FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES.

Transcription

1 New Business Team: Toll Free Phone: Fax: Toll Free Fax: Red Team Green Team Blue Team ExpressLINE Message Recorder Local Direct Line Administrative Office Fax (All Areas Except New Business & Policy Change) Policy Change Fax Policyowner (All Areas Except New Business) Pending Business : Accessible 24 hours a day, seven days a week, at MidlandNational.com Medical Reference Library: Reference for evaluating medical impairments, at MidlandNational.com /13 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES.

2 Approved Paramedical Services Use an approved paramedical service for Traditional and Tele-Underwriting applications. These paramedical services provide a full range of services throughout the U.S. Examiners associated with approved paramedical organizations will be aware of Midland National requirements for the age and amount applied for. Advise your local examiner of the tal amount of life insurance applied for and in force with Midland National, so requirements are completed accordingly. They will have the necessary supplies including the kits for blood and urine. If the service is not listed in your local telephone direcry white pages, call the 800 number or visit the website for the paramedical services listed below. American Para Professional Systems, Inc. APPS...( Examination Management Services, Inc. EMSI...( ExamOne ExamOne... ( Portamedic/Hooper Holmes Portamedic...( Superior Mobile Medics Superior...( Approved Lab (blood, urine, and oral fluid): Clinical Reference Laborary CRL... ( Form 7608 is available from Supply Online for clients request lab test results. Hooper Holmes Underwriting Solutions Cusmer Interview and Tele-Underwriting: Hours (Central Time): Monday-Thursday: 8:00 AM 9:00 PM, Friday: 8:00 AM 5:00 PM Cusmer Interviews: Tele-Underwriting: Interview by Underwriter (IBU): X-Press Testing (Common Q & A Refer MidlandNational.com) X-Press Testing is a method of assessing standard bacco and standard non-bacco risks for life insurance applicants. Through a single, painless sample, it allows the laborary check for drugs, nicotine use, and HIV. Use the oral fluid test for cases applying for standard coverage only. X-Press can be used with both Traditional and Tele-Underwriting applications using age/amount guidelines. The agent collects the sample (at the time of the application) using a swab that is inserted between the cheek and lower gum for two minutes. The applicant then places the swab in a vial, and the agent mails it the Preferred Lab. Certification In order collect the oral-fluid specimen, some very basic training (certification) is necessary. This training is available on Midland National s website at MidlandNational.com. After logging in, select New Business from the menu and click X-Press Testing. X-Press Testing consists of reviewing a brief training script and completion of a certification quiz. X-Press Limits Applies Non-Preferred Classes The agent-collected oral fluid test is fast and easy administer on standard cases not otherwise qualifying for preferred rates due age, plan of insurance, weight, or medical hisry (for example: diabetes and high blood pressure). Use traditional or tele-underwriting requirements for Preferred and rated cases. Amount $25,000 $100,000 $100,001 $300,000 Oral Fluid MVR Oral Fluid MVR Oral Fluid MVR Use Traditional Requirements or Tele-Underwriting Requirements /13 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES 1

3 Traditional Underwriting Requirements for Term, UL, VUL, WL, and IUL Products AMOUNT 0 99, , , , , , ,999 1,000,000 2,000,000 2,000,001 5,000,000 5,000,001 10,000,000 10,000,001 and up 1 If a health assessment has been completed by the primary care physician within the past six months, a Paramed Exam may be used in lieu of an MD Exam. Cusmer Interview Cusmer Interview Cusmer Interview MD Exam 1 Cusmer Interview 2 Any stress testing completed within the past 12 months may be substituted in lieu of a current Treadmill EKG. See page 12 for definitions Cusmer Interview Cusmer Interview Cusmer Interview MD Exam 1 Treadmill 2 Cusmer Interview Cusmer Interview Cusmer Interview Cusmer Interview MD Exam 1 Treadmill 2 Cusmer Interview Cusmer Interview Cusmer Interview Cusmer Interview Cusmer Interview Treadmill 2 Cusmer Interview 76+ Cusmer Interview Cusmer Interview Cusmer Interview Cusmer Interview Treadmill 2 Cusmer Interview Preparing the Applicant for a Paramed Visit (Refer form 6038) In order obtain accurate information, it is recommended that the applicant... Fast for 8 hours prior the appointment. Limit coffee and smoking one hour prior the appointment. Drink a glass of water one hour prior the appointment. Refrain from drinking alcoholic beverages for at least 12 hours prior the appointment. Provide names and dosages of current medications. Provide any hisry of problems associated with providing a blood sample. Have available member number(s) of any current health insurance plan. Have available names, addresses, and phone numbers of any docrs or clinics visited in the last five years. Medical Evidence for 0-15 $0 $250,000 Fully completed application with medical questions completed by agent. $250,001 and up Individual consideration. Contact Underwriting for requirements. Age and Amount APS Guidelines and up Risk amounts $2,000,001 and up: APS required if M.D. consulted within past year. Risk amounts $1,000,001 and up: APS required if M.D. consulted within past year. Risk amounts $250,001-$2,000,000: APS required if M.D. consulted within past year. Risk amounts $2,000,001 and up: APS required if M.D. consulted within past two years. All amounts, APS required. Attending Physician Statements may be requested on any risk amount and all ages at the Underwriter s discretion. 2 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES /13

