
| Carbatrol | Seizures | N/A | See Impairment Guide |
| Carbidopa | Parkinson’s | N/A | Decline |
| Cardizem | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Cardura | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Cartia | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Carvedilol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Carvedilol | CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
This table lists medications that impact eligibility. Plan decisions are based on medication use, diagnosis, and timing. Conditions marked with ‘N/A’ apply regardless of prescription timing. See footnotes for high blood pressure and diabetes-specific considerations.
| Medication | Use | RX Fill Within | Plan Eligibility |
|---|---|---|---|
| Digoxin | Irregular Heartbeat | N/A | Decline |
| Digoxin | CHF | N/A | Decline |
| Dilacor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Dilantin | Seizures | N/A | See Impairment Guide |
| Dilatrate SR | Angina / CHF | N/A | Decline |
| Dilor | Asthma | N/A | See Impairment Guide |
| Dilor | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Diovan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Diovan | CHF | N/A | Decline |
| Disulfiram | Alcohol / Drugs | 4 years | Decline |
| Dolophine | Opioid Dependence | 4 years | Decline |
| Donepezil HCL | Alzheimer’s / Dementia | N/A | Decline |
| Duoneb | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Dyazide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Dyazide | CHF | N/A | Decline |
| Dynacirc | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Dyrenium | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Dyrenium | CHF | N/A | Decline |
| Edecrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Edecrin | CHF | N/A | Decline |
| Edurant | AIDS | N/A | Decline |
| Eldepryl | Parkinson’s | N/A | Decline |
| Emtriva | AIDS | N/A | Decline |
| Enalapril Maleate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Enalapril Maleate | CHF | N/A | Decline |
| Enalaprilat | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Enalaprilat | CHF | N/A | Decline |
| Epitol | Seizures | N/A | See Impairment Guide |
| Epivir | AIDS | N/A | Decline |
| Eplerenone | CHF | N/A | Decline |
| Eskalith | Bi-Polar / Schizophrenia | N/A | Decline |
| Esmolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Esmolol HCL | CHF | N/A | Decline |
| Exforge | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Exforge | CHF | N/A | Decline |
| Felodipine | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Femara | Cancer | 8 years > 8 years | Decline Standard |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Foscavir | AIDS | N/A | Decline |
| Fosinopril Sodium | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Fosinopril Sodium | CHF | N/A | Decline |
| Fosrenol | Kidney Dialysis | N/A | Decline |
| Fosrenol | Renal Insufficiency / Failure | N/A | Decline |
| Fosrenol | Diabetic Nephropathy | N/A | Decline |
| Furosemide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Furosemide | CHF | N/A | Decline |
| Gabapentin | Seizures | N/A | See Impairment Guide |
| Gabapentin | Restless Leg Syndrome | N/A | Standard |
| Gleevec | Cancer | 8 years > 8 years | Decline Standard |
| Glipizide | Diabetes | N/A | See ‘#’ Below |
| Glucophage | Diabetes | N/A | See ‘#’ Below |
| Glucotrol | Diabetes | N/A | See ‘#’ Below |
| Glyburide | Diabetes | N/A | See ‘#’ Below |
| Glynase | Diabetes | N/A | See ‘#’ Below |
| Haldol | Schizophrenia | N/A | Decline |
| Haloperidol | Schizophrenia | N/A | Decline |
| HCTZ/Triamterene | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| HCTZ/Triamterene | CHF | N/A | Decline |
| Hectoral | Kidney Dialysis | N/A | Decline |
| Hectoral | Renal Insufficiency / Failure | N/A | Decline |
| Hectoral | Diabetic Nephropathy | N/A | Decline |
| Heparin | Blood Clot / Deep Vein Thrombosis | N/A | See Impairment Guide |
| Hepsera | Liver Disorder / Hepatitis | N/A | Decline |
| Hizentra | Immunodeficiency | N/A | Decline |
| Humalog | Diabetes | N/A | Decline |
| Humulin | Diabetes | N/A | Decline |
| Hydralazine HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Hydralazine HCL | CHF | N/A | Decline |
| Hydroxychloroquine | Systemic Lupus (SLE) | N/A | Decline |
| Hydroxychloroquine | Rheumatoid Arthritis | N/A | Decline |
| Hydroxyurea | Cancer | 8 years > 8 years | Decline Standard |
| Hytrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Hyzaar | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Hyzaar | CHF | N/A | Decline |
| Imdur | Angina / CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Imuran | Organ / Tissue Transplant | N/A | Decline |
| Imuran | Rheumatoid Arthritis | N/A | Decline |
| Imuran | Systemic Lupus (SLE) | N/A | Decline |
| Inamrinone | CHF | N/A | Decline |
| Inderal | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Inderal | CHF | N/A | Decline |
| Inderide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Inderide | CHF | N/A | Decline |
| Inspra | CHF | N/A | Decline |
| Insulin | Diabetes | N/A | Decline |
| Intron-A | Cancer | 8 years > 8 years | Decline Standard |
| Intron-A | Hepatitis C | N/A | Decline |
| Invirase | AIDS | N/A | Decline |
| Ipratropium Bromide | Allergies | N/A | Standard |
| Ipratropium Bromide | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Isoptin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Isordil | Angina / CHF | N/A | Decline |
| Isosorbide Dinitrate/ Mononitrate | Angina / CHF | N/A | Decline |
| Janumet | Diabetes | N/A | See ‘#’ Below |
| Januvia | Diabetes | N/A | See ‘#’ Below |
| Kaletra | AIDS | N/A | Decline |
| Kemadrin | Parkinson’s | N/A | Decline |
| Kerlone | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Kerlone | Glaucoma | N/A | Standard |
| Labetalol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Labetalol | Angina | N/A | Decline |
| Lamictal | Seizures | N/A | See Impairment Guide |
| Lamictal | Bi-polar / Major depression | N/A | Decline |
| Lamotrigine | Seizures | N/A | See Impairment Guide |
| Lamotrigine | Bi-polar / Major depression | N/A | Decline |
| Lanoxicaps | Irregular Heartbeat | N/A | Decline |
| Lanoxicaps | CHF | N/A | Decline |
| Lanoxin | Irregular Heartbeat | N/A | Decline |
| Lanoxin | CHF | N/A | Decline |
| Lantus | Diabetes | N/A | Decline |
| Larodopa | Parkinson’s | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Lasix | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Lasix | CHF | N/A | Decline |
| Leukeran | Cancer | 8 years > 8 years | Decline Standard |
| Levatol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Levatol | Angina | N/A | Decline |
| Levemir | Diabetes | N/A | Decline |
| Levocarnitine | Kidney Dialysis | N/A | Decline |
| Levocarnitine | Renal Insufficiency / Failure | N/A | Decline |
| Levocarnitine | Diabetic Nephropathy | N/A | Decline |
| Levodopa | Parkinson’s | N/A | Decline |
| Lexiva | AIDS | N/A | Decline |
| Lipitor | Cholesterol | N/A | Standard |
| Lisinopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Lisinopril | CHF | N/A | Decline |
| Lithium | Bi-Polar / Schizophrenia | N/A | Decline |
| Lodosyn | Parkinson’s | N/A | Decline |
| Lopressor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Losartan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Losartan | CHF | N/A | Decline |
| Lotensin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Lotensin | CHF | N/A | Decline |
| Loxapine | Schizophrenia | N/A | Decline |
| Loxitane | Schizophrenia | N/A | Decline |
| Lozol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Lupron | Cancer | 8 years > 8 years | Decline Standard |
| Lyrica | Seizures | N/A | See Impairment Guide |
| Mavik | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Mavik | CHF | N/A | Decline |
| Maxzide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Maxzide | CHF | N/A | Decline |
| Mellaril | Schizophrenia | N/A | Decline |
| Metformin | Diabetes | N/A | See ‘#’ Below |
| Methadone | Opioid Dependence | 4 years | Decline |
| Methadose | Opioid Dependence | 4 years | Decline |
| Methotrexate | Cancer | 8 years > 8 years | Decline Standard |
| Methotrexate | Rheumatoid Arthritis | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Metoprolol HCTZ | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Metoprolol HCTZ | CHF | N/A | Decline |
| Metoprolol Tartrate / Succinate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Metoprolol Tartrate / Succinate | CHF | N/A | Decline |
| Micardis | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Micardis | CHF | N/A | Decline |
| Micronase | Diabetes | N/A | See ‘#’ Below |
| Milrinone | CHF / Cardiomyopathy | N/A | Decline |
| Minipress | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Minitran | Angina / CHF | N/A | Decline |
| Mirapex | Parkinson’s | N/A | Decline |
| Mirapex | Other Use | N/A | Standard |
| Moban | Schizophrenia | N/A | Decline |
| Moduretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Moduretic | CHF | N/A | Decline |
| Moexipril HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Moexipril HCL | CHF | N/A | Decline |
| Monoket | Angina / CHF | N/A | Decline |
| Monopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Monopril | CHF | N/A | Decline |
| Mysoline | Seizures | N/A | See Impairment Guide |
| Nadolol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Nadolol | CHF | N/A | Decline |
| Naloxone | Alcohol / Drugs | 4 years | Decline |
| Naltrexone | Alcohol / Drugs | 4 years | Decline |
