Agent Guide.pdf - Supporting Independent Agents

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Agent Guide.pdf - Supporting Independent Agents

UNIVERSAL LIFE

ADVANTAGE TERM

SELECT TERM

INDEX UNIVERSAL LIFE

Field

Underwriting

Guide

Alliance Group LC,

is an independent

contractor representing

Western Reserve Life

Assurance Co. of Ohio

64487 1009

PRODUCER USE ONLY. NOT FOR PUBLIC DISTRIBUTION.

Policy and rider form numbers may vary by jurisdiction.


Alliance Solutions

Table of Contents

Page

Helpful Guidelines...................................................................................1

Alliance Solutions Universal Life and Advantage Term ....................... 2-4

Underwriting Requirements...............................................................2

Underwriting Classes.........................................................................3

Height and Weight Chart...................................................................3

Preferred Underwriting Guidelines.....................................................4

Alliance Solutions Select Term and Index Universal Life ................... 6-10

Underwriting Requirements...............................................................6

Underwriting Classes.........................................................................7

Height and Weight Chart...................................................................7

Height and Weight Max.....................................................................8

Preferred Underwriting Guidelines...................................................10

Additional Guidelines - All Products......................................................11

Medical Impairments & Questionnaires – All Products................... 12-30

Uninsurable Risks and Highly Substandard Risks – All Products...........31

Probable Action for Underwriting Conditions................................. 32-41

Tentative Rating Tables for Diabetes................................................ 42-43

Disability Income Rider – Occupation Listing.................................. 44-49

Disability Income Rider – Medical Impairments.............................. 50-51


Helpful Guidelines

New Business

1. To assist in the processing, please complete

all required forms and gather the necessary

signatures. Also, it is helpful if all written

communication is printed legibly.

2. Complete all sections of the application.

(Missed questions or information will result in

an amendment)

3. Complete all state required forms. See forms

listing on ANI for details.

4. Complete the appropriate questionnaire for

medical impairments or other risks. Additional

information regarding Questionnaires are

included in this guide.

5. Illustration or Illustration Certification Form

should be submitted according to the product

and state requirements.

Submitting Premium

1. If annual premium exceeds $10,000 annually

or the face amount is greater than $500,001,

premiums must not be collected until after

underwriting approval.

2. Acceptable forms of payment include the

following:

• Payor’s Personal Check

• Payor’s Business Check

• Pre-Authorized Withdrawal Form

• Money orders (form is required)

• Cashier Checks (form is required)

Unacceptable forms of payment

Agent/Agency checks (unless there is a

personal relationship identified between the

insured and/or owner)

• Third Party Checks

• Cash

• Postdated checks

(these will be cashed immediately)

• Cannot charge the agents account.

All forms of payment are subject to review.

3. Payors of the initial and/or reoccurring

premium must have an acceptable relationship

to the insured or policy owner.

4. If primary insured is not listed on the form of

payment please print insured’s name on the

form of payment. If the proposed insured’s

name is not on the check, indicate if they are

an authorized signor to the account. If the

client’s name is not on the check, indicate if

they are an authorized user of the account.

5. Checks are cashed on the following business

day from the date of receipt. Pre-Authorized

Withdrawal payments are taken next

business day following receipt of the form

and billing information.

Underwriting Tips

Underwriting is the process of estimating the

mortality and/or morbidity of an individual, by

applying the law of large numbers and the specifics

of that individual’s health history and habits. This

estimate is based upon information gathered on the

individual from a variety of sources.

In many cases, the underwriting process can be

completed with a single review of the application.

The best way to help the underwriting process

is to ask your client detailed questions regarding

their past and present health status and include

all of this information on the application. The

more information the underwriter has initially, the

quicker a decision can be made.

1. Qualify the client during the phone

interview. Ask for build, all medications,

and any significant medical history for the

past ten years.

2. Use the Underwriting Guide for

classification due to build and availability

of DIR based on build and occupation.

Order correct requirements based on age/

amount/class/medical history.

3. Use the Tentative Quote Process or Trial

Application Process on questionable

health risks.

4. Use Questionnaires, if appropriate, to

reduce APS requests.

5. Complete the Oral Fluid forms and mail

the Oral Fluid specimen the same day as

collected (specific instructions are included

later in this section).

