SBA SUPER CLOSE For Binding Required Loan Life Insurance
|
|
|
- Beatrix Tucker
- 6 years ago
- Views:
Transcription
1 SBA SUPER CLOSE For Binding Required Loan Life Insurance Services Provided by Himmelstein Financial Paul Himmelstein CLU, ChFC & CS Financial Charles Snider (Qualified Agent)
2 Many Times SBA Lenders Require Life Insurance Many lenders require Principal(s) to obtain Life Insurance before the bank releases money to their business The Lending Bank May Have several requirements Banks require binders Banks also require collateral assignments They require the process have a short time requirement (as short as 2 days) Lenders want to do business with experienced agents and financial advisers
3 Benefits to The Lender(s) Lenders want to provide great customer service Lenders can transact business more efficiently Boost your clients satisfaction by releasing much needed funding sooner than anticipated Exceeding expectations allows for the opportunity to earn future business from your clients Stay informed directly by the insurance company about premiums due and any other service notification requirements Lenders conduct business with only the most qualified representatives and underwriters (CS Financial Himmelstein & Associates have a combined 50+ years of industry experience) All pricing is fully disclosed and the firm has a quick quote website
4 Benefits to the Borrower(s) Coverage is customizable Borrowers are provided with all of the necessary information Because there are numerous companies competing for the business you are assured highly competitive rates Policies can be issued even if the borrower has substantial health issues They have some of the most qualified representatives (Himmelstein & Associates principal has been in business over 34 years) They have fully disclosed prices. The firm has a quick quote website They have the best underwriting
5 Super SBA Close Features NOT Limited to one insurance company as a provider NOT Guaranteed issue or guaranteed to issue Does not increase costs to either the lender or borrower (other than premiums paid) Can or Cannot be simplified issue depending upon the insurance company and product
6 SBA Super Close Loan Requirements Loan requires or would like to require life insurance on borrower(s) Policy to be collaterally assigned to lender No minimum or maximum size of insurance contract
7 Benefit Options Although most lenders require term insurance, other life products could be used if desired by borrower Term products guarantees can be as low as one year and as long as lifetime. (frequently quoted guarantee periods include: 1,5,10, 15, 20, 25, 30 year, and lifetime) New contracts can have living benefits that can pay for chronic care, long term care, critical illness
8 Do NOT assume coverage will be denied! Diabetics, Asthma, CAD, Depression Mood Disorders and Heart Patients, Cancer, Stroke, etc. are not necessarily uninsurable or rated People who have different avocational interests can get standard coverage ( Cigar Smokers, Tobacco Chewers, Race Car Drivers, Pilots, Scuba divers, etc..)
9 Himmelstein Financial Provides Approved collateral assignment forms Potential to allow the lender to be premium payer and/or beneficiary in certain circumstances Binder for coverage Duplicate policies for both the lender and borrower if needed Completed after approval valid enforceable collateral assignment forms acknowledgment by insurance company Expert advice for the best contract(s) for the best price Shopping service for non standard risks amongst 30+ companies Cooperative and expedited service and communication for status of the cases
10 Necessary Steps Establish if insurance is needed by the SBA lender Call, , to determine what may be the most appropriate product and pricing Inform the client that this is not a FDIC requirement and that the insurance has no relationship with FDIC Contact either Himmelstein Financial Personnel or CS Financial to implement the application process Agent or our staff arranges physical and communication with clients health practitioners for underwriting information Client informs their personal physician that they are applying for coverage needed to obtain a loan and that when the Doctor is contacted to respond very promptly Client writes binder check and associated agent or HF Company staff provides binder agreement Borrower relaxes and schedules their closing