| Narcan | Alcohol / Drugs | 4 years | Decline |
| Natrecor | CHF | N/A | Decline |
| Navane | Schizophrenia | N/A | Decline |
| Neurontin | Seizures | N/A | See Impairment Guide |
| Nifedipine | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Nimodipine | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
| Nimotop | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
| Nitrek | Angina / CHF | N/A | Decline |
| Nitro-bid | Angina / CHF | N/A | Decline |
| Nitro-dur | Angina / CHF | N/A | Decline |
| Nitroglycerine / Nitrotab / Nitroquick/Nitrostat | Angina / CHF | N/A | Decline |
| Nitrol | Angina / CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Normodyne | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Norpace | Irregular Heartbeat | N/A | Decline |
| Norvir | AIDS | N/A | Decline |
| Novolin | Diabetes | N/A | Decline |
| Novolog | Diabetes | N/A | Decline |
| Pacerone | Irregular Heartbeat | N/A | Decline |
| Pancrease | Chronic Pancreatitis | N/A | Decline |
| Parcopa | Parkinson’s | N/A | Decline |
| Parlodel | Parkinson’s | N/A | Decline |
| Pegasys | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Peg-Intron | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Pentam 300 | AIDS | N/A | Decline |
| Pentamidine Isethionate | AIDS | N/A | Decline |
| Pergolide Mesylate | Parkinson’s | N/A | Decline |
| Permax | Parkinson’s | N/A | Decline |
| Phenobarbital | Seizures | N/A | See Impairment Guide |
| Phoslo | Kidney Dialysis | N/A | Decline |
| Phoslo | Renal Insufficiency / Failure | N/A | Decline |
| Phoslo | Diabetic Nephropathy | N/A | Decline |
| Plaquenil | Systemic Lupus (SLE) | N/A | Decline |
| Plaquenil | Malaria | N/A | Standard |
| Plaquenil | Rheumatoid Arthritis | N/A | Decline |
| Plavix | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
| Plendil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Prandin | Diabetes | N/A | See ‘#’ Below |
| Prazosin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Primacor | CHF | N/A | Decline |
| Prinivil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Prinivil | CHF | N/A | Decline |
| Prinzide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Prinzide | CHF | N/A | Decline |
| Procardia | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Prograf | Organ / Tissue Transplant | N/A | Decline |
| Proleukin | Cancer | 8 years > 8 years | Decline Standard |
| Prolixin | Schizophrenia | N/A | Decline |
| Propranolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Propranolol HCL | CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Proventil | Asthma | N/A | See Impairment Guide |
| Proventil | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Prozac | Depressive Disorder | N/A | Standard |
| Quinapril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Quinapril | CHF | N/A | Decline |
| Quinaretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Quinaretic | CHF | N/A | Decline |
| Ramipril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Ramipril | CHF | N/A | Decline |
| Ranexa | Angina / CHF | N/A | Decline |
| Rapamune | Organ / Tissue Transplant | N/A | Decline |
| Rebetol | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Rebetron | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Rebif | Multiple Sclerosis | N/A | Decline |
| Renagel | Kidney Dialysis | N/A | Decline |
| Renagel | Renal Insufficiency / Failure | N/A | Decline |
| Renagel | Diabetic Nephropathy | N/A | Decline |
| Renvela | Kidney Dialysis | N/A | Decline |
| Renvela | Renal Insufficiency / Failure | N/A | Decline |
| Renvela | Diabetic Nephropathy | N/A | Decline |
| Requip | Parkinson’s | N/A | Decline |
| Requip | Restless Leg Syndrome | N/A | Standard |
| Ribavirin | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
| Rilutek | ALS / Motor Neuron Disease | N/A | Decline |
| Risperdal | Bi-Polar / Schizophrenia | N/A | Decline |
| Risperidone | Bi-Polar / Schizophrenia | N/A | Decline |
| Rituxan | Cancer | 8 years > 8 years | Decline Standard |
| Rituxan | Rheumatoid Arthritis | N/A | Decline |
| Ropinirole | Parkinson’s | N/A | Decline |
| Ropinirole | Restless Leg Syndrome | N/A | Standard |
| Rythmol | Irregular Heartbeat | N/A | Decline |
| Serevent | Asthma | N/A | See Impairment Guide |
| Serevent | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Seroquel | Bi-Polar / Schizophrenia | N/A | Decline |
| Sinemet/Sinemet CR | Parkinson’s | N/A | Decline |
| Sodium Edecrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Sodium Edecrin | CHF | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Sotalol Hydrochloride | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Sotalol Hydrochloride | CHF | N/A | Decline |
| Sotalol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Sotalol HCL | CHF | N/A | Decline |
| Spiriva | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Spironolactone | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Spironolactone | CHF | N/A | Decline |
| Sprycel | Cancer | 8 years > 8 years | Decline Standard |
| Stalevo | Parkinson’s | N/A | Decline |
| Starlix | Diabetes | N/A | See ‘#’ Below |
| Suboxone | Alcohol / Drugs | 4 years | Decline |
| Subutex | Alcohol / Drugs | 4 years | Decline |
| Sustiva | AIDS | N/A | Decline |
| Symbicort | Asthma | N/A | Standard |
| Symbicort | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Symmetrel | Parkinson’s | N/A | Decline |
| Tambocor | Irregular Heartbeat | N/A | Decline |
| Tamoxifen | Cancer | 8 years > 8 years | Decline Standard |
| Tarka | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tarka | CHF | N/A | Decline |
| Tasmar | Parkinson’s | N/A | Decline |
| Tegretol | Seizures | N/A | See Impairment Guide |
| Tenex | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tenoretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tenoretic | CHF | N/A | Decline |
| Tenormin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tenormin | CHF | N/A | Decline |
| Theo-Dur | Asthma | N/A | See Impairment Guide |
| Theo-Dur | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Theophylline | Asthma | N/A | See Impairment Guide |
| Theophylline | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Thioridazine | Schizophrenia | N/A | Decline |
| Thiothixene | Schizophrenia | N/A | Decline |
| Thorazine | Schizophrenia | N/A | Decline |
| Tiazac | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tolazamide | Diabetes | N/A | See ‘#’ Below |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Tolbutamide | Diabetes | N/A | See ‘#’ Below |
| Tolinase | Diabetes | N/A | See ‘#’ Below |
| Toprol XL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Toprol XL | CHF | N/A | Decline |
| Torsemide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Torsemide | CHF | N/A | Decline |
| Trandate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Trandate | CHF | N/A | Decline |
| Triamterene | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Triamterene | CHF | N/A | Decline |
| Tribenzor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Tribenzor | CHF | N/A | Decline |
| Trihexyphenidyl HCL | Parkinson’s | N/A | Decline |
| Tresiba (Insulin) | Diabetes | N/A | Decline |
| Truvada | AIDS | N/A | Decline |
| Tyzeka | Liver Disorder / Hepatitis | N/A | Decline |
| Uniretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Uniretic | CHF | N/A | Decline |
| Univasc | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Univasc | CHF | N/A | Decline |
| Valcyte | AIDS | N/A | Decline |
| Valproic Acid | Seizures | N/A | See Impairment Guide |
| Valstar | Cancer | 8 years > 8 years | Decline Standard |
| Valturna | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Valturna | CHF | N/A | Decline |
| Vascor | Angina | N/A | Decline |
| Vaseretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Vaseretic | CHF | N/A | Decline |
| Vasotec | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Vasotec | CHF | N/A | Decline |
| Ventolin | Asthma | N/A | See Impairment Guide |
| Ventolin | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Verapamil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Viaspan | Organ / Tissue Transplant | N/A | Decline |
| Viracept | AIDS | N/A | Decline |
| Viramune | AIDS | N/A | Decline |
| Viread | AIDS | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| Visken | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Visken | CHF | N/A | Decline |
| Vivitrol | Alcohol / Drugs | 4 years | Decline |
| Warfarin | Blood Clot / Deep Vein Thrombosis | N/A | See Impairment Guide |
| Warfarin | Stroke / Heart or Circulatory Disease or Disorder / Heart Valve Disease | N/A | Decline |
| Xeloda | Cancer | 8 years > 8 years | Decline Standard |
| Xopenex | Asthma | N/A | See Impairment Guide |
| Xopenex | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Zelapar | Parkinson’s | N/A | Decline |
| Zemplar | Kidney Dialysis | N/A | Decline |
| Zemplar | Renal Insufficiency / Failure | N/A | Decline |
| Zemplar | Diabetic Nephropathy | N/A | Decline |
| Zestoretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Zestoretic | CHF | N/A | Decline |
| Zestril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Zestril | CHF | N/A | Decline |
| Ziac | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Ziac | CHF | N/A | Decline |
| Zyprexa | Bi-Polar / Schizophrenia | N/A | Decline |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Non-ROP: Convertible to permanent coverage anytime before the earlier of: policy expiry, age 75, or 5 years from issue date (if issued after age 75).