4 TELE-Underwriting Requirements for Term, UL, VUL, WL, and IUL Products AMOUNT 0 99, , , , , , ,999 1,000,000 2,000,000 2,000,001 5,000,000 5,000,001 10,000,000 10,000,001 and up 1 Any stress testing completed within the past 12 months may be substituted in lieu of a current Treadmill EKG. See page 12 for definitions Treadmill Treadmill Treadmill Treadmill 1 Tele-Underwriting (Common Q & A Refer MidlandNational.com) Tele-Underwriting is available for applicants age 16 and over on any face amount. Complete the State Appropriate short-form Tele-Underwriting Application On the application, indicate whether you have completed an X-Press test, will schedule the paramedical visit, or whether the company should schedule the visit. (If your preference is not indicated, we will assume you are making arrangements with the paramedical service.) Follow the age and amount chart for Tele-Underwriting requirements (see chart). Upon receipt of the application, New Business sends the information the Tele-Underwriting Unit. The paramedical visit is arranged immediately with the agent s preferred paramedical service (when the agent wants the company make the arrangements). When the Tele-Underwriting interview is completed, and voice signature permission granted, documents are scanned and sent New Business electronically. Status of your Tele-Underwriting cases can be followed by clicking on the Tele-Underwriting requirement under the case information on your Pending Business. Medical Evidence for 0-15 $0 $250,000 Fully completed application with medical questions completed by agent. $250,001 and up Individual consideration. Contact Underwriting for requirements. Age and Amount APS Guidelines and up Risk amounts $2,000,001 and up: APS required if M.D. consulted within past year. Risk amounts $1,000,001 and up: APS required if M.D. consulted within past year. Risk amounts $250,001-$2,000,000: APS required if M.D. consulted within past year. Risk amounts $2,000,001 and up: APS required if M.D. consulted within past two years. All amounts, APS required. Attending Physician Statements may be requested on any risk amount and all ages at the Underwriter s discretion /13 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES 3

5 General Guidelines Requirements are based on the face amount tal of current applications and all amounts in force with Midland National. Midland National reserves the right require examinations and other testing of any person proposed for coverage. All cusmer interviews will be initiated from the Administrative Office. Applications must be completed in ink. Any changes and corrections must be initialed by the proposed insured/applicant. All New Business paperwork (applications, state required forms, and Health Statements for example) may be faxed the appropriate New Business team fax number. Premium checks and original 1035 forms are be sent through the mail. Please contact your Case Manager for questions regarding state form requirements. Use the Agent s (5520) or a cover letter provide supporting information. This will help expedite application processing, policy issue and commission payment. The maximum participation limit for Waiver of Premium and Accidental Death Benefit (ADB) with ALL companies: - $250,000 on ADB (ADB amounts are not included in determining underwriting requirements). - $5,000,000 on Waiver of Premium or Waiver of Charges. Temporary Insurance Agreement The Temporary Insurance Agreement (TIA) provides a solid guarantee for your clients because they have coverage in place as long as the conditions in the Agreement have been met. The TIA is available on face amounts $1,000,000 (tal in force and applied for with Midland National) and ages 16 days age 70 (age nearest birthday). If the applicant elects have coverage under the Temporary Insurance Agreement, the TIA form (7218) MUST be completed at the time of the application, bearing the same date as the application signed date, and submitted with the application (no exceptions). One full monthly premium (check or EFT) must be collected with the application and TIA. With the TIA, premium is accepted ONLY at the time of application. For the TIA be effective with allotments, list bills, or CSAs, a check (one full monthly premium) must be collected and submitted with the application and the completed TIA form. Tobacco Use Definitions Underwriting classes vary by product. Please refer the Preferred Criteria, product feature cards, and plan description for rate classes available. Preferred Plus (PPN) Must not have used any bacco or nicotine based products (including patches and nicotine gum ) as outlined in the product Preferred Criteria chart. Preferred Non-Tobacco (PN) Must not have used any bacco or nicotine based products (including patches and nicotine gum ) as outlined in the product Preferred Criteria chart. Preferred Tobacco (PT) In addition the Preferred Underwriting Guidelines listed, all forms of bacco allowed. Non-Tobacco (NT) Proposed insureds who have not used bacco in any form and have not used any product containing nicotine within the past 12 months. Lab test results must be negative for nicotine byproducts. Tobacco (ST) Proposed insureds who have smoked cigarettes or used other bacco products, including patches, gum, inhalers or other sp-smoking products within the past 12 months or are found have nicotine byproducts in their lab test results. 4 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES /13