11 Relevant Contact Information Himmelstein Financial and Associates Websites: Phone: Local: Toll Free: Quote Request Link: =55776&SN= Snider Financial Services Phone: Direct: LinkedIn: (copy and paste the following link into your browser)
SBA SUPER CLOSE For Binding Required Loan Life Insurance. Services Provided by Himmelstein Financial Paul Himmelstein CLU, ChFC
SBA SUPER CLOSE For Binding Required Loan Life Insurance Services Provided by Himmelstein Financial Paul Himmelstein CLU, ChFC Many Times SBA Lenders Require Life Insurance Many lenders require Principal(s)
CREATED EXCLUSIVELY FOR FINANCIAL PROFESSIONALS. Underwriting 101. What You Need to Know. Presented by:
Underwriting 101 What You Need to Know Presented by: The Prudential Insurance Company of America, Newark, NJ 0232361-00001-00 Ed. 10/2012 Exp. 4/3/2014 Where Underwriting Fits In CREATED EXCLUSIVELY FOR
CARRIER PRODUCT AND UNDERWRITING NICHES
CARRIER PRODUCT AND Lifetime Foundation IUL which provides lifetime guarantees (DB drops to 50% around LE) / Solid cash build on the non Guaranteed side and COIs drop off at age 95 which allow the DB on
A guide to understanding, getting and using health insurance. The. Health Insurance
A guide to understanding, getting and using health insurance The Health Insurance THE ABC S OF HEALTH INSURANCE: WHY IS HEALTH INSURANCE IMPORTANT? Even if you are in GOOD HEALTH, you will need to use
A CONSUMER S GUIDE TO CANCER INSURANCE
A CONSUMER S GUIDE TO CANCER INSURANCE WHAT IS CANCER INSURANCE? Cancer insurance provides benefits only if you are diagnosed with cancer, as defined by the terms of the policy contract. These policies
More Than One-Quarter of Insured Adults Were Underinsured in 2016
Exhibit 1 More Than One-Quarter of Insured Adults Were Underinsured in 216 Percent adults ages 19 64 insured all year who were underinsured* 28 22 23 23 2 12 13 1 23 25 21 212 214 216 * Underinsured defined
Health Care in California: The Chronically Ill
Health Care in California: The Chronically Ill A report for the California HealthCare Foundation prepared by Prepared for the California HealthCare Foundation by Harris Interactive Contents About this
Family Physicians of Johnson City 303 Med Tech Parkway, Suite 100 Johnson City, TN 37604
Family Physicians of Johnson City 303 Med Tech Parkway, Suite 100 Johnson City, TN 37604 Patient Registration Form Last Name First Name Middle Initial Sex: M F of Birth Address City State Zip Code Social
In This Issue (click to jump):
May 7, 2014 In This Issue (click to jump): Analysis of Trends in Health Spending 2013 2014 Spotlight on Medicare Advantage Enrollment Oncology Drug Trend Report S&P Predicts Shift from Job-Based Coverage
PATIENT INFORMATION FORM RICHARD L. MALINICK, M.D. ORTHOPAEDIC SURGERY 1125 Via Verde, San Dimas, CA
Email Address Last Name First Name Previous Name Address City State Zip Country Social Security - - Home Phone - - Cell Phone - - Work Phone - - Ext Drivers License State Responsible Party SELF (use info
Transition of Care/ Continuity of Care
Having trouble understanding some of the health insurance terms on this form? See definitions on page 3. Transition of Care/ Continuity of Care Overview Transition of Care gives new UnitedHealthcare members
Group Term Life Application for 10-Year or 20-Year Level Term Rate
E Group Term Life Application for 10-Year or 20-Year Level Term Rate Please complete the entire application. The proposed insured should fill out this application. Please print clearly in dark ink and
Innovative solutions. World class underwriting. Remarkable service.
Underwriting guidelines Financial Professional Innovative solutions. World class underwriting. Remarkable service. Insurance products are issued by Minnesota Life Insurance Company in all states except
MN DEPARTMENT OF HEALTH PROVIDER PEER GROUPING (PPG) ADVISORY GROUP DEFINING PARAMETERS ANN ROBINOW
MN DEPARTMENT OF HEALTH PROVIDER PEER GROUPING (PPG) ADVISORY GROUP DEFINING PARAMETERS ANN ROBINOW MEETING 2: JUNE 26, 2009 Introduction Comments and changes to meeting summary? Review of questions or
Figure ES-1. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to ER
Figure ES-1. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to ER Percent saying very or somewhat difficult 1 53 56 6 59 32 32 42 44 7 * 6 * Significant difference between below and
Innovative solutions. World class underwriting. Remarkable service.