ROP: Convertible before the end of the level term period or policy anniversary of age 75. No evidence of insurability required.
Carrier: Kansas City Life Insurance Company
Product: Signature Term Express (STE) and Signature Term Express ROP (STE ROP)
Product Types: 10-, 15-, 20-, 30-Year Level Term (STE); 20-, 25-, 30-Year ROP (STE ROP)
Issue Ages: STE: 10-Year (18–70), 15-Year (18–65), 20-Year (18–60), 30-Year (18–50); STE ROP: 20-Year (20–55), 25-Year (20–50), 30-Year (20–50)
Face Amounts: Minimum $50,000; Maximum $300,000 (Ages 18–65), $150,000 (Ages 66–70)
Target Market: Mortgage protection, short-term income replacement, return-of-premium term
Signature Term Express is a simplified issue term life insurance product with rapid underwriting and competitive pricing. It is designed for clients seeking efficient mortgage protection and short-term income replacement. Available in 10-, 15-, 20-, and 30-year level term durations, the product also offers Return of Premium (ROP) options in 20-, 25-, and 30-year terms. STE policies provide automatic living benefit riders and several optional riders to enhance flexibility.
For STE (non-ROP):
10-Year Term: Ages 18–70
15-Year Term: Ages 18–65
20-Year Term: Ages 18–60
30-Year Term: Ages 18–50
For STE ROP:
20-Year ROP: Ages 20–55
25-Year ROP: Ages 20–50
30-Year ROP: Ages 20–50
Minimum Face Amount: $50,000
Maximum Face Amount:
Ages 18–65: $300,000
Ages 66–70: $150,000
Signature Term Express (10, 15, 20, 30 year level term)
Signature Term Express ROP (20, 25, 30 year return-of-premium)
STE is issued on a simplified issue basis. There are no medical exams required, but underwriting utilizes the following tools:
MIB, MVR, and Risk Score: Used across all applications.
APS: May be ordered for face amounts $250,001–$300,000 or for older ages.
Build Chart: Evaluated in underwriting.
Mandatory MVR:
Ages 18–45 (STE)
Ages 20–45 (STE ROP)
Diabetes Guidelines:
Declined if diagnosed before age 50
Declined for insulin use at any age
Declined if diabetic with complications
Mortgage Requirement: Applicant must have purchased or refinanced a home in the past 2 years. Application must include mortgage loan amount and financial institution name.
Visa Requirements:
Acceptable Visas: Permanent Residency, H1B, L1
Must reside in U.S. for a minimum of 1 year
Must provide I-94, I-797A, or residency documentation
Applicants currently taking any of the following medications are not eligible and will be automatically declined. The complete exclusion list includes:
Abacavir, Abilify, Adcirca, Aggrenox, Alkeran, Amiodarone, Ampyra, Antabuse, Anoro Ellipta, Aricept, Arimidex, Atripla, Avonex, Azilect, Baraclude, Betaseron, Breo Ellipta, Buprenorphine (Subutex), Calcium Acetate, Campath, Campral, Caprelsa, Carbidopa/Levodopa, Casodex, Cayston, Cellcept, Chlorpromazine Hcl, Clozapine, Cognex, Combivir, Comtan, Copaxone, Crixivan, Cyclosporine, Cytoxan, Daklinza, Daliresp, Descovy, Digitek, Digoxin, Dobutamine Hcl, Donepezil, Droxia, Eldepryl, Eligard, Eliquis, Eminase, Enbrel, Entresto, Erythropoietin, Epivir Hbv, Ergoloid Mesylates, Exelon, Fanapt, Femara, Flecainide, Fluorouracil, Galantamine Hydrobromide, Gammagard, Gamunex, Gengraf, Genvoya, Geodon, Haldol, Haloperidol, Harvoni, Hepsera, Humira, Hydrea, Hydroxyurea, Infergen, Inspra, Insulin, Invega, Invirase, Isentress, Kaletra, Kalydeco, Keytruda, Lamictal, Lanoxin, Latuda, Leucovorin Calcium, Lexiva, Limbitrol, Lithium, Megestrol Acetate (Megace), Mercaptopurine, Methadone, Methotrexate, Mitomycin, Morphine Sulfate, Mycophenolate Mofetil, Myfortic, Nabi-Hb, Naloxone Hcl, Naltrexone Hcl, Namenda, Neupogen, Nitroglycerin, Odefsey, Olysio, Opdivo, Panretin, Pegasys, Peg-Intron, Perphenazine, Pradaxa, Prograf, Quinidine, Ranexa, Razadyne, Rebif, Retrovir, Revia, Revlimid, Rexulti, Rhythmol, Ribavirin, Rilutek, Risperdal, Rituxan, Sandimmune, Saphris, Seroquel, Serzone, Sinemet, Sotalol, Sovaldi, Spiriva, Stalevo, Stribild, Suboxone, Sustiva, Symbyax, Tamoxifen, Targretin, Temodar, Teslac, Tikosyn, Tolcapone, Truvada, Tudorza, Tysabri, Viracept, Viramune, Viread, Vraylor, Xarelto, Xeljanz, Yervoy, Zenapax, Zemplar, Zerit, Ziagen, Zidovudine, Zoladex, Zyprexa
Individual Consideration Medications: The following drugs may be accepted with explanation provided on the application: Carvedilol, Clopidogrel, Coreg, Coumadin, Enoxaparin Sodium, Lovenox, Prednisone, Plavix, Warfarin
| Height | Min Weight | Max Weight | Table Max (Diabetic/Meds) |
|---|---|---|---|
| 4’8” | 78 | 195 | 182 |
| 4’9” | 80 | 200 | 187 |
| 4’10” | 83 | 206 | 192 |
| 4’11” | 86 | 213 | 197 |
| 5’ | 89 | 218 | 203 |
| 5’1” | 92 | 225 | 208 |
| 5’2” | 95 | 231 | 213 |
| 5’3” | 97 | 237 | 218 |
| 5’4” | 100 | 243 | 223 |
| 5’5” | 104 | 250 | 229 |
| 5’6” | 107 | 257 | 236 |
| 5’7” | 109 | 264 | 242 |
| 5’8” | 113 | 272 | 248 |
| 5’9” | 116 | 280 | 256 |
| 5’10” | 119 | 288 | 263 |
| 5’11” | 123 | 296 | 271 |
| 6’ | 127 | 304 | 279 |
| 6’1” | 131 | 312 | 287 |
| 6’2” | 135 | 320 | 294 |
| 6’3” | 139 | 328 | 301 |
| 6’4” | 143 | 336 | 310 |
| 6’5” | 146 | 345 | 318 |
| 6’6” | 150 | 354 | 326 |
| 6’7” | 154 | 364 | 334 |
| 6’8” | 159 | 374 | 343 |
| 6’9” | 164 | 384 | 350 |
| 6’10” | 169 | 394 | 357 |
Included at No Cost:
Accelerated Death Benefit (ADB) – Chronic, Critical, and Terminal Illness
Waiver of Premium for Residential Damage
Waiver of Premium for Unemployment
Optional Riders:
ADB – Accidental Death Benefit (Issue Ages 18–60 STE; 20–55 ROP)
CTI – Children’s Term Insurance (14 days–17 years)
IAO – Income Assured Option (Installment Death Benefit Option)
WP – Waiver of Premium (Issue Ages 18–55 STE; 20–55 ROP)
Available after Year 2 through earlier of Policy Year 12 or Age 65
10-Year Term: convertible only through Year 10 or Age 65 (whichever is sooner)
Converts to eligible Kansas City Life permanent plans
No evidence of insurability required
Conversion not allowed if premiums are currently waived under WP rider
Reinstatement: Allowed within 3 years with proof of insurability and back premiums + 6% interest
Prepaid Premium Discount: Available on annual premiums only (not allowed with ROP plans)
STE ROP Features:
Tax-free return of base premiums (excludes riders) if policy is outlived
Extended term or paid-up insurance available at lapse (nonforfeiture options)
Automatic premium loan option available upon request
Loans available with 8% annual interest, repayable by cash value
This guide is intended for internal agent use only and is based on Kansas City Life's most recent specifications and agent material.
