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


DISEASE/DISORDER

�1

Angioplasty/Stent Implant



If more than 10 years:

POSSIBLE ACCEPT

DECLINE DECLINE

No symptoms:POSSIBLE STANDARD

EXPRESS

5+ years since diagnosis:

POSSIBLE STANDARD PLUS


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




POSSIBLE ACCEPT

DECLINE DECLINE


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


Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:

Alliance Life DISEASE/DISORDER

�2

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)




POSSIBLE ACCEPT

DECLINE DECLINE

No underlying heart disease or cardiac

symptoms: POSSIBLE STANDARD

EXPRESS Any underlying heart

disease:DECLINE


Bipolar Disorder

If received diagnosis or required follow-up within the past 10

years: DECLINE

DECLINE DECLINE

STANDARD EXPRESS


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



Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�3

Bypass Surgery (CABG)



POSSIBLE ACCEPT if more than 10 years

DECLINE DECLINE

10+ years since surgery: POSSIBLE

STANDARD EXPRESS

Less than 10 years since surgery:

DECLINE


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




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


Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�4

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


CHF (Congestive Heart Failure)


1 year post full recovery: STANDARD

PLUS Table F to DECLINE

Current:DECLINE


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


Dementia DECLINE DECLINE DECLINE

Acute toxic dementia with full recovery: STANDARD PLUS

All others:DECLINE


Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�5

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


Disabled/Disability ACCEPT ACCEPT

If maternity, fractures,

spinal or back disorders, hip or knee replacements:

ACCEPT

Otherwise: DECLINE

STANDARD PLUS


Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�6

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


Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�7

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


Heart Murmur




“Innocent” and no symptoms: ACCEPT

DECLINE

Mild or Moderate with no symptoms:

STANDARD EXPRESSSevere with cardiac

symptoms: STANDARD EXPRESS

to DECLINE

Heart Surgery




DECLINE DECLINE

10+ years since surgery:

STANDARD PLUS

Within past 10 years possible:

STANDARD EXPRESS



Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�8

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


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


Stones, acute infection:

ACCEPT


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


DECLINE

Discoid: STANDARD PLUS



Liver Disease/Transplant

DECLINE DECLINE DECLINE DECLINE


Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�9

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:


Progressive: DECLINE

Muscular Dystrophy (MD)


POSSIBLE STANDARD EXPRESS

to DECLINE

Oxygen Use (excluding Sleep Apnea)

DECLINE DECLINE DECLINE DECLINE

Pacemaker




DECLINE DECLINE



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



Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�10

Parkinson’s DiseaseModerate, Severe or

Progressive: DECLINEDECLINE DECLINE

Possible: STANDARD EXPRESS


Peripheral Vascular Disease (PVD)


Mild or Moderate: STANDARD EXPRESS

Current tobacco user,

or severe:DECLINE


Pregnancy ACCEPT ACCEPT ACCEPT STANDARD PLUS

Pulmonary Embolism N/A DECLINE DECLINE

Single episode and all clear:

STANDARD PLUS

Sarcoidosis



Pulmonary: DECLINE

Localized, non-pulmonary: ACCEPT

DECLINE

Depends on organs involved. Eyes, skin,

joints: STANDARD PLUS

Liver, heart, kidneys, nervous system:



Schizophrenia





Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�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.


Safe Shield

FORESTERS:


MUTUAL OF OMAHA:


GPM:


�12

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

�1

columbian financial foresters: gpm: group: … · disease/disorder columbian financial group: safe...

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