Individual Life Insurance Underwriting Guidelines Financial Professional Innovative solutions. World class underwriting. Remarkable service. Insurance products are issued by Minnesota Life Insurance Company
EstateWise. Agent Guide. Single Premium Whole Life Insurance. For Internal Use Only Not for distribution to the public
18 SPWLntGuide2018_All_Guides:Layout 1 9/28/2018 10:04 AM Page 11 EstateWise nt Guide For Internal Use Only Not for distribution to the public Not a deposit Not guaranteed by any bank or credit union Not
Application for Alumni Insurance
Application for Alumni Insurance Especially for: Underwritten by: Insurance Plan Choices (Do not include insurance already in force.) New Client Existing Client Certificate # (if currently insured) Monthly
NOTICE TO APPLICANT REGARDING REPLACEMENT OF MEDICARE SUPPLEMENT INSURANCE OR MEDICARE ADVANTAGE
NOTICE TO APPLICANT REGARDING REPLACEMENT OF MEDICARE SUPPLEMENT INSURANCE OR MEDICARE ADVANTAGE UNITED HEALTHCARE INSURANCE COMPANY Fort Washington, Pennsylvania SAVE THIS NOTICE! IT MAY BE IMPORTANT
Examining the Drivers of High Cost Healthcare Usage in Prince Edward Island
Examining the Drivers of High Cost Healthcare Usage in Prince Edward Island Mary-Ann MacSwain, Michelle Patterson, George Kephart, Juergen Krause Preliminary results of the study, Small Area Variation
Please Present Insurance Card at Each Office Visit
PATIENT REGISTRATION FORM RONALD J ESCUDERO, MD, FACS Please print clearly and fill out completely Patient Legal Name Birthdate Age Address Social Security # City ST ZIP Email Phone Numbers ( ) Home (
CITRUS ORTHOPAEDIC AND JOINT INSTITUTE PATIENT INFO. SHEET
CITRUS ORTHOPAEDIC AND JOINT INSTITUTE PATIENT INFO. SHEET DATE: TIME: DR: PATIENT INFO: PRIMARY CARE DOCTOR: REFERRING: NAM E: First Middle Last SEX: AGE: DOB: SS# RACE: ETHNICITY: Hispanic Non Hispanic
SKINNER FAMILY PRACTICE 1
SKINNER FAMILY PRACTICE 1 Health History Patient Name: DO YOU HAVE A PERSONAL HISTORY OF DIABETES (E11.9) COPD (J44.9) BLOOD PRESSURE (I10) CROHNS DISEASE (K50.10) HEART DISEASE (I51.9) TUBERCULOSIS (A15.9)
CARRIER PRODUCT AND UNDERWRITING NICHES
CARRIER PRODUCT AND AG Secure Lifetime GUL 3 AG Secure Survivor GULII Elite Global Plus Elite Survivor Index II Max Accumulator+ IUL Value+ Protector IUL Term s Lifestyle Income Solution / Asset Protector
CARRIER PRODUCT AND UNDERWRITING NICHES
CARRIER PRODUCT AND Lifetime Foundation IUL which provides lifetime guarantees (DB drops to 50% around LE) / Solid cash build on the non Guaranteed side and COIs drop off at age 95 which allow the DB on
Minimize the financial impact of a serious illness. Take control today with critical illness insurance.
What would happen if you were suddenly Minimize the financial impact of a serious illness. Take control today with critical illness insurance. What is critical illness insurance? How is critical illness
Sun Par Accumulator II
Sun Par Accumulator II premium payment period: payable to age 100 dividend option: enhanced insurance Policy number: LI-1234,567-8 Owner: Jim Doe The following policy wording is provided solely for your
1150 Prairie Parkway Suite 102 Dr. Heidi Western, D.C. West Fargo, ND (701)
AKER CHIROPRACTIC Dr. JaNyne Aker, D.C. 1150 Prairie Parkway Suite 102 Dr. Heidi Western, D.C. West Fargo, ND 58078 (701) 356-4900 PATIENT INFORMATION: TODAY S DATE: / / Name First MI Last Address City
Referring Physician: Primary Care Physician: Other Physician(s)/Specialty: EMERGENCY CONTACT INFORMATION INSURANCE INFORMATION
PATIENT INFORMATION Name: Date of Birth: Sex: Male Status: Single Married Divorced Widowed Other 502 Elm Street NE Language: Female Race: American Indian or Alaska Native Native Hawaiian or Or Pacific
Line of Credit Critical Illness Insurance Claim Creditor Insurance Policy no
Line of Credit Critical Illness Insurance Claim Creditor Insurance Policy no. 57904 BMO Bank of Montreal Representative: First name Last name Branch Domicile Stamp Signature X Fax number What information
HealthStats HIDI A TWO-PART SERIES ON WOMEN S HEALTH PART ONE: THE IMPORTANCE OF HEALTH INSURANCE COVERAGE JANUARY 2015
HIDI HealthStats Statistics and Analysis From the Hospital Industry Data Institute Key Points: Uninsured women are often diagnosed with breast and cervical cancer at later stages when treatment is less
UNDERWRITING GUIDE. Term Life Insurance. FOR AGENT USE ONLY. Not for use with consumers. Product availability, features and rates may vary by state.