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Carrier: Mutual of Omaha (United of Omaha Life Insurance Company)
Guide: Simplified Issue Life Insurance Underwriting Guide — Term and Permanent Products
Guide Version: Updated April 2026
Products: Living Promise Whole Life, Term Life Express (TLE), IUL Express (IULE), and Children’s Whole Life where noted
Product Types: Simplified whole life, simplified term life, simplified indexed universal life
Target Market: Final expense, income replacement, business insurance, charitable giving through Living Promise, and permanent coverage through IUL Express or conversion options
Product Name and Carrier
This guide covers simplified issue life insurance products underwritten by United of Omaha Life Insurance Company, including:
Living Promise Whole Life
Term Life Express (TLE)
IUL Express (IULE)
Children’s Whole Life (included in some application, ownership, and combined coverage rules)
Issue Ages and Face Amounts
Each product has distinct age and coverage guidelines:
Term Life Express (TLE) and IUL Express (IULE):
Ages 18–50: $25,000 to $550,000
Ages 51–60: $25,000 to $450,000
Ages 61–75: $25,000 to $350,000
Living Promise Whole Life:
Level Benefit: Ages 45–85; $2,000 to $50,000
Graded Benefit: Ages 45–80; $2,000 to $20,000
Issue ages and face amounts may vary by state.
Available Terms and Plan Types
Term Life Express: Simplified term life coverage
IUL Express: Indexed universal life with simplified underwriting
Living Promise: Whole life coverage with Level Benefit and Graded Benefit plans
Children’s Whole Life: Separate policies may be issued for multiple children on one application
Underwriting Requirements for Simplified Issue Policies
Term Life Express / IUL Express:
Simplified underwriting
Build chart
MIB
Pharmaceutical check
Medical data check
MVR mandatory for ages 18–35
MVR as needed for ages 36–50
Phone interview as needed
Living Promise:
Simplified underwriting
Build chart
MIB
Pharmaceutical check
Medical data check
MVR as needed
Random phone interview
If an individual has a previous offer from United of Omaha Life Insurance Company with a risk class greater than Table 4, or has been declined, that person will not qualify for Express products.
Additional notes: Phone interviews may be recorded and relied upon as part of risk analysis. Medical questionnaires and/or an occasional APS may also be requested at the underwriter’s discretion.
Non-Smoker / Non-Nicotine Qualifications
To qualify for non-nicotine rates, the proposed insured must not have used tobacco or nicotine products in any form within the prior 12 months.
No tobacco or nicotine products in any form within the prior 12 months
Marijuana use may be allowable for non-tobacco rates
Blood pressure treatment allowable
No hospitalization for high blood pressure in the past 5 years
No alcohol or drug use, treatment, or convictions in the past 10 years
No DWI, DUI, or reckless driving convictions in the last 5 years
No convictions of 4 or more moving violations
No participation in any hazardous occupation, avocation, sport, or aviation exposure
Build must fit the simplified issue underwriting build chart
There must not be any other significant health problems
Occasional cigar use does not qualify for non-tobacco rates on simplified issue products. Final risk determination is made by the home office underwriter. Timeframes may vary by state and are referenced on the application.
Build Chart
The underwriting build chart includes minimum and maximum weight limits by height for TLE, IULE, Living Promise, and the DI Rider. Use the chart below to determine eligibility.
| Height | TLE/IULE/Living Promise Min Weight | TLE/IULE Max Weight | DI Rider Max Weight | Table 2 Max Weight (Multiple Impairments) | Living Promise Level Max Weight | Living Promise Graded Max Weight |
|---|---|---|---|---|---|---|
| 4’ 8” | 74 | 197 | 170 | 184 | 204 | 221 |
| 4’ 9” | 77 | 202 | 176 | 189 | 209 | 225 |
| 4’ 10” | 79 | 208 | 182 | 194 | 214 | 231 |
| 4’ 11” | 82 | 214 | 187 | 199 | 220 | 237 |
| 5’ 0” | 85 | 220 | 193 | 205 | 226 | 244 |
| 5’ 1” | 88 | 226 | 199 | 211 | 233 | 250 |
| 5’ 2” | 91 | 232 | 205 | 215 | 239 | 257 |
| 5’ 3” | 94 | 238 | 213 | 220 | 246 | 264 |
| 5’ 4” | 97 | 245 | 221 | 225 | 252 | 270 |
| 5’ 5” | 100 | 251 | 226 | 231 | 259 | 277 |
| 5’ 6” | 103 | 258 | 232 | 239 | 268 | 285 |
| 5’ 7” | 106 | 265 | 239 | 245 | 275 | 293 |
| 5’ 8” | 109 | 274 | 246 | 251 | 283 | 300 |
| 5’ 9” | 112 | 282 | 254 | 258 | 291 | 309 |
| 5’ 10” | 115 | 289 | 262 | 266 | 300 | 316 |
| 5’ 11” | 119 | 298 | 269 | 274 | 307 | 325 |
| 6’ 0” | 122 | 305 | 275 | 281 | 315 | 333 |
| 6’ 1” | 126 | 313 | 282 | 289 | 322 | 340 |
| 6’ 2” | 129 | 321 | 289 | 296 | 331 | 349 |
| 6’ 3” | 133 | 329 | 296 | 303 | 339 | 358 |
| 6’ 4” | 136 | 338 | 301 | 311 | 348 | 367 |
| 6’ 5” | 140 | 347 | 307 | 319 | 357 | 376 |
| 6’ 6” | 143 | 358 | 313 | 328 | 366 | 385 |
| 6’ 7” | 147 | 367 | 320 | 336 | 375 | 394 |
| 6’ 8” | 151 | 376 | 327 | 345 | 385 | 405 |
| 6’ 9” | 154 | 385 | 335 | 352 | 395 | 415 |
| 6’ 10” | 158 | 395 | 343 | 359 | 407 | 427 |
Multiple Impairments for Term Life Express and IUL Express
Multiple impairments resulting in a rating greater than Table 4 will be declined for Express products. Examples include:
Diabetes over age 45 with Table 2 or higher build — Decline
Diabetes over age 45 with tobacco or nicotine use — Decline
Diabetes over age 45 with Peripheral Vascular Disease (PVD) — Decline
Diabetes with any complications — Decline
Table 2 or higher build with hypertension — Decline
Table 2 or higher build with asthma and tobacco or nicotine use — Decline
Table 2 or higher build with Peripheral Vascular Disease (PVD) — Decline
Note: This is not a complete list. For California and the Virgin Islands, the reference age is 50 instead of 45.
Common Impairments for All Products
The following are examples of impairments that may result in an adjusted benefit or decline. This is a guide and not an all-inclusive list.
Abnormal/Irregular Heart Rhythm
Alcohol or drug treatment history
ALS / Lou Gehrig’s Disease
Amputation caused by disease
Asthma (chronic or severe)
Bipolar disorder, schizophrenia, major depression
Cardiomyopathy
Cerebral Palsy
Chronic Kidney Disease
Congestive Heart Failure (CHF)
Crohn’s Disease / Ulcerative Colitis
Coronary disease including heart attack or heart surgery
COPD including chronic bronchitis, emphysema, or cystic fibrosis
Cancer
Defibrillator
Diabetes (prior to specified age)
Diabetes with complications including retinopathy, nephropathy, neuropathy
Heart disease or surgery
Hepatitis B or C
Hodgkin’s Disease
Liver Disease including cirrhosis
Leukemia
Lymphoma
Melanoma
Mental incapacity
Metastatic cancer or recurrent cancer
Neurological disorders including muscular dystrophy, multiple sclerosis, and Parkinson’s Disease
Pacemaker
Pancreatitis (chronic or alcohol related)
Paralysis
Organ or bone marrow transplants
Peripheral Vascular Disease (PVD or PAD)
Renal insufficiency / failure
Rheumatoid Arthritis (moderate or severe)
Scleroderma
Sickle Cell Anemia
Stroke or mini stroke (TIA)
Systemic Lupus
Automated Underwriting
Mutual of Omaha offers Automated Underwriting on the e-Applications for Living Promise, Term Life Express, and IUL Express.
