guide on how to complete a foresters life insurance...

Guide to Completing a Foresters Life Insurance

Application – For Federal Employee Business &

List Bill Services

For Internal Use Only - 503517 US (07/13) 1

Important Notes

This application can only to be used for Federal Employee Business (FEB) and List Bill Services cases where the Proposed Insured is the Owner.

If the Proposed Insured is NOT the Owner (e.g. juvenile cases), the standard Foresters Life Insurance Application must be used.

This application is applicable to Term (excl. Accidental Death Term), Whole Life (excl. Final Expense) and Universal Life products only.

To avoid any delays, ensure that the proper application is used for the state where the application is signed and that all additional required forms are submitted.

For tips on how to avoid delays, see the cover page of the application package


• Cover page checklist

• 3 separate product pages – complete and submit only the applicable

product page

• 4-page1 Application for Individual Life Insurance (Federal Employee & List Bill

only)

• Temporary Life Insurance Agreement (TIA)

• Notices page

• Producer Report

• Overflow Form, where applicable

1 State variation applications are 5 pages.

Application Package


Use an Overflow Form if additional space is required to complete:

1. A questionnaire(s)

2. The following application sections

• Children’s Questions

• Additional Information

• Other Insurance

• Beneficiary Information

Be sure to have the Overflow Form reviewed and signed by the Proposed Insured/Owner.

When To Use An Overflow Form


Product Details Page – TERM

Do not submit this page to Foresters if a term product is not applied for

Proposed Insured:

• Ensure the name here matches the proposed insured’s name entered on page 1 of the Application for Individual Life Insurance (Federal Employee or List Bill Only)

Product Details:

• Fill in the amount and select one term • 10 year term not available on non-medical basis

Rider Details:

• Select the desired rider(s) – the appropriate circle must be filled in along with an amount (where applicable).

• Interstate Compact Product page (form # starting with ICC) is applicable for most Interstate Compact states. It lists all optional riders – to avoid selecting riders that are not approved in your state, be sure to check State Availability Map on Foresters producer website

Important Notes

• If underwriting approval is given other than as quoted, Foresters will contact you and, if we do not receive direction otherwise, the certificate will be issued to maintain face amount.

• If maintaining the face amount would cause the premium to fall below our minimum premium guidelines the certificate will be issued to maintain premium, and in certain instances, additional medical requirements will be requested.

• If the premium quoted changes, the payroll deduction form from the appropriate TPA service provider will need to be completed and readjusted to reflect the adjusted premium amount.

Print legibly in ink. Any corrections must be

initialed by the proposed insured and

producer. Please do not use white out


Important Notes




Enter Proposed Insured’s basic information

Enter the planned modal premium

Print legibly in ink. Any corrections must be initialed by the proposed insured and the producer. Please do not use white out

DO NOT use this application for juvenile cases, i.e. proposed insured is < age 16.

For juvenile cases, a standard Foresters Life Insurance Application must be used

Do not submit this page to Foresters if SMART UL is not applied for

Product Details Page – SMART UL


New – SMART is now available for both non-medical and medical plans

• Submit a signed illustration or Illustration Certification at time of application to avoid delays

• Fill in the amount of life insurance

• If riders are selected, the appropriate circle must be filled in along with an amount (if applicable)

• Interstate Compact Product page (form # starting with ICC) is applicable for all Interstate Compact states. It lists all optional riders – to avoid selecting riders that are not approved in your state, be sure to check State Availability Map on Foresters producer website

• Select either Non-medical or Medical Underwriting – since some issue ages have face amount ranges where both underwriting types are available, it is important to indicate which type is being applied for

• A Death Benefit Option (Level or Increasing) and a Life Insurance Qualification Test (GPT or CVAT) must be selected (see product guide or product presentation for more information)

• Submit a signed illustration or Illustration Certification at time of application to avoid delays

• Fill in the amount of life insurance

• Plan type must be selected

• If riders are selected, the appropriate circle must be filled in along with an amount (if applicable)

• Interstate Compact Product page (form # starting with ICC) is applicable for all Interstate Compact states. It lists all optional riders – to avoid selecting riders that are not approved in your state, be sure to check State Availability Map on Foresters producer website

• Select either Non-medical or Medical Underwriting – since some issue ages have face amount ranges where both underwriting types are available, it is important to indicate which type is being applied for

• A Dividend Option must be selected (see producer guide for more information). As well, “Yes” or “No” must be indicated for the automatic premium loan provision

Important Notes




Enter Proposed Insured’s basic information

Select Plan Type: Paid up at 100 or 20 Pay

DO NOT use this application for juvenile cases, i.e. proposed insured is < age 16.