UNDERWRITING GUIDE FOR AGENT USE ONLY. Not for use with consumers. Product availability, features and rates may vary by state. 15-178-01111 (11/17) Important Notice Underwriting Guide for Assurity Assurity
ACCELERATED PROCESS FOR A FAST-MOVING WORLD
ACCELERATED PROCESS FOR A FAST-MOVING WORLD TRENDSETTER TERM LIFE POINT OF SALE DECISIONS As part of our dedication to innovation, Transamerica has introduced an accelerated process for non-medical underwriting
13065 W McDowell Rd., Suite C101, Avondale, Arizona Phone: Fax:
Personal Information - Please Print Last Name: First Name: Initial: DOB: SS# Address: Home Phone: Cell: Work: Email: Gender: Language: Marital Status: Ethnicity: Hispanic/Latino Non-Hispanic/Latino Race:
CARRIER PRODUCT AND UNDERWRITING NICHES
CARRIER PRODUCT AND Elite Global Plus Elite Survivor Index II Max Accumulator+ IUL Secure Lifetime GUL 3 Secure Survivor GULII Select-a-Term Value+ Protector IUL Lifestyle Income Solution / Asset Protector
Understanding Transition of Care and Continuity of Care.
Understanding Transition of Care and Continuity of Care. Transition of Care gives new UnitedHealthcare members the option to request extended coverage from their current, out-of-network health care professional
HIPAA PLAN. Louisiana Health Plan
HIPAA PLAN Louisiana Health Plan INSTRUCTIONS FOR COMPLETION OF APPLICATION 1. A separate application must be completed for each person who is applying for coverage. Individual policies will be issued
Table of Contents P R E F E R R E D U N D E R W R I T I N G GUIDE The Prudential Insurance Company of America, Newark, NJ
P R E F E R R E D U N D E R W R I T I N G GUIDE Table of Contents Introduction...2 The Underwriting Categories...2 Medical Requirements...2 Individuals Under Age 18 and Face Amounts Under $100,000...3
SCOTTISH WIDOWS ENHANCED ANNUITY HOW COULD YOU MAKE MORE OF YOUR RETIREMENT INCOME?
SCOTTISH WIDOWS ENHANCED ANNUITY HOW COULD YOU MAKE MORE OF YOUR RETIREMENT INCOME? PAGE 1 HOW COULD YOU MAKE MORE OF YOUR RETIREMENT INCOME? PAGE 2 CAN YOU GET MORE INCOME FROM YOUR ANNUITY? PAGE 3 ARE
TRENDSETTER LB (LIVING BENEFITS)
TRENDSETTER LB (LIVING BENEFITS) FREQUENTLY ASKED QUESTIONS TABLE OF CONTENTS Why do I need Living Benefits?...1 What are Living Benefits on a Life Insurance Policy and Accelerated Death Benefits?... How
VOLUNTARY GROUP TERM LIFE INSURANCE:
VOLUNTARY GROUP TERM LIFE INSURANCE: This plan offers you and your dependents an excellent opportunity to purchase affordable group term life insurance on a payroll deduction basis. The important plan
CARRIER PRODUCT AND UNDERWRITING NICHES
CARRIER PRODUCT AND Elite Global Plus Elite Survivor Index II Max Accumulator+ IUL Secure Lifetime GUL 3 Secure Survivor GULII Select-a-Term Value+ Protector IUL Lifestyle Income Solution / Asset Protector
EMI HEALTH MEDIGAP APPLICATION - WEBSITE
EMI Health 5101 S. Commerce Dr. Murray, Ut ah 84107 801-262-7475 EMI HEALTH MEDIGAP APPLICATION - WEBSITE Please select one - this application request is for: Open Enrollment If you are applying for coverage
Stonebridge Adult Medicine, P.A. Registration Form (Please Print)
Stonebridge Adult Medicine, P.A. Registration Form (Please Print) PATIENT INFORMATION Last Name: First Name: Is this your legal name? Yes No If not what is your legal name: Date of Birth: Sex: male female
Reinstatement Application for Life Insurance California Version
American General Life Insurance Company, Houston, TX The United States Life Insurance Company in the City of New York, New York, NY (Non-NY Residents) Reinstatement Application for Life Insurance California
Transition of Care/ Continuity of Care Overview Transition of care gives new UnitedHealthcare members the option to request