Possible outcomes: Approved, Referred to Underwriting, or Declined
Use the same iGO e-App through Sales Professional Access
Available on desktop, laptop, or mobile device
Useful contacts:
Underwriting Support: 1-800-775-7896
iGO e-App Support: 1-800-641-6557
Sales Support: 1-800-693-6083
Completing Simplified Issue Applications
General Guidelines
Select the appropriate state application and forms based on the state where the application will be signed by the policy owner
Add current medications, reasons for use, and supplemental information in the Optional Comments section
Kansas residents require the producer to be licensed and appointed in Kansas and in the state where the application is signed
The Producer Report must be completed and sent with each Term Life Express, IUL Express, and Living Promise application
Term Life Express or IUL Express Applications
Only one base policy can be applied for per application
Complete all sections including plan, amount, riders, payment mode, and premium
Select the product name and amount of insurance applied for
A signed illustration is required for all IUL Express policies
IUL Allocation Form is required if applying for IUL Express and not using Easy Solve
Disability Supplemental Application is required for the Disability Benefits Rider
Children’s Rider Supplemental Application is required for the Children’s Rider
Complete the Monthly Bank Withdrawal Form if applicable
All changes should be initialed by the Applicant/Owner
Always submit the Producer Statement and provide the client with MIB Group Inc. Pre-Notice, Notice of Information Practices, and Life Insurance Buyer’s Guide
A signed Accelerated Death Benefit Disclosure Form is required
Complete the Conditional Receipt Form only if the initial premium was collected
Have the client sign state replacement forms if applicable
If a financial institution receives compensation, the Financial Institution Consumer Disclosure must be signed
Living Promise Applications
Only one base policy can be applied for per application
Complete all sections including plan, amount, ADB rider if applicable, payment mode, and premium
If the proposed insured answers “YES” to any Part One underwriting question, that person may not be eligible for coverage under the application
If the proposed insured answers “YES” to any Part Two underwriting question, that person is eligible only for the Graded Benefit Product
If all underwriting questions are answered “NO,” the applicant is eligible for the Level Benefit Product
Complete the Conditional Receipt Form only if the initial premium was collected
Have the client sign state replacement forms if applicable
Always submit the Producer Statement and provide the client with MIB Group Inc. Pre-Notice, Notice of Information Practices, and Life Insurance Buyer’s Guide
Children’s Whole Life Applications
Multiple children, up to 8, can be written on one application
Each child will be issued a separate policy
Grandparents can sign the application without a parent’s signature
No conditional receipt is required
Conditional Receipts
Kansas uses a Temporary Insurance Agreement (TIA) instead of a conditional receipt
The conditional receipt does not apply to Children’s Whole Life
A check or electronic payment authorization for the full initial modal premium must be submitted with the application
No conditional coverage is provided if a completed conditional receipt is not submitted with the application
All required medical examinations must be completed within 60 days of the application date
The applicant must qualify for the exact policy applied for under underwriting rules then in effect
All statements and answers must be true and complete
All application parts, supplements, questionnaires, amendments, and any required exams must be completed and received by the home office
Maximum conditional insurance coverage: $100,000, or $50,000 for Living Promise, and never more than the amount applied for
If the application is not approved and accepted within 60 days of the effective date of the receipt, conditional coverage ceases and liability is limited to return of premium paid
Financial Underwriting Guidelines
Income Replacement Amounts
Under age 30: 40x annual earned income
Ages 30–39: 35x annual earned income
Ages 40–49: 30x annual earned income
Ages 50–59: 20x annual earned income
Ages 60–64: 10x annual earned income
Ages 65+: 7x annual earned income
Income replacement is generally not considered over age 66 unless the individual is actively at work or a surviving spouse may lose a larger spousal Social Security or pension benefit.
Other Financial Underwriting Notes
Non-Working Spouse: Usually equal to the amount in force and applied for on the breadwinner; if no active or pending life coverage exists, the maximum allowed is $100,000 total combined in-force coverage
Business Insurance: Simplified underwriting is available; face amounts over $100,000 usually require additional information and the Employer Owned Form if the business is owner or beneficiary
Key Person: Generally 5–10x earned income plus bonuses; ownership interest may allow adding the appropriate percentage of company net income
Buy/Sell: Coverage should generally be proportional to ownership interest, and financial statements or buy/sell agreements may be required
Charitable Giving: Limited to Living Promise; the foundation or charitable institution cannot be the owner of the policy
Maximum Total Combined Coverage Amounts
Ages 18–50: $550,000
Ages 51–60: $450,000
Ages 61–75: $350,000
ADB Rider maximum combined limit: Ages 18–25 = $100,000; Ages 26–60 = $250,000
Child Rider maximum combined limit: $10,000 per child
Simplified whole life coverage maximum: $50,000
Maximum combined graded benefit coverages: $25,000
Ownership and Beneficiary Rules
Acceptable owner/beneficiary relationships include:
Spouse, fiancée, domestic partner
Parent
Adult child
Life insurance trust
Business or business partner
Acceptable beneficiary-only relationships include:
Estate
Siblings
Grandparents and grandchildren
Close relatives by marriage, including in-laws and step-relations
Ex-spouse
Acceptable contingent beneficiary relationships include:
Other distant relatives such as aunts, uncles, nieces, nephews, and cousins
Friends
Any other owner/beneficiary relationships will not be approved.
Power of Attorney (POA)
An application signed by someone holding POA is not an acceptable authorization for issue on these life policies.
Prescription Drug Exclusions
Term Life Express or IUL Express
If the proposed insured currently takes any of the following medications, include the reason for use on the application. Additional medications or combinations may be added at the carrier’s discretion.
Abacavir, Adcirca, Aggrenox, Alkeran, Amiodarone, Ampyra, Anoro Ellipta, Antabuse, Aricept, Arimidex, Atripla, Avonex, Azilect, Baraclude, Betaseron, Calcium Acetate, Campath, Campral, Caprelsa, Carbidopa/Levodopa, Casodex, Cellcept, Chlorpromazine Hcl, Clozapine, Cognex, Combivir, Copaxone, Crixivan, Cyclosporine, Cytoxan, Daliresp, Digitek, Digoxin, Dobutamine Hcl, Donepezil, Droxia, Eligard, Eliquis, Enbrel, Epivir Hbv, Ergoloid Mesylates, Exelon, Femara, Floxuridine, Fluorouracil, Galantamine Hydrobromide, Gammagard, Gamunex, Gengraf, Geodon, Haldol, Haloperidol, Hepsera, Humira, Hydrea, Hydroxyurea, Infergen, Invega, Invirase, Isentress, Kalydeco, Keytruda, Lanoxin, Latuda, Leucovorin Calcium, Lexiva, Lithium, Megestrol Acetate (Megace), Methadone, Methotrexate, Mitomycin, Morphine Sulfate, Mycophenolate Mofetil, Myfortic, Nabi-Hb, Naloxone Hcl, Naltrexone Hcl, Namenda, Neupogen, Opdivo, Panretin, Pegasys, Peg-Intron, Perphenazine, Prograf, Ranexa, Razadyne, Rebif, Retrovir, Revia, Revlimid, Ribavirin, Risperdal, Rituxan, Sandimmune, Saphris, Sinemet, Spiriva, Stalevo, Stribild, Suboxone, Sustiva, Symbyax, Tamoxifen, Targretin, Teslac, Tudorza, Tysabri, Viracept, Viramune, Viread, Xarelto, Xeljanz, Zenapax, Zerit, Ziagen, Zidovudine, Zoladex, Zyprexa
Living Promise Whole Life
The following medications are not eligible for Living Promise coverage. Medications marked with an asterisk may qualify for the graded benefit product.
