Broker/Agent Handout - Goheen Companies...G O H E E N COMPANIES Broker/Agent Handout 713.530.8721...

G O H E E NCOMPANIES

Broker/AgentHandout

713.530.8721164OO Kensington Drive, Sugar Land, TX 77479

GoheenCompanies.com

Insuring Your Life. Ensuring Your Legacy

713.530.8721164OO Kensington Drive

Sugar Land, TX 77479

GoheenCompanies.com

2

Our Team

Goheen Companies was established in 1990 by Shawn Goheen. We offer advanced life insurance planning to high net worth individuals and business owners.

Whether you’re seeking to secure your personal legacy, professional legacy, or both, maximizing the performance of your life insurance assets is our highest mission. Goheen Companies thrives on providing

an exceptional life insurance experience that is second to none.

Shawn GoheenFounder + President

Jerry DresnerCFO

Patti NelsonExecutive Vice President

Morgan GoheenLife Sales

John BiedermannPartner & EVP of Client/Broker Relations

Ron NelsonDirector Of Operations

Kim EvettsPresident Group Health

Stacey GoheenCOO

Karen SturrockUnderwriting Director



GoheenCompanies.com

3

Many high net worth individuals need life insurance to address inheritance, business, and retirement income protection. Goheen Companies offers advanced life insurance solutions by

means of premium financing.

Premium financing is an alternative method of funding life insurance premiums that involves borrowing the amounts needed to pay the premiums from a commercial lender as opposed to paying them out of pocket. By financing a life insurance premium, the initial cost becomes only

the loan interest, versus the full cost of a premium.

Though premium finance and our various life insurance solutions offer a multitude of benefits, there are some risks involved.

Top Reasons for Premium Finance

1

1

2

2

3

3What Are the Considerations?

Premium FinancingAN ADVANCED WEALTH ACCUMULATION STRATEGY

High net worth clients often earn large returns on investments. By utilizing premium finance, clients can keep money working in high

returning assets, allowing for additional investment opportunities.

It is important to be aware of the possibility of rates increasing more than anticipated. If this occurs, you will be responsible for coming up

with additional money or collateral to cover the cost.

Premium financing allows clients to leverage current assets and their

policy’s cash surrender value to obtain sufficient coverage.

Premium finance can be a long process. It often takes much more

longer than standard life insurance, so be aware of this before starting

the transaction.

By properly structuring ownership of life insurance and paying interest

instead of premiums, clients can obtain tax-free retirement income and significantly minimize gift and

estate taxes.

One popular form of collateral, a letter of credit from the policy

holder’s financial institution, can be challenging and costly to obtain.

LEVERAGE

RATEFLUCTUATIONS

RETAINED CAPITAL

LONGERTIMETABLE

TAX SAVINGS

FINANCING



GoheenCompanies.com

4

Checklist

Personal Borrower/Guarantor � Signed insurance application

� Signed bank credit application to include insured, spouse, and guarantor signatures

� Signed and dated Personal Financial Statement (must be less than six months old)

� Bank and brokerage statements to support liquid assets on Personal Financial Statement

� Previous two years filed tax returns signed and dated (Business tax returns needed if business makes up substantial part of net worth)

� Corporate formation documents (Articles of Incorporation) if client owns a business

� Complete executed living trust documents (if any assets are held in trust)

� Complete copy of executed Trust

� Copy of driver’s license from the insured and person providing credit support

� Insurance carrier illustration at zero percent

Corporate Borrower/Guarantor � Consolidated corporate financial statements for the previous two years plus interim statements for the following:

� Cash flow statement

� Income statement

� Balance sheet

� Corporate tax returns - previous two years (complete with all schedules, signed, and dated by officer of company)

� Corporate formation documents (Articles of Incorporation)

PREMIUM FINANCE



GoheenCompanies.com

5

» LOC’s and Money Markets are generally valued at 100%

» CD’s are generally valued at 95% in order to account for changes that could occur if a bank has to liquidate prior to maturity

» Stocks are generally valued at 50%, however depending on the concentration of stock, lack of diversification within a portfolio, and the quality of the stock might cause a further decrease

» Real Estate

» Residential (Primary Residence & Income-Producing)