6 Financial Underwriting Guidelines Purpose of Insurance Formulas and Guidelines Information Required P e r s o n a l C o v e r a g e Income Replacement Maximum Coverage Facr times earned income Gross annual earned income* & Up 5 Risk Amounts $2,000,001 and up Financial Supplement. Risk Amounts $5,000,001 and up Third Party Financials. *Earned income includes salary, wages, tips, regular bonus, regular commission, deferred compensation, and other employee benefits that are the direct result of the proposed insured s effort and abilities that will cease at their death. Where income fluctuates from year year, use a three year average. Estate Preservation Estate value appreciation at interest rate of 7.5% x 1/2 of life expectancy x maximum tax rate of 50%. Cover letter explaining purpose of coverage and how the amount was determined. Amounts over $5,000,000 financials verified by third party. Juvenile Coverage Key Person Death Benefit Guidelines: - $100,000 for pre-high school age and younger (minimum age 15 days) - $250,000 for high school through college ages. B u s i n e s s C o v e r a g e Up 10 times annual income derived from the business covered. Both parents are insured for twice the child s death benefit. Please list this information on the agent s report or cover letter. All siblings are insured equally list names and death benefits on the agent s report or cover letter. Applications for minors must be signed by the parent or guardian with whom the child lives on a regular basis. Agent cover letters are required for the following applications: To note the reason why both parents are not insured for twice the child s death benefit. To note why all the siblings are not insured equally. Death benefits over the above guidelines explaining the additional financial loss the beneficiary. For grandparent-owned insurance, list each grandchild and their death benefit as well as the parent s in force insurance. A parent s signature is required on the application. Please consult with the underwriter as necessary. demonstrating income derived from the business being covered. List of other key persons and their coverage in favor of the business. Amounts over $5,000,000 copy of business financials. Buy/Sell or Sck Repurchase Ownership % x value of company. Explanation regarding the purpose of the coverage and how the amount was determined. Details of buy/sell agreement and % of ownership in the business. Market value of the business with supporting corporate financials /13 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES 5

