COLUMBIAN FINANCIAL FORESTERS: GPM: GROUP: … · DISEASE/DISORDER COLUMBIAN FINANCIAL GROUP: Safe...
Transcript of COLUMBIAN FINANCIAL FORESTERS: GPM: GROUP: … · DISEASE/DISORDER COLUMBIAN FINANCIAL GROUP: Safe...
DISEASE/DISORDER
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life
AIDS DECLINE DECLINE DECLINE DECLINE
Alcoholism Within past 5 years:
DECLINE
After 5 years, without relapse, no current use:
ACCEPT
Within past 10 years: DECLINE
After 5 years since treatment:
STANDARD PLUS
Current use, or within 5 years:DECLINE
Alzheimer’s
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
DECLINE DECLINE DECLINE
Amputation
Injury: POSSIBLE ACCEPT
Disease: DECLINE
Injury: ACCEPT
Disease: DECLINE
Injury: ACCEPT
Disease: DECLINE
Injury: STANDARD PLUS
Disease: DECLINE
Aneurysm DECLINE DECLINE DECLINE
Treated, recovered or repaired within 3 years: POSSIBLE
STANDARD EXPRESS
More than 3 years: STANDARD PLUS
*Call for Risk Assessment
Angina (Chest Pain) DECLINE DECLINE DECLINE
STANDARD EXPRESSto
DECLINE
*Call for Risk Assessment
DISEASE/DISORDER
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Angioplasty/Stent Implant
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
If more than 10 years:
POSSIBLE ACCEPT
DECLINE DECLINE
No symptoms:POSSIBLE STANDARD
EXPRESS
5+ years since diagnosis:
POSSIBLE STANDARD PLUS
*Call for Risk Assessment
Anxiety ACCEPT
Mild, > age 25, onset more than 1 year or
later, no hospitalizations or time
off work: ACCEPT
If hospitalized within the past 10 years due to:
DECLINE
Otherwise: ACCEPT
Within 2 years of last symptoms:
STANDARD EXPRESSMore than 2 years: STANDARD PLUS
Arrhythmia
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
If more than 10 years:
POSSIBLE ACCEPT
DECLINE DECLINE
*Call for Risk Assessment
Arthritis
Rheumatoid - required follow-up ever:
DECLINE
Other: ACCEPT
Osteoarthritis: ACCEPT
Rheumatoid - minor no limitations: ACCEPT
Severe/Moderate (RX
include Humira, Enbrel, Prednisone): DECLINE
Moderate/Severe rheumatoid arthritis treated with Humira,
Enbrel or Methotrexate: DECLINE
Osteo - Mild to moderate pain:
STANDARD PLUS Severe to persistent
paid: STANDARD EXPRESS
Rheumatoid - Mild to moderate: STANDARD
PLUSSevere to persistent and/or continuous
steroid use:STANDARD PLUS or
DECLINE
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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AsthmaTobacco use or
moderate/severe or complications: DECLINE
Mild: ACCEPT
Moderate if build is 50 lbs lighter than the
build chart: ACCEPT
Severe or hospitalization:
DECLINE
Chronic or Severe: DECLINE
STANDARD PLUS
Steroid use or severe:STANDARD EXPRESS
Atrial Fibrillation (A-Fib)
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
If more than 10 years:
POSSIBLE ACCEPT
DECLINE DECLINE
No underlying heart disease or cardiac
symptoms: POSSIBLE STANDARD
EXPRESS Any underlying heart
disease:DECLINE
*Call for Risk Assessment
Bipolar Disorder
If received diagnosis or required follow-up within the past 10
years: DECLINE
DECLINE DECLINE
STANDARD EXPRESS
*Call for Risk Assessment
Blood Pressure (Hypertension)
ACCEPT
If controlled. MUST be 50 lbs lighter than
relative build chart: ACCEPT
ACCEPT
Table 2 or higher build with multiple impairments or hospitalizations within past 10 years: DECLINE
STANDARD PLUS
Bronchitis
ACCEPT
If moderate to severe, if a smoker or any complications:
DECLINE
Acute: ACCEPT
Chronic: DECLINEDECLINE
STANDARD EXPRESS
Oxygen or Smoker: DECLINE
*Call for Risk Assessment
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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Bypass Surgery (CABG)
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
POSSIBLE ACCEPT if more than 10 years
DECLINE DECLINE
10+ years since surgery: POSSIBLE