Having Trouble understanding some of the health insurance terms on this form? See definitions on page 3. Transition of Care/ Continuity of Care Overview Transition of care gives new UnitedHealthcare members
Illinois Standard Health Employee Application for Small Employers
Illinois Standard Health Employee Application for Small Employers INSURER USE ONLY Policy/Group No. Section No. Effective Date New Hire Waiting Period For assistance in completing this application, please
Family Foot and Ankle Centers Patient Registration Form (Please present your insurance cards to the receptionist upon arrival)
Family Foot and Ankle Centers Patient Registration Form (Please present your insurance cards to the receptionist upon arrival) Patient s Name First Last M.I. Nickname Address # City State Zip code Phone:
The benefits of the PBS to the Australian Community and the impact of increased copayments
The benefits of the PBS to the Australian Community and the impact of increased copayments Health Issues No 71 June 2002 Executive Summary The purpose of this paper is to argue that the Pharmaceutical
PATIENT HISTORY FORM. DOB: Age: Male Female Marital Status. Address: Preferred Method of Contact: Home Cell Work Text
PATIENT HISTORY FORM Name: SSN: (Last) (First) (MI) DOB: Age: Male Female Marital Status Address: (Street) (City) (State) (Zip) Home Phone: Cell: Work: Email Address: Preferred Method of Contact: Home
Protect tomorrow and embrace today
Principal Universal Life Flex II SM Protect tomorrow and embrace today BB9782-10 Protect your family or business The death benefit 1 provided through life insurance provides reassurance that when you pass
NOTICE TO OUR PATIENTS
NOTICE TO OUR PATIENTS Although we participate with most insurance plans, you as the patient and/or insured party are responsible for co-pays, deductibles and any non-covered services, which are outlined,
Click on the New Business tab. Click on Replacement Highlighters (located in the drop-down box). Important Notes About This Guide...
CREATED EXCLUSIVELY FOR FINANCIAL PROFESSIONALS SERVICE Guide to Completing Life Insurance Applications PURPOSE OF THIS GUIDE This guide provides information that will help the user accurately complete
Name (Last, First, MI): Date of Birth: / /
Name (Last, First, MI): Address: Age: City: State: Zip: Sex: Male / Female Phone #: (Home): (Cell): (Work): Personal Email: Social Security #: Race: Ethnicity: Hispanic/Latino Non-Hispanic/Latino Other
Personal Medical History Form Please Print
Personal Medical History Form Please Print PATIENT S LEGAL NAME: REFERRED BY: REASON FOR VISIT: TODAY S DATE: BIRTH DATE: PLEASE ANSWER ALL OF THE QUESTIONS AS ACCURATELY AS POSSIBLE. IF YOU DO NOT UNDERSTAND
ANNUAL WELLNESS AND PREVENTATIVE EXAMS
ANNUAL WELLNESS AND PREVENTATIVE EXAMS INFORMATION REGARDING BILLING AND INSURANCE Due to changes in health care laws, we are required to distinguish and bill separately for annual wellness exams and new
The Affordable Care Act (ACA) Medicare Updates
The Affordable Care Act (ACA) Medicare Updates Agenda: Affordable Care Act (ACA) General Introduction Focusing on the Quality of Care Improving Coverage Preventive Services Preserving the Medicare Hospital
PREFERRED UNDERWRITING CLASSIFICATIONS
term ADVISOR GUIDE PREFERRED UNDERWRITING CLASSIFICATIONS ABOUT EQUITABLE LIFE OF CANADA Equitable Life is one of Canada s largest mutual life insurance companies. For generations we ve provided policyholders
Securities offered through LPL Financial, Member FINRA/SIPC th St SW Suite 633 Lynnwood WA Sound Investment Services
Securities offered through LPL Financial, Member FINRA/SIPC. 3500 188th St SW Suite 633 Lynnwood WA 98037 2008 Sound Investment Services Who May Need Long Term Care Insurance? Without a crystal ball, it