7 70 and Under Essential Guaranteed and Term Products 1 Underwriting Criteria for Preferred Plus, Preferred Non-Tobacco, and Preferred Tobacco Preferred Plus Preferred Non-Tobacco Preferred Tobacco Tobacco Use No bacco use or nicotine based products (including patches and nicorette gum) within the last five years. Occasional cigar (up 12 per year) if admitted on the application and lab test results are negative for nicotine by-products. No bacco use or nicotine based products (including patches and nicorette gum) within the last three years. Occasional cigar (up 12 per year) if admitted on the application and lab test results are negative for nicotine by-products. All bacco allowed. Alcohol/Drug No hisry of alcohol/drug abuse or treatment in ten years. No hisry of alcohol/drug abuse or treatment in ten years. No hisry of alcohol/drug abuse or treatment in ten years. Aviation Non ratable pilots for major airlines only, or aviation exclusion rider. Non ratable commercial and private pilots acceptable. Non ratable commercial and private pilots acceptable. Blood Pressure To age 50: 135/ : 140/ : 145/85 (without treatment) To age 50: 140/ : 145/ : 145/90 (with or without treatment) To age 50: 140/ : 145/ : 145/90 (with or without treatment) Cholesterol Cholesterol or less and cholesterol/hdl ratio 4.5 or less. (with or without treatment) Cholesterol 240 or less and cholesterol/hdl ratio 5.5 or less. (with or without treatment) Cholesterol 240 or less and cholesterol/hdl ratio 5.5 or less. (with or without treatment) Citizenship Driving Record No more than one moving violation in past three years; no DWI, DUI, or reckless driving conviction or nonadministrative license suspension in past five years. No more than two moving violations in past three years; no DWI, DUI, or reckless driving conviction or nonadministrative license suspension in past five years. No more than two moving violations in past three years; no DWI, DUI, or reckless driving conviction or nonadministrative license suspension in past five years. Family Hisry No death or diagnosis of natural parent or sibling from coronary artery disease or cancer prior age 60. No death of natural parent from coronary artery disease or cancer prior age 60. No death of natural parent from coronary artery disease or cancer prior age 60. Foreign Travel No travel countries or areas that are politically unstable or underdeveloped. No travel countries or areas that are politically unstable or underdeveloped. No travel countries or areas that are politically unstable or underdeveloped. Personal Hisry No hisry of cancer (excluding non-melanoma skin cancers), diabetes, cardiovascular disease, coronary artery disease, or other significant health problems. No hisry of cancer (excluding non-melanoma skin cancers), diabetes, cardiovascular disease, coronary artery disease, or other significant health problems. No hisry of cancer (excluding non-melanoma skin cancers), diabetes, cardiovascular disease, coronary artery disease, or other significant health problems. Physical Measurements Ratings within range shown in Preferred Plus build chart. within range shown in Preferred build chart. within range shown in Preferred build chart. Must not be substandard for any reason. Must not be substandard for any reason. Must not be substandard for any reason. Recreation No participation in hazardous sports within past 24 months, with no future plans. Non-technical scuba (50 ft. max.) acceptable. Non-ratable hazardous sports are acceptable. Non-ratable hazardous sports are acceptable. 6 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES /13

8 70 and Under Essential Guaranteed and Term Products Build Chart Male and Female Preferred Plus (PPN) Preferred (PN and PT) Male Female Male Female Standard (NT and ST) Male and Female Height Minimum Maximum Maximum Maximum Maximum Minimum Maximum Height Table A T a b l e R a t i n g s f o r B u i l d Table B M a l e & F e m a l e Table C Table D Table E Table F Table H Table J /13 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES 7

9 70 and Under UL (except Essential Guaranteed), VUL and IUL Products Underwriting Criteria for Preferred Plus, Preferred Non-Tobacco and Preferred Tobacco Tobacco Use Preferred Plus Preferred Non-Tobacco Preferred Tobacco No bacco use or nicotine based products (including patches and nicorette gum) within the last three years. Occasional cigar (up 12 per year) if admitted on the application and lab test results are negative for nicotine by-products. No bacco use or nicotine based products (including patches and nicorette gum) within the last two years. Occasional cigar (up 12 per year) if admitted on the application and lab test results are negative for nicotine by-products. All bacco allowed. Alcohol/Drug No hisry of alcohol/drug abuse or treatment in ten years. No hisry of alcohol/drug abuse or treatment in ten years. No hisry of alcohol/drug abuse or treatment in ten years Aviation Private pilots acceptable with 300+ solo hours experience, IFR, flying hrs per year, all flights within the USA. Flat extra allowed for aviation. Flat extra allowed for aviation. Blood Pressure To age 50: 140/ : 145/ : 150/85 (without treatment) To age 50: 140/ : 145/ : 150/90 (with or without treatment) To age 50: 140/ : 145/ : 150/90 (with or without treatment) Cholesterol Cholesterol or less and cholesterol/hdl ratio 5.0 or less. (with or without treatment) Cholesterol 240 or less and cholesterol/hdl ratio 6.0 or less. (with or without treatment) Cholesterol 240 or less and cholesterol/hdl ratio 6.0 or less. (with or without treatment) Citizenship Driving Record No more than one moving violation in past three years; no DWI, DUI, or reckless driving conviction or nonadministrative license suspension in past five years. No more than two moving violations in past three years; no DWI, DUI, or reckless driving conviction or nonadministrative license suspension in past five years. No more than two moving violations in past three years; no DWI, DUI, or reckless driving conviction or nonadministrative license suspension in past five years. Family Hisry No death or diagnosis of natural parent or sibling from coronary artery disease or cancer prior age 60. No death of natural parent from coronary artery disease or cancer prior age 60. No death of natural parent from coronary artery disease or cancer prior age 60. Foreign Travel No travel countries or areas that are politically unstable or underdeveloped. No travel countries or areas that are politically unstable or underdeveloped. No travel countries or areas that are politically unstable or underdeveloped. Personal Hisry No hisry of cancer (excluding non-melanoma skin cancers), diabetes, cardiovascular disease, coronary artery disease, or other significant health problems. No hisry of cancer (excluding non-melanoma skin cancers), diabetes, cardiovascular disease, coronary artery disease, or other significant health problems. No hisry of cancer (excluding non-melanoma skin cancers), diabetes, cardiovascular disease, coronary artery disease, or other significant health problems. Physical Measurements within range shown in Preferred Plus build chart. within range shown in Preferred build chart. within range shown in Preferred build chart. Ratings Must not be substandard for any reason. Must not be substandard for any reason other than flat extra for aviation or avocation. Must not be substandard for any reason other than flat extra for aviation or avocation. Recreation No participation in hazardous sports within past 24 months, with no future plans. Non-technical scuba (50 ft. max.) acceptable. Non-ratable hazardous sports are acceptable. Non-ratable hazardous sports are acceptable. 8 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES /13