Abacavir, Alkeran, Amiodarone*, Ampyra*, Anoro Ellipta*, Antabuse*, Aricept, Atripla, Avonex*, Azilect*, Betaseron*, Calcium Acetate*, Campath, Campral*, Caprelsa, Carbidopa/Levodopa*, Casodex, Cellcept, Chlorpromazine Hcl*, Clozapine*, Cognex, Combivir, Copaxone*, Crixivan, Cyclosporine, Cytoxan, Daliresp*, Donepezil, Droxia, Eligard, Epivir Hbv, Ergoloid Mesylates, Exelon, Floxuridine, Fluorouracil, Galantamine Hydrobromide, Gammagard, Gamunex, Gengraf, Geodon*, Haldol*, Haloperidol*, Hydrea, Hydroxyurea, Invega*, Invirase, Isentress, Keytruda, Latuda*, Leucovorin Calcium, Lexiva, Lithium*, Megace, Megestrol Acetate (Megace), Mitomycin, Mycophenolate Mofetil, Myfortic, Naloxone Hcl*, Naltrexone Hcl*, Namenda, Neupogen, Opdivo, Panretin, Perphenazine*, Prograf, Ranexa*, Razadyne, Rebif*, Retrovir, Revia*, Revlimid, Ribavirin*, Risperdal*, Rituxan, Sandimmune, Saphris*, Sinemet*, Spiriva*, Stalevo*, Stribild, Suboxone*, Sustiva, Symbyax*, Targretin, Teslac, Tudorza*, Viracept, Viramune, Viread, Zenapax, Zerit, Ziagen, Zidovudine, Zoladex, Zyprexa*
Living Promise Additional Information Required
If the proposed insured currently takes any of the following medications, include the reason for use on the application:
Abilify, Aggrenox, Arimidex, Baraclude, Carvedilol, Clopidogrel, Coreg, Coumadin, Digitek, Digoxin, Eliquis, Enoxaparin Sodium, Femara, Infergen, Lanoxin, Lovenox, Pegasys, Peg-Intron, Plavix, Pradaxa, Seroquel, Tamoxifen, Truvada, Warfarin, Xarelto
Occupations
Some occupations may be declined for life coverage and the DI Rider.
Law enforcement hazards such as narcotics, vice, bomb squad, undercover work — Decline for Life and DIR
Military aircraft crew or hazardous activities such as diving, parachuting, explosives, hazardous material exposure — Decline for Life and DIR
Federal/government hazardous activities such as explosives, bomb disposal, hazardous material exposure — Decline for Life and DIR
Hazardous work such as steeplejack, tower erector, structural steel, explosives, or heights above 49 feet — Decline for Life and DIR
Private duty nurse, CNA, elderly caregiver, or home health aide — Accept for Life, Decline for DIR
Occupational travel outside the U.S. to areas of active war, political unrest, or terrorism — Decline for Life and DIR
Avocations
The following are not allowable with simplified underwriting:
Motor sports racing
Boat racing
Parachuting
Skydiving
Hang gliding
Base jumping
Rock or mountain climbing
Foreign National and Immigrant Residency Policy
Permanent Residents Living Permanently in the United States
Must possess a valid Permanent Resident Card
Must have lived in the U.S. for at least 12 continuous months
Must have a minimum annual income of $20,000 from U.S.-based assets, entitlement benefits such as Social Security or pension benefits, or U.S.-based employment
Income from SSI or SSDI cannot be included
Must complete the Foreign National and Foreign Travel Questionnaire, L5719_0107
Temporary Visa Holders Living in the United States
Acceptable visas: E-1, E-2, H-1B, H-4, L-1, L-2
Term Conversion Guidelines
Clients can convert eligible Term Life Express policies to a new permanent policy within face amount, issue age, and risk class guidelines for the permanent product
Conversion can occur through the last conversion date shown on the policy data page
Term Life Express policies issued prior to May 1, 2014 are not eligible for conversion
No evidence of insurability is required
Partial conversions are available as long as minimum face amount requirements are met
We cannot convert term coverage into an existing universal life policy
Riders are not automatically carried over
Products Available for Term Conversions
IUL Express — minimum face amount $25,000
Whole Life (conversion only product) — minimum face amount $5,000
Substandard Conversions
IUL Express is not available for a substandard term conversion
Term conversions with a rate up must convert to a UL product that allows for a rate up, such as AccumUL Answers, Income Advantage IUL, or Life Protection Advantage IUL
Rider Conversions
Riders on the conversion policy must already exist on the term policy
Disability Waiver of Premium is not guaranteed convertible and requires a signed statement that the client is not disabled and is performing normal occupational duties
Accidental Death Benefit and Children’s Riders are guaranteed convertible if available on the new permanent product
Other Insured Rider can be converted into a separate permanent policy at the insured’s current attained age
Submitting Applications / Contact Information
Mailing Address: Mutual of Omaha, 3300 Mutual of Omaha Plaza, Omaha, NE 68175
Fax: (402) 997-1804
New Applications Email: lifeapps@mutualofomaha.com
Requirements Email: liferequirements@mutualofomaha.com
Risk Assessment Email: ExpressRiskAssessment@mutualofomaha.com
Risk Assessment Phone: 888-624-1173
Underwriting Support: 1-800-775-7896
iGO e-App Support: 1-800-641-6557
Sales Support: 1-800-693-6083
Carrier: Occidental / American Amicable (AmAm)
Product: Term Made Simple (TMS)
Product Types: 10-Year, 15-Year, 20-Year, and 30-Year Level Term
Issue Ages: 18–75
Face Amounts: $50,000 to $500,000
Target Market: Mortgage protection, income replacement, and applicants seeking non-med term coverage with living benefits
Underwriting Notes: No medical exam. MIB, Rx, and MVR check. E-application with instant decision available. Available for both Tobacco and Non-Tobacco users. Riders include Critical Illness, Terminal Illness, and Accelerated Death Benefits.
Occidental / American Amicable (AmAm):
Product Name: Term Made Simple (TMS) – Level Term Life Insurance
Term Made Simple is a simplified issue level term life insurance policy that provides protection to age 95. It is available in four level term durations: 10, 15, 20, and 30 years. Premiums are guaranteed to remain level for the selected term duration. The product uses standard-only underwriting — there are no table ratings. Applicants must qualify under simplified issue criteria including health questions, build chart, MIB, Rx, and MVR reports.
| Height | Min Weight | Max Weight (Table 2) | Max Weight (Table 4) |
|---|---|---|---|
| HEIGHT | MINIMUM WEIGHT MUST BE AT LEAST | MAXIMUM WEIGHT WITHIN TABLE 2 | MAXIMUM WEIGHT WITHIN TABLE 4 |
| 4’10” | 86 | 182 | 199 |
| 4’11” | 88 | 188 | 205 |
| 5’ | 90 | 195 | 212 |
| 5’1” | 93 | 201 | 220 |
| 5’2” | 95 | 208 | 227 |
| 5’3” | 99 | 215 | 234 |
| 5’4” | 101 | 221 | 242 |
| 5’5” | 104 | 228 | 249 |
| 5’6” | 106 | 235 | 257 |
| 5’7” | 110 | 243 | 265 |
| 5’8” | 113 | 250 | 273 |
| 5’9” | 117 | 257 | 281 |
| 5’10” | 120 | 265 | 289 |
| 5’11” | 125 | 272 | 298 |
| 6’ | 129 | 280 | 306 |
| 6’1” | 133 | 288 | 315 |
| 6’2” | 136 | 296 | 323 |
| 6’3” | 140 | 304 | 332 |
| 6’4” | 143 | 312 | 341 |
| 6’5” | 146 | 320 | 350 |
| 6’6” | 149 | 329 | 359 |
| 6’7” | 153 | 337 | 368 |
| 6’8” | 157 | 346 | 378 |
| 6’9” | 160 | 355 | 387 |
| Impairment | Criteria | Life | DI Rider | AODIR | Critical Illness Rider | Application Question |
|---|---|---|---|---|---|---|
| Abscess | Present | Decline | Decline | Decline | Decline | A:1j |
| Abscess | Removed, with full recovery and confirmed to be benign | Standard | Standard | Standard | Standard | A:1j |
| Addison’s Disease | Acute Single Episode | Standard | Standard | Standard | Standard | A:1j |
| Addison’s Disease | Others | Decline | Decline | Decline | Decline | A:1j |
| ADL's (Activities of Daily Living) | Currently require assistance (from anyone) with any ADL. | Decline | Decline | Decline | Decline | A:3 |
| AIDS / ARC | Medically treated or diagnosed by a medical professional as having | Decline | Decline | Decline | Decline | A:1k |
| Alcoholism | Within 4 years since abstained from use | Decline | Decline | Decline | Decline | C:3 |
| Alcoholism | After 4 years since abstained from use | Standard | Decline | Decline | Standard | C:3 |
| Alzheimer’s | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1f |
| Amputation | Caused by injury | Standard | Decline* | Decline* | Standard | A:1j |
| Amputation | Caused by disease | Decline | Decline | Decline | Decline | A:1b |
| Anemia | Iron Deficiency on vitamins only | Standard | Standard | Standard | Standard | A:1b |
| Anemia | Others | Decline | Decline | Decline | Decline | A:1b |
| Aneurysm | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1b |
| Angina | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Angioplasty | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Ankylosis | Medically diagnosed, treated, or taken medi- cation for | Standard | Decline | Standard | Decline | A:1i |
| Anxiety/Depression | Anxiety, 1 medication, situational in nature | Standard | Standard | Standard | Standard | A:1f |
| Anxiety/Depression | Major depression, bipolar disorder, schizophrenia | Decline | Decline | Decline | Decline | A:1f |