STANDARD EXPRESS
Less than 10 years since surgery:
DECLINE
*Call for Risk Assessment
CancerMelanoma/Skin/Basal/Squamous
More than 5 years since last diagnosis and
treatment: POSSIBLE ACCEPT
EVER Metastatic
(spread), Hodgkins Disease, Leukemia,
Lymphoma, Live, Lung or Pancreatic: DECLINE
Diagnosis and end of treatment over 10 years
ago or recurrence: ACCEPT
Basal Cell: ACCEPT
All others including
Hodgkin’s Lymphoma: DECLINE
DECLINE
*Call for Risk Assessment and
refer to underwriting guide
1-800-938-4765 Ext 2299
Cardiomyopathy
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
If more than 10 years:
POSSIBLE ACCEPT
DECLINE DECLINE
Current, or within 3 years:
DECLINE Over 3 years since full recovery: POSSIBLE
STANDARD EXPRESS*Call for Risk Assessment
Crohn’s
If less than 3 years since last flare-up Crohn’s Disease:
DECLINE
> 5 years in remission: ACCEPT
ACCEPT*Call for Risk Assessment
Colitis Moderate to severe UC:
DECLINEUlcerative: DECLINE ACCEPT
I.B.S: STANDARD PLUS
Ulcerative: STANDARD EXPRESS
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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COPD (Chronic Obstructive
Pulmonary Disease)
If moderate to severe, if a smoker or any
complications: DECLINE
Otherwise: POSSIBLE ACCEPT
Strong Foundation: Non Smoker, mild
COPD, no oxygen, no steroids or serious COPD medications:
ACCEPT
Smart UL: COPD, Chronic Bronchitis or Emphysema: DECLINE
Chronic Bronchitis or Emphysema: DECLINE
Mild to moderate, smoker/non smoker: STANDARD EXPRESS
to DECLINE
*Call for Risk Assessment
CHF (Congestive Heart Failure)
DECLINE DECLINE DECLINE
1 year post full recovery: STANDARD
PLUS Table F to DECLINE
Current:DECLINE
*Call for Risk Assessment
Cystic Fibrosis DECLINE DECLINE DECLINE DECLINE
Depression
ACCEPT
Moderate to several diagnosed within the
past 3 years: DECLINE
Mild > age 25, onset more than 1 year or
later, no hospitalizations or time
off work: ACCEPT
Severe, major depression, bipolar, schizophrenia(Rx include Lithium, Seroquel, Abilify,
Respidol) DECLINE
ACCEPT
Hospitalized within the past 10 years, or severe
depression: DECLINE
STANDARD PLUS to DECLINE
*Call for Risk Assessment
Dementia DECLINE DECLINE DECLINE
Acute toxic dementia with full recovery: STANDARD PLUS
All others:DECLINE
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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Diabetes
*Must be under table 2 build. Refer to
diabetic build chart.
Type I - Any tobacco use, ratable table 2
build or higher, diabetic complications or Coronary Artery
Disease: DECLINE
Type 2 - Any tobacco use age 50 and
younger, ratable table 2 build or higher, diabetic
complications or Coronary Artery
Disease: DECLINE
Otherwise: POSSIBLE ACCEPT
*Refer to underwriting
guide for complete restrictions
Strong Foundation: Treated with oral meds,
Insulin or diet; and good control; and non-smoker or <1 pack/day.
ACCEPT
*REQUIRED: See Foresters Product
Guide for criteria on age of diagnosis and
duration since diagnosis.
Smart UL:Treated with oral meds,
or diet; and good control; and non-
smoker or <1 pack/day: ACCEPT
Treated with insulin; or
any treatment with build exceeding
standard build chart, poor control or complications:
DECLINE
Diagnosed < age 50, table 2 or higher build, tobacco
use or PVD: DECLINE
Otherwise: ACCEPT
Pill form diabetic(type 2): STANDARD PLUS
to STANDARD EXPRESS
Uses Insulin (type 1): STANDARD EXPRESS
to DECLINE
*Call for Risk Assessment
Disabled/Disability ACCEPT ACCEPT
If maternity, fractures,
spinal or back disorders, hip or knee replacements:
ACCEPT
Otherwise: DECLINE
STANDARD PLUS
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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Driving Record (Including D.U.I.)