For juvenile cases, a standard Foresters Life Insurance Application must be used

Print legibly in ink. Any corrections must be initialed by the owner, proposed insured and the producer. Please do not use white out

Must select Dividend Option and answer “Yes” or “No” for automatic premium loan provision

Product Details Page – Advantage Plus Whole Life

Do not submit this page to Foresters if Advantage Plus is not applied for


New - Select Underwriting basis – non-medical or medical

Term Rider:

• Client can choose either 10-year term or 20-year term, but not both

PUA Rider (available on both non-medical and medical underwriting basis) :

• Client can choose Flexible payment paid-up additions or Single payment paid-up additions, or both

• Flexible payment paid-up additions (available on medical underwriting basis only): • Enter the annual PUA amount applied for in the Maximum

annual payment amount field (subject to underwriting and the maximum annual amount in effect at the time of application). Note that the amount input in this field will be multiplied by the appropriate UW factor and then added to the base certificate coverage amount and the Term rider amount (if applicable), to determine underwriting requirements

• Enter the desired payment amount in the Planned payment amount field: • Client can choose any amount as long as it meets our

modal minimum payment amounts (mode must match that chosen for the certificate premiums) of $50 monthly, $150 quarterly, $300 semi-annually or $600 annually and doesn’t exceed the maximum annual payment amount entered above. Enter $0.00 if the client does not want to begin making a PUA rider payment at this time

• The amount will be added to the premiums for the base certificate and riders as the total drafted amount.




PUA Rider (cont.):

• Single payment paid-up additions (available on both non-medical and medical underwriting basis):

• Enter the desired lump sum amount in the Planned payment amount field. Note that the amount input in this field will be multiplied by the appropriate UW factor and then added to the base certificate coverage amount and the Term rider amount (if applicable) to determine underwriting requirements

• The amount input in this field will be added to the premiums for the base certificate and riders as the total withdrawal for the first premium payment

• If Transfer is selected, be sure to enter the Source of payment (e.g. 1035 exchange, and submit a completed 1035 exchange form(s) with the application)

• If applying for non-medical underwriting basis, the source of payment must be 1035 exchange. No other form of payment is allowed




Application for Individual Life Insurance (Federal Employee or List Bill Only)

Print legibly in ink. Any corrections must be initialed by the proposed insured and the producer

FEB or List Bill identification:

• Complete this section

• Check off the appropriate box to indicate the case is FEB or List Bill

Proposed Insured:

• Proposed Insured and owner must be the same person

• Provide phone # (home or cell) where the Proposed Insured can be contacted

Important Notes

• Record the responses to every question. If a question is blank or incomplete you may have to contact the proposed insured for additional information

• Producer must be present - complete the application in the presence of the proposed insured to verify his/her good health and to witness the signature(s) on the application

Enter the monthly premium amount here in the Monthly Premium Quoted field, regardless of the payroll deduction frequency chosen (i.e. if bi-weekly payroll deduction is selected in the payroll authorization form, do NOT enter the bi-weekly deduction amount here).

Monthly premium amount can be obtained from our illustration software or mobile quote tool.

10 For Internal Use Only - 503517 US (07/13)


Print legibly in ink. Any corrections must be initialed by the owner, proposed insured and the producer

Indicate tobacco/nicotine use - Smoking status is based on the date that the proposed insured last used cigarettes, marijuana or other tobacco or nicotine products

Questions

• Provide details to all ‘Yes’ answers by completing the corresponding questionnaire(s)

• If no corresponding questionnaire is available, provide details in the Additional Information section, or use an Overflow Form if more space is required

Important Notes

• Ask each question exactly as worded and record each answer as given by the proposed insured (even if you know or suspect that a given answer is incorrect. If this happens, alert the underwriter on the Producer Report or in a cover letter)

• Recording an accurate and complete health history is extremely important for expediting the underwriting process. Partial or vague declarations often raise more questions which may cause delays in processing the application