McKenzie-Hastings Institute For Foot & Ankle Surgery Patient Registration
McKenzie-Hastings Institute For Foot & Ankle Surgery Patient Registration Patient Name: Gender: Birthdate: Social Security: Email: Home Phone: Cell: Work: Pharmacy: Location: Phone: Responsible Party (if
Preliminary inquiry on insurability (Not an application)
Preliminary inquiry on insurability (Not an application) All questions pertain to and must be answered by the proposed insured person. Note: If the proposed insured is under age 16 (18 in Quebec) the questions
221 Madison Ave Morristown, New Jersey (973) Fax (973) PATIENT INFORMATION. Mailing Address: City: State: Zip: Birth Date:
221 Madison Ave Morristown, New Jersey 07960 (973) 538 4444 Fax (973) 538 0420 PATIENT INFORMATION Marc A. Cohen, MD, FAAOS, FACS Diplomate American Board of Spinal Surgery Fellow American College of Spinal
REFERENCE GUIDE HOW-TO HANDBOOK
Abacus Medical Support Insurance Plan REFERENCE GUIDE HOW-TO HANDBOOK TABLE OF CONTENTS I. About The Product Benefit Sheets II. Underwriting III. Claims How to File a Claim Sample of Hospital Bill Toll
Enjoy your life. Leave a legacy.
Product Guide Enjoy your life. Leave a legacy. GenBu i l d e r SM Single PREMIUM Universal Life Insurance LBL7687 FOR BROKER-DEALER OR AGENT USE ONLY This material may not be quoted, reproduced or shown
REGISTRATION FORM. Physician (PCP): PATIENT INFORMATION. Last Name: First Name: MI: Billing Address: City: ST Zip Code:
: REGISTRATION FORM Physician (PCP): PATIENT INFORMATION Last Name: First Name: MI: Social Security #: DOB: Sex: M F Billing Address: City: ST Zip Code: Home Phone#:( ) Cell Phone#:( ) Work Phone#:( )
The Health Care Law and
The Health Care Law and Office of the Regional Director Community Resource California-Based, extensive travel to AZ, NV, Indian Country, and HI. Day-to-day, week-to-week, month-to-month Educate the public
FG Life-Elite. Product Guide. Fixed Indexed Universal Life Insurance. For Producer Use Only Not For Use With The General Public
Product Guide FG Life-Elite Fixed Indexed Universal Life Insurance For Producer Use Only Not For Use With The General Public ADV 1312 (09-2012) Rev. 06-2014 14-369 FG Life-Elite Fixed Indexed Universal
Plan for tomorrow. Live for today. The living benefits of life insurance. Chronic Illness Death Benefit Advance Rider BB
Chronic Illness Death Benefit Advance Rider Plan for tomorrow. Live for today. The living benefits of life insurance BB10935-07 Plan for tomorrow. Live for today. 1 Live fully, with living benefits When
Your Health is Critical Are You Protected?
Your Health is Critical Are You Protected? By Jim Dehoney Since its development in the early 1980s by South African physician Dr. Marius Barnard (brother of famed pioneer heart transplant physician Dr.
The Prudential Insurance Company of America
The Prudential Insurance Company of America 751 Broad Street, Newark NJ 0710 State Bar of Texas 47080 Please print all answers using black ink. Request for LTD Coverage Form Return this completed form
A positive nicotine on oral fluid will be issued as a smoker. Tobacco users in any form are not eligible for preferred classes.
SUBMISSION REQUIREMENTS 1. Tobacco Use Individuals who use tobacco in any form (including gum, patch or nicotine spray) or who show nicotine in their urine will be charged tobacco user rates, other than
Simplified Issue Whole Life Guaranteed Issue Whole Life AGENT GUIDE
Simplified Whole Life Guaranteed Whole Life AGENT GUIDE www.unitedhomelife.com 800-428-3001 Whole Life Portfolio Five Products for ages 0 to 80 1. Simple yes/no applications. Affordable, guaranteed 2 coverage.