License suspended or revoked. Past 3 years:
DWI, DUI, 3 or more driving violations or combination thereof:
DECLINE
Past 5 years: License suspended or revoked,
3 or more moving violations or 1 or more
DUIs: POSSIBLE DECLINE
Last 5 years: 4 or more moving violations, DUI, or
reckless driving convictions:
DECLINE
Driver license suspended or revoked or any DUI violations
within the past 5 years: STANDARD
PLUS with temporary price rating for 2-3
years
Drug Abuse/Addiction
In the past 5 years, used or had been
treated for amphetamines,
cocaine, narcotics, hallucinogens, or
barbiturates: DECLINE
Other than occasional marijuana use (tobacco
rates apply): DECLINE
Used or convicted unlawful drugs or prescription drugs
other than as prescribed within the past 10 years:
DECLINE
10+ years:STANDARD PLUS
5-10 years:
STANDARD EXPRESS
Within the past 5 years: DECLINE
EpilepsyWith seizures in the
past year: DECLINE
Controlled on meds, no seizures for 2 years, no
complications: POSSIBLE ACCEPT
DECLINE
Grand Maul seizure-free for at least 2
years:STANDARD PLUS to
STANDARD EXPRESS
Within the past 2 years:
STANDARD EXPRESS
*All other seizures 2+ years ago:
STANDARD PLUS
Felony (Probation & Parole)
Past 3 years: DECLINE
If on probation or parole: DECLINE
1 year after probation:
ACCEPT
If jail time has been served, consider 5 years after parole.
Past 10 years: DECLINE
Probation and Parole: POSSIBLE DECLINE
Released from probation/parole: STANDARD PLUS
Serving time:
DECLINE
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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Fibromyalgia ACCEPTNo depression and working full time:
ACCEPTACCEPT STANDARD PLUS
Gastric Bypass ACCEPTAfter 1 year, weight stabilized: ACCEPT
After 1 year: ACCEPT
6+ months post surgery:
STANDARD PLUS
*Check client current build
Heart Attack
DECLINE
Heart attack after 10 years may be
considered, but may require medical
records: POSSIBLE ACCEPT
DECLINE DECLINE
Within past 10 years possible:
STANDARD EXPRESS to DECLINE
*Call for Risk Assessment
Heart Murmur
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
POSSIBLE ACCEPT if more than 10 years
“Innocent” and no symptoms: ACCEPT
DECLINE
Mild or Moderate with no symptoms:
STANDARD EXPRESSSevere with cardiac
symptoms: STANDARD EXPRESS
to DECLINE
Heart Surgery
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
POSSIBLE ACCEPT if more than 10 years
DECLINE DECLINE
10+ years since surgery:
STANDARD PLUS
Within past 10 years possible:
STANDARD EXPRESS
*Call for Risk Assessment
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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HepatitisA, recovered: ACCEPT
B or C: DECLINE
A, recovered: ACCEPT
B or C: DECLINE
A: POSSIBLE ACCEPT
B or C: DECLINE
A or B treated/all clear:
STANDARD PLUS
C: Resolved, STANDARD EXPRESS
to DECLINE
*Call for Risk Assessment
HIV + VE DECLINE DECLINE DECLINE
Currently taking anti-viral medications, but never diagnosed with HIV: STANDARD PLUS
Diagnosed: DECLINE
Hyper/Hypo Thyroidism
ACCEPTTreated, no symptoms:
ACCEPTACCEPT STANDARD PLUS
Kidney Disease/Failure/DialysisKidney Stones
Disease/Dialysis: DECLINE
Stones: ACCEPT
Disease/Dialysis: DECLINE
Stones, acute infection:
ACCEPT
Disease/Dialysis: DECLINE
Stones: ACCEPT
Acute episode, fully recovered: STANDARD
PLUSChronic: DECLINE
On or advised to seek
dialysis treatment: DECLINE
Leukemia DECLINE DECLINE DECLINE DECLINE
Lupus
Discoid: ACCEPT
Systemic:(Erythematous) if
diagnosed less than 5 years ago with
medications: DECLINE
Discoid: ACCEPT
Systemic:(Erythematous)
DECLINE
Discoid: ACCEPT
Systemic:(Erythematous)
DECLINE
Discoid: STANDARD PLUS
Systemic:(Erythematous)
STANDARD EXPRESS to DECLINE
Liver Disease/Transplant
DECLINE DECLINE DECLINE DECLINE
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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Marijuana Possible tobacco rates (occasional use only):
ACCEPT
Possible tobacco rates (occasional use only):
ACCEPT
Used or convicted unlawful drugs or prescription drugs
other than as prescribed within the past 10 years:
DECLINE
Uses 1-2 times recreationally per