| Aortic Insufficiency | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Aortic Stenosis | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Appendectomy | Medically diagnosed, treated, or taken medi- cation for | Standard | Standard | Standard | Standard | A:1j |
| Arteriosclerosis | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Arthritis | Rheumatoid - minimal, slight impairment | Standard | Decline | Standard | Standard | A:1i |
| Arthritis | Rheumatoid - all others | Decline | Decline | Decline | Decline | A:1i |
| NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at |
| Asthma | Mild, occasional, brief episodes, allergic, seasonal | Standard | Standard | Standard | Standard | A:1d |
| Asthma | Moderate, more than 1 episode a month | Standard | Decline | Standard | Standard | A:1d |
| Asthma | Severe, hospitalization, or ER visit in past 12 months | Decline | Decline | Decline | Decline | A:1d |
| Asthma | Maintenance steroid use | Decline | Decline | Decline | Decline | A:1d |
| Asthma | Combined with Tobacco Use - Smoker | Decline | Decline | Decline | Decline | A:1d |
| Aviation | Commercial pilot for regularly scheduled airline | Standard | Standard | Standard | Standard | C:3c |
| Aviation | Other pilots flying for pay | Decline | Decline | Decline | Decline | C:3c |
| Aviation | Student Pilot | Decline | Decline | Decline | Decline | C:3c |
| Aviation | Private Pilot with more than 100 solo hours | Standard | Standard | Standard | Standard | C:3c |
| Back Injury | Medically diagnosed, treated, or taken medi- cation for within the past 12 months | Standard | Decline* | Decline* | Standard | A:1i |
| Bi-Polar Disorder | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1f |
| Blindness | Caused by diabetes, circulatory disorder, or other illness | Decline | Decline | Decline | Decline | A:1j |
| Blindness | Other causes | Standard | Decline | Decline | Decline | A:1j |
| Bronchitis | Acute- Recovered | Standard | Standard | Standard | Standard | A:1d |
| Bronchitis | Chronic | Decline | Decline | Decline | Decline | A:1d |
| Buerger’s Disease | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| By-Pass Surgery (CABG or Stent) | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Cancer / Mela- noma | Basal or Squamous cell skin carcinoma, isolated occurrence | Standard | Standard | Standard | Standard | A:1e |
| Cancer / Mela- noma | Within the past 8 years been medically diagnosed, treated, or taken medication for no recurrence or additional occurrence | Standard | Standard | Standard | Decline | A:1e |
| Cancer / Mela- noma | All others or history of metastatic cancer | Decline | Decline | Decline | Decline | A:1e |
| Cardiomyopathy | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Carotid Artery Disease | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Cerebral Palsy | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1h |
| Cholesterol | Controlled with medication | Standard | Standard | Standard | Standard | A:1a |
| Chronic Obstructive Pul- monary Disease (COPD) | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1d |
| Cirrhosis of Liver | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1c |
| Connective Tissue Disease | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1h |
| Concussion – Cerebral | Full recovery with no residual effects | Standard | Standard | Standard | Standard | A:1j |
| Congestive Heart Fail- ure CHF) | Medically diagnosed, treated, or taken medi- cation for | Decline | Decline | Decline | Decline | A:1a |
| Criminal History | Convicted of any felony within the past 5 years | Decline | Decline | Decline | Decline | C:3a |
| Criminal History | Probation or parole within the past 6 months | Decline | Decline | Decline | Decline | C:3a |
| Crohn’s Disease | Medically diagnosed, treated, or taken medi- cation for prior to age 20 or within the past 12 months | Decline | Decline | Decline | Decline | A:1c |
| Cystic Fibrosis | Medically diagnosed, treated, or taken medica- tion for | Decline | Decline | Decline | Decline | A:1h |
| NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at | NOTE: * Underwriting will consider issuing the Total Disability Benefit Rider with an exclusion rider. Please contact our Underwriting Department for details via our Online Chat or at |
| Medication | Common Use of Concern | RX Fill Within | Plan Eligibility |
|---|---|---|---|
| MEDICATION | COMMON USE OF CONCERN | RX FILL WITHIN | PLAN ELIGIBILITY |
| Abilify | Bi-Polar / Schizophrenia | N/A | Decline |
| Accupril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Accupril | CHF | N/A | Decline |
| Accuretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Accuretic | CHF | N/A | Decline |
| Acebutolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Acebutolol HCL | CHF | N/A | Decline |
| Aceon | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Aceon | CHF | N/A | Decline |
| Actoplus | Diabetes | N/A | See ‘#’ Below |
| Actos | Diabetes | N/A | See ‘#’ Below |
| Advair | Asthma | N/A | See Impairment Guide |
| Advair | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Aggrenox | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
| Albuterol | Asthma | N/A | See Impairment Guide |
| Albuterol | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Aldactazide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Aldactazide | CHF | N/A | Decline |
| Aldactone | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Aldactone | CHF | N/A | Decline |
| Allopurinol | Gout | N/A | See Impairment Guide |
| Altace | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Altace | CHF | N/A | Decline |
| Amantadine HCL | Parkinson’s | N/A | Decline |
| Amaryl | Diabetes | N/A | See ‘#’ Below |
| Ambisome | AIDS | N/A | Decline |
| Amiloride HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Amiloride HCL | CHF | N/A | Decline |
| Amlodipine Besylate/ Benaz | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Amlodipine Besylate/ Benaz | CHF | N/A | Decline |
| Amyl Nitrate | Angina / CHF | N/A | Decline |
| Antabuse | Alcohol / Drugs | 4 years | Decline |
| Apokyn | Parkinson’s | N/A | Decline |
| Apresoline | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Apresoline | CHF | N/A | Decline |
| Aptivus | AIDS | N/A | Decline |
| Arimidex | Cancer | 8 years > 8 years | Decline Standard |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If cur- rently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If cur- rently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If cur- rently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If cur- rently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
| MEDICATION | COMMON USE OF CONCERN | RX FILL WITHIN | PLAN ELIGIBILITY |
| Atacand | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Atacand | CHF | N/A | Decline |
| Atamet | Parkinson’s | N/A | Decline |
| Atenolol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Atenolol | CHF | N/A | Decline |
| Atgam | Organ / Tissue Transplant | N/A | Decline |
| Atripla | AIDS | N/A | Decline |
| Atrovent/Atrovent HFA Atrovent (Nasal) | Allergies | N/A | Standard |
| Atrovent/Atrovent HFA Atrovent (Nasal) | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Avalide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Avalide | CHF | N/A | Decline |
| Avandia | Diabetes | N/A | See ‘#’ Below |
| Avapro | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Avapro | CHF | N/A | Decline |
| Avonex | Multiple Sclerosis | N/A | Decline |
| Azasan | Organ / Tissue Transplant | N/A | Decline |
| Azasan | Rheumatoid Arthritis | N/A | Decline |
| Azasan | Systemic Lupus (SLE) | N/A | Decline |
| Azathioprine | Organ / Tissue Transplant | N/A | Decline |
| Azathioprine | Rheumatoid Arthritis | N/A | Decline |
| Azathioprine | Systemic Lupus (SLE) | N/A | Decline |
| Azilect | Parkinson’s | N/A | Decline |
| Azmacort | Asthma | N/A | See Impairment Guide |
| Azmacort | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
| Azor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Azor | CHF | N/A | Decline |
| Baclofen | Multiple Sclerosis | N/A | Decline |
| Baraclude | Liver Disorder / Hepatitis | N/A | Decline |
| Baraclude | Liver Failure | N/A | Decline |
| Benazepril HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Benazepril HCL | CHF | N/A | Decline |
| Benicar | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
| Benicar | CHF | N/A | Decline |
| Benlysta | Systemic Lupus (SLE) | N/A | Decline |
| Benztropine Mesylate | Parkinson’s | N/A | Decline |
| Benztropine Mesylate | Other Use | N/A | Standard |
| * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
| # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If cur- rently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If cur- rently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If cur- rently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If cur- rently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Note: The DIR and AODIR cannot be issued together. The Critical Illness Rider cannot be issued with Waiver of Premium – Disability.