» Up to 75% of appraised value

» 0% in states where Homestead exemption was declared

» Commercial

» Up to 75% of appraised value

» Farmland

» Up to 35% of appraised value for non-income-producing

» Government Bonds/Treasuries are usually valued at 100%

» Corporate Bonds are usually valued between 50% - 80% depending on the concentration, diversification, and quality of the bond

» Variable policies and variable annuities are generally valued at 50%

» Penny stocks are not accepted

All collateral is subject to review and approval by credit companies used on a case-by-case basis

GAP CollateralCONSIDERATIONS



GoheenCompanies.com

6

Date Advisor

Phone Email Referred By

Application& INFORMATION SHEET

Male DOB Tobacco: Yes No

Female DOB Tobacco: Yes No

Issue State Relationship with client

Preferred Standard Table Rated

Preferred Standard Table Rated

Cash & Equivalents $ Mortgages $

Marketable Securities $ Other Liabilities $

Real Estate $ Total Liabilities $

Business Valuation $ Net Income $

Other $ Occupation

Total Assets $ Notes

Inforce Policies Mr: CSV $ DB $ Premium $

Inforce Policies Mrs: CSV $ DB $ Premium $

1035 Exchanges?

New Insurance Need Mr $ Mrs $

Inforce Policies Mrs: DB $ Premium $

Purpose for Insurance

Have Illustrations Been Presented to Client?

Notes



GoheenCompanies.com

7

I authorize any: person licensed to provide health care services, hospital, clinic or other medical or medically related facility, insurer, reinsurer, insurance support organization, the Medical Information Bureau, Inc., consumer reporting agency, state motor vehicle agency, employer, or any other person or institution to release to: each of the companies listed below, as well as to their reinsurers, any insurance support organizations, and those persons authorized to represent them, and Goheen Companies; any information related to my mental and physical health, lab results, other insurance coverage, hazardous activities, character, general reputation, finances, occupation, other personal traits, drug and/or alcohol use and driving record for me and my minor children who are to be insured. This includes information on the diagnosis or treatment of Human Immunodeficiency Virus (HIV) infection and sexually transmitted diseases.

By my signature below, I acknowledge that any agreements I have made to restrict my protected health information do not apply to this authorization and I instruct any physician, health care professional, hospital, clinic, medical facility, or other health care provider to release and disclose my entire medical record without restriction.

I understand that my insurance agent, the companies listed below, and their reinsurers will use this information to help determine my eligibility for insurance and they may discuss and disclose this information with each other in helping determine my eligibility. The insurance agent may also use this information to help update and improve my insurance program.

I agree that the above named parties may also disclose my information to other insurers, reinsurers, the Medical Information Bureau, Inc., and other persons or organizations performing business or legal services in connection with the underwriting process, or as may be otherwise lawfully required. I further authorize any person licensed to provide health care services, hospital, clinic, or other medical related facility, insurer, insurance support organization, the Medical Information Bureau Inc, consumer reporting agency, state motor vehicle agency, employer, or any other person or institution to discuss with Strategic Medical Consulting (SMC) and/or any of its representatives, matters concerning my medical treatment, condition, prognosis, prescriptions, medical information, and records.

HIPAA Compliant AuthorizationTO OBTAIN AND DISCLOSE INFORMATION

Name of Proposed Insured / Patient (Please type or print) Date of Birth

First MI Last Month Day Year



GoheenCompanies.com

8

I understand and agree that this form is not an application for life insurance and that no life insurance coverage is provided in connection with this form.

This authorization shall remain in force for 24 months following the date of my signature below. I understand that I have the right to revoke this authorization in writing, at any time, by providing written notification to Goheen Companies at the above Service Office address.

I understand that any information that is disclosed pursuant to this authorization is no longer covered by federal rules governing privacy and confidentiality of health information, but will not be redisclosed by Goheen Companies except as provided in this agreement or authorized by me or as required by law.

I agree that a photographic copy or facsimile of this Authorization shall be valid as the original. I understand that my Providers may not refuse to provide treatment or payment for health care services if I refuse to sign this authorization. I further understand that if I refuse to sign this authorization to release my complete medical record, the carriers listed below may not be able to review my medical file. I understand that any authorized representative or I will receive a copy of this authorization upon request.