Children’s Questions

• Complete only if applying for Children’s Term Rider

• Use an Overflow Form to list additional children or if more space is required to complete questions 21a or 21b



Additional Information:

• Use an Overflow Form if more space is required

Other Insurance:

• Indicate all annuities or insurance pending and in-force, including group insurance and whether it will be replaced


• Producers must comply with any replacement laws and regulations and are expected to offer suitable products and services to meet the proposed insured/owner’s needs. Please refer to Foresters producer website (Tools & Resources -> Toolkit) for details

Declarations and Agreements

• Proposed insured (i.e. the owner) must review the declarations and agreements


Be sure to complete required State/Foresters replacement, rollover, surrender and/or disclosure forms.


Beneficiary Information


Temporary Life Insurance

• To qualify, at least one monthly premium, which includes the planned payment amount for the PUA rider if applied for, is provided or authorized no later than the application date.

• For FEB/List Bill business, payroll deduction is an acceptable method for the first premium in relation to TIA

• It provides temporary life insurance agreement (“TIA”) up to $500,000 if the following pre-conditions are met, subject to the terms of TIA. Be sure to leave the TIA agreement with the Proposed Insured(i.e. Owner) if:

• All TIA questions are answered ‘No’ and these answers are truthful

• Total coverage applied for (excluding all riders payable upon death) is less than or equal to $1,000,000

• Proposed insured older than 15 days old or younger than age 71

• If first premium is paid by 1035 exchange (i.e. instead of a separate check), the case will not be eligible for TIA


Enter beneficiary’s date of birth and address here. Should a claim become payable, the information will help speed up the claims payment process.

TIA pre-conditions not met: Check ‘No’ and obtain the Proposed Insured’s initials


Authorization To Obtain And Disclose Information

• Proposed insured must review

Signature Section

• For Proposed Insured’s signature - One signature for the entire application

Producer Certification

• Indicates that you certify the points in this section including that you are not aware of undisclosed information that might affect insurability


Be sure to answer these questions


Temporary Life Insurance Agreement

Temporary Life Insurance Agreement (TIA)

• To be left with the owner if the pre-conditions are met.

• If Pre-conditions Not Met:

• Do not leave the TIA with the Proposed Insured

• On page 4 of the application

• check ‘No’ to the first acknowledgement question (below “Will the TIA be left with the Proposed Insured?”)

• obtain the Proposed Insured’s initials

If TIA pre-conditions met, leave TIA with the Proposed Insured – see slide 14 for a list of the pre-conditions


Notices

• Provide to Proposed Insured for review

• Leave this page with the Proposed Insured

• This page:

• Contains the notices legally required and Foresters contact information

• Includes the privacy notice, underwriting process and Medical Information Bureau (MIB) information

• Gives a description of some of the additional sources of underwriting information. The Proposed Insured consents to the release of this information to the MIB by signing the authorization to obtain and disclose information page. If the Proposed Insured requires further information about MIB or their record with them, they should contact MIB directly at the address provided on this page

17

Notices page

For Internal Use Only - 503517 US (07/13)

Producer Report

• If producer is related to Proposed Insured, state relationship in the Producer Comments section

This is a list of available supplemental questionnaires for the Questions section which may be answered “yes”.

Complete an Overflow Form if additional space is required.

If no corresponding questionnaire is available or none is submitted, advise the proposed insured that Foresters may contact them

18

Producer Report


• This application is ONLY to be used for Federal Employee Business and List Bill Services cases where the Proposed Insured is the Owner

• If the Proposed Insured is NOT the Owner (e.g. juvenile case), the standard Foresters Life Insurance Application must be used

• Provide corresponding supplemental questionnaires for “yes” answers in the Questions section

• Complete an Overflow Form if additional space is required to complete a questionnaire(s) or the following application sections:

• Children’s Questions

• Additional Information

• Other Insurance

• Beneficiary Information

• To avoid selecting riders that are not approved in your state, be sure to check State Availability Map on Foresters producer website for a list of approved optional riders

• Provide all applicable replacement, rollover, surrender and disclosure forms


19

Reminder


Visit Foresters producer website - for application package and supplemental forms for your state

For more information on Federal Employee Business or List Bill Services, please visit:

www.forestersfeb.com or www.foresterslistbill.com


http://www.forestersfeb.com/

http://www.foresterslistbill.com/

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