Health Care Reform: Chapter Three. The U.S. Senate and America s Healthy Future Act
Health Care Reform: Chapter Three The U.S. Senate and America s Healthy Future Act SECA Policy Brief Initial Publication September 2009 Updated October 2009 2 The Senate Finance Committee Chairman Introduces
PATIENT INFORMATION. Last Name: First Name: M.I. DOB: Gender: Marital Status: Cell phone: - - Home phone: - - SSN: - - Driver s License Number:
PATIENT INFORMATION Last Name: First Name: M.I. DOB: Gender: Marital Status: Cell phone: - - Home phone: - - SSN: - - Driver s License Number: Mailing Address: Physical Address: Emergency Contact: Phone:
Elevate by Denver Health Medical Plan
Quality Overview Elevate by Denver Health Medical Plan Accreditation Exchange Product Accrediting Organization: NCQA HMO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating
Underwriting Guidelines
LINCOLN FOR LIFE ADVISOR GUIDE Underwriting Guidelines Lincoln individual and survivorship products LCN2045568 The Lincoln National Life Insurance Company Lincoln Life & Annuity Company of New York Not
Group Term Life Insurance for The Missouri Bar 10-year level premium
Group Term Life Insurance for The Missouri Bar 10-year level premium For Missouri Bar members, their families and their employees About life insurance Life insurance provides basic protection for your
One Stop Medical Center Tel:
PATIENT DEMOGRAPHICS TODAY S DATE PATIENT NAME BIRTHDATE AGE SEX M F ADDRESS CITY STATE ZIP HOME#( ) CELL#( ) WORK #( ) May OSMC leave a message on your: Home Phone: y n Work: y n Cell : y n MARITAL STATUS
PATIENT REGISTRATION FORM CAROLINA EAR, NOSE & THROAT
PATIENT REGISTRATION FORM CAROLINA EAR, NOSE & THROAT Last Name: First: M.I.: Sex: Age: Date of Birth / / Social Security # - - Race: Ethnicity: Language Spoken: If patient is child / under 18: Parent
Get the most out of life.
Get the most out of life. P H O E N I X S A F E H A R B O R T E R M SM L I F E P H O E N I X S A F E H A R B O R T E R M SM L I F E E X P R E S S A term life insurance policy with living benefits designed
If you are prescribed any medications, where would you like the script sent? Pharmacy Name: Pharmacy Phone:
AMELIA A. PARÉ, M.D. PATIENT REGISTRATION Date of visit: PATIENT INFORMATION (PLEASE PRINT) Name: Date of Birth: Age: Male Female Race Social Security #: Marital Status: Single Married Divorced Widowed
Get the most out of life.
Get the most out of life. Phoenix safe harbor term SM Life Phoenix safe harbor term SM Life express A term life insurance policy with living benefits designed to protect the future of loved ones and plan
Northwest Functional Neurology Dr. Glen Zielinski DC, DACNB, FACFN 4035 SW Mercantile Dr., Suite 112 Lake Oswego OR
rthwest Functional Neurology Dr. Glen Zielinski DC, DACNB, FACFN 4035 SW Mercantile Dr., Suite 112 Lake Oswego OR 97035 503-850-4526 DEMOGRAPHCS Last Name: First Name: MI: Date of Birth / / Gender: SS#:
CLIENT IV Vitamin /Nutrients
IV NUTRIENTS COMPANY CLIENT IV Vitamin /Nutrients INTAKE EVALUATION Name: Phone / - email: Street: City State Zip Emergency Contact: DOB / / Age Male Female Height Weight What Service are you here for?