Policies may be converted to any permanent life insurance plan currently offered by the carrier, without evidence of insurability, under the following conditions:
Product: Quility Level Term
Product Type: Simple Issue Level Term Life Insurance
Term Lengths: 10, 15, 20, 25, 30 years
Issue Ages: 18–60 (non-med), up to 75 (with exam)
Face Amounts: $100,000–$1,000,000 (non-med), up to $5M (with exam)
Target Market: Clients seeking fast, digital term life insurance with optional riders and living benefits
Underwriting Notes: Instant decision for most applicants using MIB, Rx, and database checks. No phone interview required. Higher face amounts or older ages may require paramed.
Policies may be renewed beyond the level term period on an annual renewable term basis until age 85. Premiums will increase annually and the policy terminates at age 85. No evidence of insurability is required for renewal.
An annual policy fee of $50 applies. This fee is non-commissionable and is modalized for non-annual payment modes.
Fast, simplified issue underwriting with a yes/no decision within minutes. No medical exams, no PHI, no attending physician statements (APS), and no health or paramedical screenings (HOS). In limited cases, applications may be referred for manual underwriting and additional review.
| Height | Preferred+ Non-Nic | Preferred Non-Nic | Select Non-Nic | Standard Non-Nic | Preferred Nicotine | Standard Nicotine |
|---|---|---|---|---|---|---|
| 4’8” | 126 | 127-135 | 136-147 | 148-164 | 131 | 132-164 |
| 4’9” | 131 | 132-140 | 141-152 | 153-170 | 136 | 137-170 |
| 4’10” | 135 | 136-145 | 146-157 | 158-176 | 141 | 142-176 |
| 4’11” | 140 | 141-150 | 151-162 | 163-182 | 146 | 147-182 |
| 5’0” | 145 | 146-155 | 156-168 | 169-188 | 151 | 152-188 |
| 5’1” | 150 | 151-160 | 161-173 | 174-194 | 156 | 157-194 |
| 5’2” | 155 | 156-165 | 166-178 | 179-200 | 161 | 162-200 |
| 5’3” | 160 | 161-170 | 171-183 | 184-206 | 166 | 167-206 |
| 5’4” | 165 | 166-175 | 176-188 | 189-212 | 171 | 172-212 |
| 5’5” | 170 | 171-180 | 181-194 | 195-218 | 176 | 177-218 |
| 5’6” | 175 | 176-185 | 186-199 | 200-224 | 181 | 182-224 |
| 5’7” | 180 | 181-190 | 191-204 | 205-230 | 186 | 187-230 |
| 5’8” | 185 | 186-195 | 196-210 | 211-236 | 191 | 192-236 |
| 5’9” | 190 | 191-200 | 201-215 | 216-242 | 196 | 197-242 |
| 5’10” | 195 | 196-205 | 206-220 | 221-248 | 201 | 202-248 |
| 5’11” | 200 | 201-210 | 211-225 | 226-254 | 206 | 207-254 |
| 6’0” | 205 | 206-215 | 216-230 | 231-260 | 211 | 212-260 |
| 6’1” | 210 | 211-220 | 221-236 | 237-266 | 216 | 217-266 |
| 6’2” | 215 | 216-225 | 226-241 | 242-272 | 221 | 222-272 |
| 6’3” | 220 | 221-230 | 231-247 | 248-278 | 226 | 227-278 |
| 6’4” | 225 | 226-235 | 236-252 | 253-284 | 231 | 232-284 |
Conversion is available to a universal life product at any time prior to the earlier of attained age 70 or the end of the level term period. Conversion is allowed only for face amounts of $100,000 or more. Partial conversions are permitted provided the remaining face amount meets minimum product requirements.
Note: Term conversions to universal life are temporarily unavailable in California.
The Quility Level Term product includes several riders to enhance policy value and offer broader protection. Some riders are automatically included, while others are available at additional cost. LegacyShield® services are also provided with every policy at no additional charge.
This rider is automatically included at no additional cost. It allows the insured to accelerate up to 50% of the base policy’s death benefit (not to exceed $250,000) in the event of a terminal illness expected to result in death within 12 months. This benefit is paid to the policy owner and is treated as a lien against the death benefit, accruing interest annually. The rider terminates upon use or when the base policy terminates. An administrative fee applies upon benefit activation.
Automatically included, this rider provides an additional 0.5% of the policy's face amount to a qualified 501(c)(3) charitable organization of the policyowner’s choice upon death. The donation is separate from and in addition to the policy’s death benefit and is made in the name of the insured. If no charity is selected, the default is Make-A-Wish Foundation of America. This donation is tax-free and not included in the insured’s estate.
Also automatically included at no extra charge, this rider waives all premiums (base policy and riders) for up to six months if the insured becomes involuntarily unemployed. It can only be used once during the level term period and requires a 9-month waiting period after policy issue. Proof of unemployment benefits for at least four continuous weeks is required. The rider expires at age 65 or at the end of the term period.
This optional rider provides coverage of $5,000 or $10,000 for all eligible children (biological, legally adopted, or stepchildren) who are at least 30 days old and under 17 years old. The rider costs $12 per $1,000 annually. Each covered child can convert this coverage to permanent insurance up to age 25. New children can be added at no extra cost if eligibility criteria are met, but must be declared through a new application. Coverage ends when the child reaches age 25 or the base policy terminates.
This optional rider provides additional death benefit coverage if the insured dies due to accidental bodily injury within 180 days of the event, as verified by a physician. Available in increments of $25,000 up to a maximum of $250,000 (or half the base policy amount). Issue ages are 18–60. Exclusions include death by suicide, illegal activity, intoxication, military activity, extreme sports, or self-inflicted harm. Rider is not available if the case is referred to manual underwriting.
Each Quility policy includes complimentary access to LegacyShield®, a secure online platform that helps clients prepare and share important documents and wishes with loved ones. Services include:
LegacyShield is not insurance and is not intended as legal, tax, or investment advice. It is provided by LegacyShield®, a subsidiary of SBLI, and clients are encouraged to consult appropriate advisors for personal guidance.
Quility Level Term Life Insurance uses a streamlined simplified issue underwriting process designed to produce instant decisions with no medical exams, labs, or attending physician statements (APS). However, strict eligibility guidelines and knockout conditions must be followed to ensure approval.
Applicants with any of the following conditions in the specified timeframes will be declined:
Applications will also be declined for the following lifestyle risks:
The Quility Level Term application process is designed to be efficient and digital-first. Agents follow a simple three-step process:
The following documents are included in the e-application process and must be acknowledged or signed electronically:
Electronic Funds Transfer (EFT) is the only accepted method. EFT drafts are scheduled based on the policy effective date. If the scheduled date falls on a weekend or holiday, the charge will occur on the next business day.
The Customer Service Department handles all post-issue transactions and can be contacted at 800-694-7254 or customerservice@sbli.com.
Owners may surrender their policy at any time with a signed Surrender Request Form. If the original policy is lost, a declaration must be completed. Surrenders must be received 10 business days prior to EFT draft to avoid payment processing. TIN and IRS certification are required to process the disbursement.
After the level term ends, the policy automatically renews as an annually renewable term up to age 85. Premiums increase annually and no evidence of insurability is required. Policy lapses if premium is not paid.
All death, rider, and charitable giving claims are handled by SBLI's Customer Service Department. Prompt and complete submission of documentation is essential for swift processing.
Claims for the Children’s Rider or Accelerated Death Benefit should be initiated by the policyowner or producer by calling SBLI at 800-694-7254. Required information includes:
Policyholders may convert their Quility Level Term policy to a Universal Life product available at the time of conversion. This can occur at any time during the level premium period, provided the insured is younger than age 70.
| Contact Area | Phone | |
|---|---|---|
| Quility Sales Support | 855-642-0023 or 903-600-8812 | quility@sbli.com |
| New Business / Policyholder Services | 888-224-7254 (Option 3) | customerservice@sbli.com |
| Commissions | 888-224-7254 (Option 5) | sblicommissions@sbli.com |
| Website Access | www.sbliagent.com | |
This guide is intended for internal use only. Do not share this content with clients. All sales, claims, and conversion discussions must follow SBLI guidelines and cannot be misrepresented. Always consult SBLI if you are uncertain about any aspect of application suitability, eligibility, or claim processing.
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