Signature of Proposed Insured

Signature of Additional Proposed Insured

City State

Name of Proposed Insured

Name of Additional Proposed Insured

Month Day Year




GoheenCompanies.com

9

Accordia Life and Annuity CompanyAllianzAmerican General Life Ins. Co.American NationalAviva Life and Annuity Co.AXABannerExceptional Risk Advisors LLCFinancial Independence Group, Inc. (FIG)Genworth INGGlobal Atlantic Financial GroupJefferson Pilot Financial Ins. Co.John Hancock Life Ins. Co.Life/LSW (Life of the Southwest)Lincoln Benefit LifeLincoln FinancialLloyd’s of LondonMass MutualMetLife InvestorsMinnesota Life Insurance Co./Securian Mutual of OmahaNationwide Financial NationalNew York LifeNorth AmericanOne America/State Life Pacific Life Insurance Co.Pacific Life Insurance CompanyPenn MutualPhoenix Home LifePrincipal FinancialProtective LifePrudential Life Ins. Co.The Savings Bank Life Insurance Co. of Massachusetts (SBLI)Strategic Medical Consulting, Inc. (SMC)Summit AllianceSun Life of CanadaThe HartfordTransamerica Life Insurance Co.Union CentralWest Coast Life Insurance Co.


This Authorization Applies to the Following



GoheenCompanies.com

10

Informal InquiryNOT AN APPLICATION FOR LIFE INSURANCE

Date Producer

Face Amount Product Type

Applicant � Male � Female DOB

SS# Driver’s License# Place of Birth

Address City State Zip

Home Phone Occupation How Long?

Income Assets Liabilities Net Worth

Premium Tolerance/Offer needed to place:

Has Owner/Insured ever sold an insurance policy? � Yes � No If so, when?

Will this case be premium financed? � Yes � No If so, program considered?

Can you provide 3rd party financials signed by a CPA? � Yes � No

Have you ever used any kind of tobacco or any other products containing nicotine? � Yes � No

Do you have any knowledge that an application or informal inquiry has been seen by any carriers within the last year?

� Yes � No

If yes, please indicate which form: � Cigarette � Pipe � Nicotine Gum/Patch

� Cigar (how many per year? Other

Has use been discontinued? � Yes � No Date Discontinued:

Do you participate in any hazardous? � Flying � Scuba � Mountain Climbing Other

Do you plan any foreign travel? � Yes � No (if Yes, please advise where, when, purpose, length):

Insurance Currently in ForceCompany Year Issued Face Amount Replace? Offer to be Replaced

Carrier Offer Declined?



GoheenCompanies.com

11

Medical Information

Height Weight

Do You Have a History of:High Blood Pressure? � Yes � No What medications are you taking?

Have you ever been hospitalized? � Yes � No Using CPAP? � Yes � No Date

Heart Condition / Coronary Artery Disease? � Yes � No When did it occur?

Arthritis? � Yes � No Type?

Was there a biopsy? � Yes � No What stage is/was the cancer?

Cancer? � Yes � No Type? Where Date of Diagnosis

Cerebral Vascular Accident? � Yes � No Type: � Stroke � TIA Date of occurrence

Diabetes? � Yes � No � Type 1 � Type 2 Age when diagnosed?

Respiratory Disease? � Yes � No Check appropriate box: � Asthma � COPD � Sleep Apnea

Complications: � Kidneys � Peripheral vascular disease � Neuropathy � Retinopathy

Last AIC Numbers Last Glucose Readings Therapy type and doses

� Heart Attack � Bypass � Stent(s) How many vessels affected? Last EKG/Stress test?

Name & address of treating physician





Dates of Radiation and/or Chemotherapy

Who would have the pathology report?

List any conditions not indicated above

Name & address of physicians involved in treatment

Last Pulmonary Function Test

List of medications/doses

Family Health History Age (if deceased, age at death) History of Heart Disease? History of Cancer?

MotherFatherBrother(s)Sister(s)



GoheenCompanies.com

12

Senior Supplement 70+

Have you ever been diagnosed with Alzheimers or Dementia? � Yes � No

Do you have a history of falls? � Yes � No If so, please explain

Do you exercise on a daily basis? � Yes � No If yes, how many hours?

Have you ever been diagnosed with depression? � Yes � No Details

Have you ever been diagnosed with anemia? � Yes � No Details

Physician Name Phone

Date Last Seen Reason

Address



Address



Address



Address



Address

Do you require assistance with daily chores? � Yes � No Do you drink alcohol? � Yes � No

Have you ever been tested for memory problems? � Yes � No

Do you require assistive devices for walking? � Yes � No

What medications are you currently on?