month:STANDARD PLUS NON
TOBACCO
Multiple Sclerosis (MS)
In the past 10 years, received diagnosis of or
required follow-up; progressive or
relapsing: DECLINE
DECLINE DECLINE
Not progressive or relapsing-remitting:
STANDARD EXPRESS to DECLINE
Progressive: DECLINE
Muscular Dystrophy (MD)
DECLINE DECLINE DECLINE
POSSIBLE STANDARD EXPRESS
to DECLINE
Oxygen Use (excluding Sleep Apnea)
DECLINE DECLINE DECLINE DECLINE
Pacemaker
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
POSSIBLE ACCEPT if more than 10 years
DECLINE DECLINE
STANDARD EXPRESS to DECLINE
*Call for Risk Assessment
Pancreatitis DECLINE
Single attack, acute > 1 year ago, non alcohol-
related, no complications: ACCEPT
Alcohol related,
chronic: DECLINE
ACCEPT
Acute, more than 1 year since recovery:
STANDARD EXPRESS
Chronic: DECLINE *Call for Risk Assessment
ParalysisAny Paraplegia or
Quadriplegia: DECLINEParaplegia or
Quadriplegia: DECLINEAny Paraplegia or
Quadriplegia: DECLINE
Possible: STANDARD EXPRESS
*Call for Risk Assessment
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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Parkinson’s DiseaseModerate, Severe or
Progressive: DECLINEDECLINE DECLINE
Possible: STANDARD EXPRESS
*Call for Risk Assessment
Peripheral Vascular Disease (PVD)
DECLINE DECLINE DECLINE
Mild or Moderate: STANDARD EXPRESS
Current tobacco user,
or severe:DECLINE
*Call for Risk Assessment
Pregnancy ACCEPT ACCEPT ACCEPT STANDARD PLUS
Pulmonary Embolism N/A DECLINE DECLINE
Single episode and all clear:
STANDARD PLUS
Sarcoidosis
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
Pulmonary: DECLINE
Localized, non-pulmonary: ACCEPT
DECLINE
Depends on organs involved. Eyes, skin,
joints: STANDARD PLUS
Liver, heart, kidneys, nervous system:
STANDARD EXPRESS to DECLINE
*Call for Risk Assessment
Schizophrenia
In the past 10 years received treatment/
diagnosis or had follow-up: DECLINE
DECLINE DECLINE DECLINE
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
�11
Sleep Apnea ACCEPTTreated and controlled:
ACCEPTACCEPT
If well-controlled and uses C-PAP:
STANDARD PLUS
Severe or inconsistent CPAP: STANDARD
EXPRESS
Stroke/CVA/TIA
If less than 1 year of event, less than age 40
of event, or all ages with moderate to severe
residuals: DECLINE
DECLINE DECLINE
STANDARD EXPRESS to
DECLINE
Suicide Attempt N/A DECLINE DECLINE
Single attempt, more than one year:
STANDARD PLUS with temp flat extra
Multiple attempts, over 2 years since last attempt: STANDARD
PLUS Table F with temp flat extra to
DECLINE
*History of depression, call for Risk Assessment
Transportation Assistance
Permanent use: DECLINE
DECLINE DECLINE*Call for Risk Assessment
Weight SEE BUILD CHART. SEE BUILD CHART OR
DIABETIC BUILD CHART.
SEE BUILD CHART OR MULTIPLE IMPAIRMENT BUILD CHART(TABLE 2).
SEE BUILD CHART.
COLUMBIAN FINANCIAL GROUP:
Safe Shield
FORESTERS:
Smart U.L.- Strong Foundation
MUTUAL OF OMAHA:
Term Life Express - G.U.L. Express
GPM:
Alliance Life DISEASE/DISORDER
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BUILD CHARTS - GENDER NEUTRAL
Height CFG FORESTERS
FORESTERS Standard Max
Build (Medical
Impairments)
MUTUAL OF
OMAHA MUTUAL OF
OMAHA *TABLE 2
GPMPLUS/
STANDARD
4’8" 189 185 140 197 184 159/186
4’9” 196 193 145 202 189 164/192
4’10” 203 198 150 208 194 169/199
4’11” 210 207 155 214 199 173/206
5’ 217 212 161 220 205 178/213
5’1” 224 221 166 226 211 182/220
5’2” 232 225 172 232 215 186/227
5’3” 239 234 177 238 220 192/235
5’4” 247 243 183 245 225 197/242
5’5” 255 250 189 251 231 203/250
5’6” 263 259 195 258 239 208/258
5’7” 271 265 201 265 245 214/265
5’8” 279 274 207 274 251 219/273
5’9” 287 281 213 282 258 225/282
5’10” 296 292 219 289 266 231/290
5’11" 304 298 225 298 274 236/298
6’ 313 307 232 305 281 243/306
6’1” 322 314 238 313 289 249/315
6’2” 331 325 245 321 296 255/324
6’3” 340 336 252 329 303 262/333
6’4” 349 342 258 338 311 271/341
6’5” 358 353 265 347 319 277/350
6’6” 367 360 272 358 328 285/360
6’7” 377 367 336 294/369
6’8” 386 376 345 301/378
6’9” 396 385 352 311/388
6’10” 395 359
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