6. If required, schedule paramedical exam/

labs while at the appointment (or as soon

as possible).


UNIVERSAL LIFE and Advantage Term


$25,000 to

$50,000

$50,001 to

$75,000

$75,001 to

$100,000

$100,001 to

$200,000

$200,001 to

$250,000

$250,001 to

$500,000

$500,001 to

$1,000,000

$1,000,001 to

$2,000,000

$2,000,001 to

$3,500,000

$3,500,001 to

$5,000,000

$5,000,001 to

$10,000,000

$10,000,001

and higher*

Alliance Solutions Universal Life and Advantage Term

Underwriting Requirements

0-17 18-40 41-50 51-60 61-70 71-75 76-80 81+

NM OF OF OF OF Paramed

BCP HOS

MVR

NM OF OF OF Paramed

BCP HOS

NM OF OF OF Paramed

BCP HOS

NM

NM

NM

HO

HO

HO

HO

HO

HO

OF or

Paramed

BCP HOS MVR*

Paramed

BCP HOS MVR

Paramed

BCP HOS MVR

Paramed

BCP HOS MVR

Paramed

BCP HOS MVR

Paramed

BCP HOS MVR

Paramed

BCP HOS MVR

Paramed

BCP HOS MVR

IR PFS

Medical

BCP HOS MVR

EKG IR PFS

OF or

Paramed

BCP HOS*

Paramed

BCP HOS

Paramed

BCP HOS

Paramed

BCP HOS

Paramed

BCP HOS MVR

Paramed

BCP HOS MVR

EKG

Paramed

BCP HOS MVR

EKG

Paramed

BCP HOS MVR

EKG

IR PFS

Medical

BCP HOS MVR

EKG IR PFS

Paramed

BCP HOS

Paramed

BCP HOS

Paramed

BCP HOS

Paramed

BCP HOS

EKG

Paramed

BCP HOS MVR

EKG

Paramed

BCP HOS MVR

EKG

Paramed

BCP HOS MVR

EKG

Paramed

BCP HOS MVR

EKG

IR PFS

Medical

BCP HOS MVR

TRD--EKG

IR PFS

Paramed

BCP HOS

Paramed

BCP HOS

Paramed

BCP HOS

EKG

Paramed

BCP HOS

EKG

Paramed

BCP HOS

EKG MVR

PFS

Paramed

BCP HOS MVR

EKG

IR PFS

Paramed

BCP HOS MVR

EKG

IR PFS

Paramed

BCP HOS MVR

EKG

IR PFS

Medical

BCP HOS MVR

TRD-EKG

IR PFS

Paramed

BCP HOS

MVR

Paramed

BCP HOS

MVR

Paramed

BCP HOS

EKG MVR SUP

Paramed

BCP HOS

EKG MVR SUP

Paramed

BCP HOS

EKG MVR SUP

Paramed

BCP HOS

EKG MVR SUP

PFS

Paramed

BCP HOS

EKG MVR SUP

PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Paramed

BCP HOS

MVR

Paramed

BCP HOS

MVR

Paramed

BCP HOS

MVR

Paramed

BCP HOS

EKG MVR SUP

Paramed

BCP HOS

EKG MVR SUP

Medical

BCP HOS

EKG MVR SUP

Medical

BCP HOS

EKG MVR SUP

PFS

Medical

BCP HOS

EKG MVR SUP

PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

*Advantage Term ONLY - to apply for Preferred Choice, a Paramed, BCP and HOS must be ordered

Medical BCP

HOS EKG MVR

Medical BCP

HOS EKG MVR

Medical BCP

HOS EKG MVR

Medical

BCP HOS

EKG MVR SUP

IR

Medical

BCP HOS

EKG MVR SUP

IR

Medical

BCP HOS

EKG MVR SUP

IR

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

Medical

BCP HOS

EKG MVR SUP

IR PFS

The shaded requirements apply to Universal Life, Advantage Term, Select Term and Index Universal Life.

The company reserves the right to request other evidence of insurability as it may deem necessary.