10 70 and Under UL (except Essential Guaranteed), VUL and IUL Products Build Chart Male and Female Preferred Plus (PPN) Preferred (PN and PT) Male Female Male Female Standard (NT and ST) Male and Female T a b l e R a t i n g s f o r B u i l d M a l e & F e m a l e Height Minimum Maximum Maximum Maximum Maximum Minimum Maximum Height Table A Table B Table C Table D Table E Table F Table H Table J /13 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES 9

11 71+ Underwriting Criteria for Preferred Plus, Preferred Non-Tobacco, and Preferred Tobacco Preferred Plus Preferred Non-Tobacco Preferred Tobacco Tobacco Use No bacco use or nicotine based products (including patches and nicorette gum) within the last five years. Occasional cigar (up 12 per year) if admitted on the application and lab test results are negative for Nicotine by-products. No bacco use or nicotine based products (including patches and nicorette gum) within the last three years. Occasional cigar (up 12 per year) if admitted on the application and lab test results are negative for Nicotine by-products. All bacco allowed. Alcohol/Drug Aviation Blood Pressure No hisry of alcohol/drug abuse or treatment in ten years. No hisry of alcohol/drug abuse or treatment in ten years. No hisry of alcohol/drug abuse or treatment in ten years. No participation in past 12 months or plans participate in the future. 150/85 (without treatment) and no pulse pressure greater than 75 No participation in past 12 months or plans participate in the future. 150/90 (with or without treatment) and no pulse pressure greater than 75 No participation in past 12 months or plans participate in the future 150/90 (with or without treatment) and no pulse pressure greater than 75 Cholesterol Cholesterol and HDL at least 45 (with or without treatment) Cholesterol and HDL at least 40 (with or without treatment) Cholesterol and HDL at least 40 (with or without treatment) Citizenship Cognitive Function No evidence of cognitive impairment. No evidence of cognitive impairment. No evidence of cognitive impairment. Driving Record No more than one moving violation in past three years; no DWI, DUI, or reckless driving conviction or non-administrative license suspension in past five years. No more than two moving violations in past three years; no DWI, DUI, or reckless driving conviction or non-administrative license suspension in past five years. No more than two moving violations in past three years; no DWI, DUI, or reckless driving conviction or non-administrative license suspension in past five years. Falls Kidney Function No hisry of falls within past five years. No hisry of falls within past five years. No hisry of falls within past five years. egfr greater than 70 egfr greater than 60 egfr greater than 60 Personal Hisry APS demonstrating regular health care. Must be a standard risk before credits. No hisry of chronic or recurring mental illness or depression. No hisry of cancer (excluding nonmelanoma skin cancers), heart disease or stroke. APS demonstrating regular health care. Must be a standard risk before credits. No hisry of chronic or recurring mental illness or depression. No hisry of cancer (excluding nonmelanoma skin cancers), heart disease or stroke. APS demonstrating regular health care. Must be a standard risk before credits. No hisry of chronic or recurring mental illness or depression. No hisry of cancer (excluding non-melanoma skin cancers), heart disease or stroke. Physical Measurments within range shown in Preferred Plus build chart and stable for the past two years. within range shown in Preferred build chart and stable for the past two years. within range shown in Preferred build chart and stable for the past two years. Physical/Social Activity Physically active including but not limited travel, exercise, and social activities. Independent in all ADL s* and IADL s.** Physically active including but not limited travel, exercise, and social activities. Independent in all ADL s* and IADL s.** Physically active including but not limited travel, exercise, and social activities. Independent in all ADL s* and IADL s.** Ratings Recreation Serum Albumin Must not be substandard for any reason. Must not be substandard for any reason. Must not be substandard for any reason. No participation in hazardous sports within past 24 months, with no future plans. Non-technical scuba (50 ft. max.) acceptable. Non-ratable hazardous sports are acceptable. greater than 3.9 g/dl greater than 3.8 g/dl greater than 3.8 g/dl Non-ratable hazardous sports are acceptable. 10 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES /13