Answers, Direction. Momentum. Broker Opportunity Kit
Answers, Direction Momentum Broker Opportunity Kit Dear Business Partner, Thank you for placing your trust in DIS partner to the nation s leading DI producers. And, congratulations! By requesting our Broker
VASCULAR HEART & LUNG ASSOCIATES
PATIENT INFORMATION Last Name: First Name: M.I: Address: City: State: ZIP: Telephone (Cell): (Home): (Circle preferred contact method). Email: Date of Birth (MM/DD/YEAR): / / Age: Sex: SS# Ethnicity [circle]:
ELECTRONIC APPLICATION WORKSHEET
PROPOSED INSURED Last & First Name: M F Last Name at Birth: Complete Address: Date of Birth: Conserve age Tel: Work Tel: Birthplace: Since When in Canada: SIN: Legal Status: Occupation: Since: Mandatory
SunSpectrum Term. (one insured person) Policy number: LI-1234, Owner: Jim Doe
SunSpectrum Term Policy number: LI-1234,567-8 Owner: Jim Doe The following policy wording is provided solely for your convenience and reference. It is incomplete and reflects only some of the general provisions
Guardian Last Name: Guardian First Name: M. Name: Employer Name: Employer Phone: Occupation:
PATIENT INFORMATION: TODAY S DATE Last Name: First Name: Middle Initial: Date of Birth: Sex: Male Female SS#: Marital Status: Street Address: City: State: Zip Code: Home Phone: Work Phone: Mobile Phone:
Application for Whole Life Insurance SIMPLIFIED ISSUE APPLICATION FORM
1. Your Health Application for Whole Life Insurance Underwritten by Western Life Assurance Mail Application to: Everest Team, 5150 Spectrum Way, Suite 500, Mississauga, ON L4W 5G2 1 800 913 8318 ENSURE
Billing and Collections
Policy No.: 9850-28 Original Policy Date: 3-5-97 Revision Date(s): 0-8-03; 12-23-05; 8-16-07;7-01-16 Review Date(s): 1-13-09; 3/17/17 Approval: 3-5-97 Senior Management 1-8-03 Senior Leadership 12-23-05
HAMILTON FOOT AND ANKLE CARE, LLC 9865 E. 116 th St. #300 Fishers, IN (317)
HAMILTON FOOT AND ANKLE CARE, LLC 9865 E. 116 th St. #300 Fishers, IN 46037 (317)-284-8888 Patient Name: Date of Birth: / / First MI Last SS#: Address: City: State: Zip Code: Cell Phone: ( ) - Home Phone:
John Hancock s Tickets and ExpressTrack
LIFE NEW BUSINESS A REFERENCE GUIDE TO John Hancock s Tickets and ExpressTrack FOR AGENT USE ONLY. THIS MATERIAL MAY NOT BE USED WITH THE PUBLIC. LIFE-6819 7/17 Introducing John Hancock Tickets John Hancock
WEST COAST LIFE Guide to Initial Underwriting Requirements
WEST COAST LIFE Guide to Initial Underwriting Requirements West Coast Life Underwriting West Coast Life has built its reputation by providing competent, competitive underwriting for your preferred clients
Patient Information. Last First MI (Preferred Name) Male Female Married Single Child. City State Zip Code Emergency Contact/Relation Phone
LEWIS C. COLE DMD Family and Cosmetic Dentistry 525 ENERGY CENTER BLVD SUITE 1603 NORTHPORT, AL 35473 PHONE 205.344.6900 FAX 205.344.6910 www.lewiscoledentistry.com Patient Name: Patient Information Date:
Franklin Medical Center 514 route 33 west, suite 6 Millstone, n.j Office: fax:
Franklin Medical Center 514 route 33 west, suite 6 Millstone, n.j. 08535 Office: 732-851-7007 fax: 732-786-0012 Today s date: Patient name: Last name first name middle initial Date of birth Age Male/Female
Advanced Podiatry. W E A R E V E R Y P L E A S E D T O H A V E Y O U W I T H U S! Please answer the following questions to help us become acquainted.
W E A R E V E R Y P L E A S E D T O H A V E Y O U W I T H U S! Please answer the following questions to help us become acquainted. Date How did you hear about us? (Be Specific Please) First Name Last Name
Patient Information Sheet. Spouse Information. Emergency Contact Information. Referral. Insurance Information
Patient Information Sheet Patient of Birth Patient Social Security # Street Address City, State & Zip code Home Phone Cell Phone Work Phone Email Address Pharmacy Address/Phone: Patient Employer Address
P.L. 2005, CHAPTER 172, approved August 5, 2005 Assembly, No (First Reprint)
P.L. 00, CHAPTER, approved August, 00 Assembly, No. (First Reprint) - C.:S-. - Note to - 0 0 0 AN ACT concerning managed behavioral health care services and amending and supplementing P.L., c.. BE IT ENACTED
Underwriting interview process: How to prepare for your medical history interview
Nationwide Intelligent Underwriting Process SM Client guide Underwriting interview process: How to prepare for your medical history interview Thank you for considering the Nationwide Intelligent Underwriting