Physician InformationPlease list all physicians seen within the past ten (10) years

Please use an additional page if necessary



GoheenCompanies.com

13

Credit ApplicationLIFE INSURANCE FINANCING

Loan Information

Borrower Information

SUBMITTING BROKER/AGENT

WRITING AGENT’S INFORMATION

Type of collateral to be used: � Certificate of Deposit � Letter of Credit � CSV of life insurance policy(ies) � Money Market � Brokerage Account

Last Name First Middle

Company Name

Address

City State Zip

Phone Fax Email


Company Name Phone

Address

Borrower’s Name

SSN or TIN DOB Age

Address

City State Zip

Contact Name

Phone (Home) Phone (Work) Years at this address

Prior Address (if less than 5 years)

City State Zip

State of Trust Formation (if applicable)

Current Income (from tax returns) Current Net Worth (from Financial Statement)



GoheenCompanies.com

14


Guarantor Information (if not insured)

Guarantor’s Last Name First Middle

SSN or TIN DOB Age

Address

City State Zip



City State Zip

State of Trust Formation (if applicable)


Insured Information (if insured is not borrower)Insured’s Last Name First Middle

SSN or TIN DOB Age

Additional Insured’s Last Name First Middle

SSN or TIN DOB Age

Current Address

City State Zip



City State Zip




GoheenCompanies.com

15


Personal Financial StatementTo be completed by the person of wealth, the borrower, and any guarantor

IMPORTANT: Personal Financial Statement must be filled out completely. Read these directions before completing:

• If you are applying for individual credit in your own name, are relying on your own income or assets, and not the income or assets of another person as the basis for repayment of the credit request: complete only Individual Information and Statement of Financial condition with accompanied schedules

• If you are applying for joint credit with another person: complete Individual Information, Other Party Information, and Statement of Financial condition with accompanied schedules

• If you are applying for individual credit, but are replying on income from alimony, child support, or separate maintenance or on the income or assets of another person as a basis for repayment of the credit requested: complete all Sections and provide information in Other Party Information about the person whose alimony, support, or maintenance payments or income or assets you are relying on

• If this statement relates to your guaranty of the indebtedness of another person(s), firm(s), or corporation(s): complete Individual Information and Statement of Financial condition with accompanies schedules

INDIVIDUAL INFORMATION


Residence Address

City State Zip

Phone Number of Dependants

Position/Occupation Business Name Years with Company

Business Address

City State Zip

Business Phone

1. Do you have any legal claims or judgments outstanding against you? � Yes � No If YES, please explain:

2. Have you or any firm of which you were a major owner ever declared bankruptcy? � Yes � No If YES, please explain:

3. Are you a defendant in any legal action or suit? � Yes � No If YES, please explain:

4. Do you anticipate any material charges to this statement within one year of this date? � Yes � No If YES, please explain:

5. Are you a citizen of the United States of America? � Yes � No If NO, please indicate country of citizenship:



GoheenCompanies.com

16


OTHER PARTY INFORMATION


Residence Address

City State Zip

Phone Number of Dependants

Position/Occupation Business Name Years with Company

Business Address

City State Zip

Business Phone



GoheenCompanies.com

17


STATEMENT OF FINANCIAL CONDITION As of Date

Assets(Do not include Assets

of doubtful value)

In Dollars(Omit Cents) Liabilities In Dollars

(Omit Cents)

Cash on hand and in banks(See Schedule 1)

Real Estate Mortgage Payable (See Schedule)

Marketable Securities – Stocks, Bonds, etc. (See Schedule 2) Notes Payable (See Schedule)

Primary Residence(See Schedule 6) Margin/Debt Due to Brokers

Other Real Estate(See Schedule 6)

Partnership Related Debt(See Schedule)

Investments in Partnerships(See Schedule 4) Taxes Payable

Closely Held Corporations(See Schedule 3) Credit Card Debt

Cash Value Life Insurance(See Schedule 5)

Automobiles

Personal Property

Retirement Accounts (IRAs, Keoghs & Other Qualified Plans)

Accounts & Notes Receivable

Other Assets (Please List)

TOTAL LIABILITIES

NET WORTH

Total Assets TOTAL LIABILITIES & NET WORTH

CONTINGENT LIABILITIES(See Schedule 7)



GoheenCompanies.com

18


Schedule 1 - Cash (Please provide copies of most recent bank statements)

Schedule 2 - Marketable Securities (Please provide copies of most recent brokerage statements)

Schedule 3 - Non-Marketable Securities

Schedule 4 - Investments in Partnerships (Please provide audited financial statements)

Schedule 5 - Life Insurance (Please provide copies of most recent policy summary)

Account Name Bank/Branch Name & Address Balance Account Type/Number Pledged?