12 Build Chart Male and Female Preferred Plus (PPN) Preferred (PN and PT) Male Female Male Female Standard (NT and ST) Male and Female Height Minimum Maximum Maximum Maximum Maximum Minimum Maximum Height T a b l e R a t i n g s f o r B u i l d Table A Table B M a l e & F e m a l e Table C Table D Table E Table F Table H Table J Definitions *Activities of Daily Living (ADL) 1. Hygiene (bathing, grooming, shaving and oral care). 2. Continence. 3. Dressing. 4. Eating (ability feed oneself). 5. Toileting (ability use a restroom). 6. Transferring (actions such as going from a seated standing position and getting in/ out of bed). Albumin: Routinely performed as a part of the blood chemistry testing, serum albumin is an independent marker for mortality, especially at the older ages. Albumin may be decreased in liver disease, kidney disese, malnutrition, chronic inflammary disease, malignant disease, and multiple myeloma among other conditions. Cognitive Function: Refers the ability learn and remember information; organize, plan, and problem-solve; focus, maintain, and shift attention as necessary; understand and use language; accurately percieve the environment, and perform calculations. egfr (Estimated Gomerular Filtration Rate): Obtained through routine blood testing, the egfr takes in consideration gender, height, weight, and age assess kidney function. **Instrumental Activities of Daily Living (IADL): 1. Finding and utilizing resources (looking up phone numbers, using a telephone, making and keeping docrs appointments). 2. Driving or arranging travel (either by public transportation such as Paratransit, or private car). 3. Preparing meals (opening containers, using kitchen equipment). 4. Shopping (getting sres and purchasing necessities like food or clothing). 5. Doing housework (doing laundry, cleaning up spills and maintaining a clean living space). 6. Managing medication (taking prescribed dosages at correct times and keeping track of medications). 7. Managing finances (basic budgeting, paying bills and writing checks). Pulse Pressure: The difference between syslic and a diaslic reading and represents the force that your heart generates each time it contracts. In a person with a syslic blood pressure of 120 mmhg and a diaslic pressure of 80 mmhg, the pulse pressure would be 40 mmhg /13 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES 11

13 Definitions APS (Attending Physicians Statement) Generally requesting the last five years of medical and/or clinical records on the proposed insured obtained by the Administrative Office. Blood Chemistry Panel (full blood draw) obtained by a preferred vendor. Cusmer Interview An interview with the proposed insured conducted by an approved vendor. All cusmer interviews are initiated by the Administrative Office. Dr. Direct Initiated by the Administrative Office. An impairment specific questionnaire is completed by the docr s office obtain additional information on moderate impairments. EKG A 12-lead resting electrocardiogram (without interpretation) obtained through a preferred paramedical service. Financial Supplement (form 6048) A financial statement on the proposed insured, completed by the agent. HOS Urine specimen obtained through a preferred paramedical service and mailed a preferred lab. IBU (Interview by Underwriter) A phone interview conducted by an experienced life insurance underwriter. Initiated by the Administrative Office, these interviews are requested obtain additional information regarding mild impairments. (Refer form 8879.) MD Exam Midland National s preferred paramedical service can help arrange for MD exams in most areas. Any physician, except the proposed insureds personal physician, may perform MD examinations. MVR Mor Vehicle obtained through the Administrative Office. Paramed Exam A basic paramedical examination includes medical hisry, height, weight, blood pressure, and pulse. Physical measurements Physical measurements comprise of height, weight, blood pressure, and pulse conducted by a preferred paramedical service; please note medical hisry is not acquired. SQ (Senior Questionnaire) Cognitive testing must be scheduled with a preferred paramedical service. Tele-Underwriting A simplified application is obtained by the agent. The medical hisry is acquired through a phone interview with the proposed insured. Underwriting requirements (example: physical measurements, blood and urine samples) can be scheduled by the agent or through the Administrative Office at the agent s request. Third Party Financial Certified Public Accountant prepared net income statement and balance sheet. Treadmill EKG Exercise electrocardiogram include the procol but without interpretation. This may include a treadmill or a bicycle ergometer test and arranged through our preferred vendors. X-Press Agent collected oral fluid testing. Commonly Used Application Supplements Agent s (5520) Complete this form provide supporting information on the sale. Alcohol Questionnaire (8315) Complete this questionnaire when substance dependence is noted or DUI violation within five years. Civilian Aviation Questionnaire (8143A) Complete this form when the proposed insured is a pilot or crew member (private, commercial, or military). Cusmer Identification Program Notice U.S.A. Patriot Act (7515) Complete this form with any tele-interviewing applications on each applicant (or owner), obtain signatures, and forward all pages with the application. Drug Questionnaire (9542) Complete this questionnaire when there is a hisry of controlled substance use or treatment is noted. (6048) Complete this questionnaire clarify the financial background of the proposed insured or when requested in the Underwriting Requirements Charts. Foreign Travel and Residence Questionnaire (8142R) Complete this form clarify foreign citizenship, naturalized citizenship, or when foreign travel or residency is noted on the application within the last twelve months. Important Notice: Replacement of Life Insurance or Annuities (2477) Complete this state specific form where an existing life insurance policy or annuity contract will be discontinued, changed, or will be financing new coverage. Informed Consent for the Human Immunodeficiency Virus (HIV) Antibody Test (4913) Complete this state specific form on each applicant, obtain signatures, and forward all pages with the application. Note this form follows the applicant s state of residence. Racing Questionnaire (9544) Complete this questionnaire when the proposed insured participates in any mor sport. Scuba and Skin Diving Questionnaire (9545R) Complete this questionnaire when the proposed insured participates or contemplates any form of skin or scuba diving. Temporary Life Insurance Agreement (7218) Complete this form at the time of the application (bearing the same date as the application) and submit with the premium provide coverage during the underwriting process (if all conditions in the agreement are met). Tobacco Use Statement (5054) At the Underwriter s request, complete this form clarify bacco use when nicotine is present in the lab test results and bacco use is not noted on the application. Statements About Life Insurance Illustrations (6293) Complete this form when a full illustration is not used on interest sensitive life insurance applications. Note: When an illustration is used, obtain signatures and forward all pages with the application. HIPAA Authorization (8701) This form allows the proposed insured authorize the release of health-related information. It must be signed and returned with the application. 12 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES /13

14 At Midland National, our underwriters strive create enduring relationships with you through effective communication and excellent support. With Midland National, you ll experience: Direct access your underwriter and case manager Fast, fair and consistent underwriting Average of less than 30 calendar days turnaround time We re here help you grow your business by building an enduring relationship with you. Contact Sales Support day learn more. Call ext. 30 or Judy Senior Underwriter Neal Senior Underwriter 1. Essential Guaranteed UL 2 and 3 are issued on policy form series L138 by Midland National Life Insurance Company. Not all products, features, riders, endorsements or issue ages are available in all jurisdictions. Limitations or restrictions may apply. The broker/dealer for Midland National s variable products is Sammons Securities Co., member FINRA/SIPC. Sammons Securities Co. is a registered broker/dealer under the Securities Exchange Act of Sammons Securities Co. is an indirect wholly-owned subsidiary of Sammons Enterprises, Inc. of Dallas, Texas, the ultimate parent company of Midland National. Indexed Universal Life products are not an investment in the market or in the applicable index and are subject all policy fees and charges normally associated with most universal life insurance /13 FOR AGENT/REGISTERED REPRESENTATIVE USE ONLY. NOT TO BE USED FOR CONSUMER SOLICITATION PURPOSES Administrative Office One Sammons Plaza Sioux Falls, SD MidlandNational.com