$

$

$

# Of Shares Description In Name of Pledged? Current Market Value

$

$

$

# Of Shares Description In Name of Pledged? Current Market Value

$

$

$

Partnership Name General, Limited, Other % Owned Cost Current Market Value

% $ $

% $ $

% $ $

Name of Insurance Company Owner of Policy Beneficiary Face Amt Total Policy Loan Amt

CashSurrender Value

$ $ $

$ $ $

$ $ $

� Yes � No

� Yes � No

� Yes � No

� Yes � No

� Yes � No

� Yes � No

� Yes � No

� Yes � No

� Yes � No



GoheenCompanies.com

19


Schedule 6 - Real Estate (Include Primary Residence as Property A)

Schedule 7 - Contingent Liabilities (If none, write none on schedule)

Property A Property B Property C

Address of Property

Type of Property

In Name of

% of Ownership

Date Purchased

Original Cost

Present Market Value

Name of Mortgage Holder

Mortgage Balance

Monthly Payment

Status of Mortgage

Type of Contingency State Total Amount and Type of Liability

As Guarantor or Endorser

On Leases or Contracts

For Legal Claims Or Judgments

Income Tax Claim or Dispute

Property D Property E Property F

Address of Property

Type of Property

In Name of

% of Ownership

Date Purchased

Original Cost

Present Market Value

Name of Mortgage Holder

Mortgage Balance

Monthly Payment

Status of Mortgage



GoheenCompanies.com

20


POLICY INFORMATION (Attach additional sheets if necessary)

Policy Holder Last Name First Middle

Current Address

City State Zip

Life Insurance Carrier Policy #

Face Amount Initial Premium

Beneficiary Relationship


Life Insurance Carrier Policy #

Face Amount Initial Premium



Policy 1

Policy 2



GoheenCompanies.com

21


Upon submission of this application, Goheen Companies and/or its affiliates are authorized to check my credit and employment history and to receive information about employers’ and creditors’ experiences with me.

Unless 30 days prior notice is given by me, Goheen Companies and/or its affiliates are authorized to check my credit and employment history for each year that the loan is outstanding.

I authorize Goheen Companies and/or its affiliates to make inquiries as necessary to verify the accuracy of the statements made and to determine my credit worthiness. I certify the above and the statements contained in the attachments are true and accurate as of the stated date(s).

These statements are made for the purpose of either obtaining a loan or guaranteeing a loan. I understand that any FALSE statements may result in a forfeiture of benefits and possible prosecution by the U.S. Attorney General (Reference 18 U.S.C. 1001).

Section 1014 of Title 18 of the United States Code was amended to make it a federal crime for any person to knowingly make any false statement or report, or willfully overvalue any land, property or security for the purpose of influencing in any way the action of any bank the deposits of which are insured by the Federal deposit Insurance Corporation.

GOHEEN COMPANIES and/or its affiliates collect non-public personal information about you from the following sources:

• Applications or other documents received from you;

• Current transactions you have with Wintrust, our affiliates or others; and

• A consumer reporting agency.

Goheen Companies and our affiliates do not disclose any non-public personal information about our customers or former customers to anyone, except your insurance representative as otherwise permitted by law.

Goheen Companies and our affiliates restrict access to non-public information about you to only those employees who need to know that information in order to provide products or services to you. Goheen Companies and our affiliates maintain physical, electronic and procedural safeguards that are designed to comply with federal regulations to guard your non-public information.

Waiver and Validity of Information

Name SignatureSSN DateGovernment Issued ID (passport or government issued ID)




Borrower

Additional Borrower/Guarantor (if applicable)

Insured (if not borrower)

OUR CONSUMER PRIVACY POLICY

Additional Insured (if applicable)

Broker/Agent Handout - Goheen Companies...G O H E E N COMPANIES Broker/Agent Handout 713.530.8721...

Documents

Transcript of Broker/Agent Handout - Goheen Companies...G O H E E N COMPANIES Broker/Agent Handout 713.530.8721...