Key – All requirements are ordered by the Agent, unless otherwise noted

NM

Non-medical

OF

Non-medical with Oral Fluid

Paramed Paramed exam - medical history questions, measured height and weight, pulse and blood pressure

Medical Medical exam by doctor. Must be arranged through approved Paramedical Facilities

BCP

Blood Chemistry Profile - blood studies are to be 12 hour fasting

HOS

Home Office Specimen - urine specimen

EKG

Resting Electrocardiogram - do not have interpreted

TRD-EKG Treadmill Electrocardiogram - do not have interpreted. The facility performing the test should submit the actual tracing to our office

for review by our Medical Director. A treadmill EKG should not be arranged for an applicant with a history of heart disease without

authorization from the Underwriting Department.

MVR Motor Vehicle Report (ordered by Home Office)

IR

Inspection Report (ordered by Home Office)

SUP

Senior Supplement Screen - telephone interview done by a third party; screens for cognitive ability (ordered by Home Office)

PFS

Personal Financial Statement (ordered by Home Office)

HO

Refer to Home Office


Alliance Solutions Universal Life and Advantage Term

Underwriting Classes

Preferred Choice (Term Only): Applicants in this

rate class have not used tobacco in any form in the

past 3 years.

Standard Plus Non-Tobacco: Applicants in this

rate class have not used tobacco in any form in the past

12 months.

Standard Non-Tobacco: Applicants in this rate class

have not used tobacco in any form in the past 12 months.

This rate class is designed to accept mildly substandard

risks (Table 2-4).

Standard Plus Tobacco: Applicants in this rate class

have used tobacco in any form in the past 12 months.

( )

Standard Tobacco: Applicants in this rate class

have used tobacco in any form in the past 12 months.

This rate class is designed to accept mildly substandard

risks (Table 2-4).

Substandard Cases:

Universal Life - Substandard ratings are available for

Table 5-12 for the Standard Plus Non-tobacco and

Standard Plus Tobacco classes.

Ratings are not allowed on the Standard Non-tobacco

or Standard Tobacco classes.

Term - Substandard ratings are available for Table 5-8

for the Standard Plus Non-tobacco and Standard Plus

Tobacco classes.

Ratings are not allowed on the Standard Non-tobacco

or Standard Tobacco classes.

Height and Weight Chart

(Maximum weight to qualify for each rate class or rider)

Maximum weight*

Advantage Standard Plus Standard

Height Term Only Non-Tobacco & Non-Tobacco & Disability Advantage

Feet Preferred Choice Tobacco Tobacco Income Rider Universal Life Term

4’8” 140 144 178 162

211 199

4’9” 144 149 185 167

219 206

4’10” 147 153 191 172

227 213

4’11” 151 157 198 176

235 221

5’0” 151 162 205 180

243 228

5’1” 156 166 212 185

251 236

5’2” 160 170 219 189

259 244

5’3” 165 175 226 194

268 252

5’4” 171 180 233 199

276 260

5’5” 176 186 240 205

285 268

5’6” 180 191 248 210

294 276

5’7” 187 196 255 216

303 285

5’8” 191 202 263 222

312 293

5’9” 196 207 271 227

321 302

5’10” 201 214 279 234

331 311

5’11” 207 218 287 239

340 320

6’0” 214 225 295 246

350 329

6’1” 219 231 303 252

360 338

6’2” 225 237 312 258

369 347

6’3” 231 244 320 265

380 357

6’4” 236 252 329 273

390 366

6’5” 244 258 337 281

400 376

6’6” 250 266 346 290

411 386

6’7” 257 274 355 299

421 396

6’8” 264 283 364 308

432 406

6’9” 272 290 373 317

443 416

UNIVERSAL LIFE and advantage term

*Maximum weight to qualify for a rated policy; anything above these weights will be declined.


Alliance Solutions Advantage Term

Preferred Underwriting Guidelines

Tobacco Usage

Includes tobacco or

nicotine based products

Non-tobacco

Preferred

Choice

None in

the past

3 Years

Cholesterol

Cholesterol


This page

intentionally

left blank.


Additional Guidelines - All Products

Underwriting Amount

The underwriting amount is the total of the base policy

being applied for plus any term riders.

Personal History Interview (PHI)

Please inform the applicant that a WRL representative

may contact them for information. Please provide the

best time to contact the applicant on the application.

Inspection Reports

Through $2,999,999: Underwriter’s discretion

$3,000,000 and up: Inspection Report

Motor Vehicle Report (MVR)

Refer to underwriting guideline. An MVR may also be

requested at the underwriter’s discretion, based on the

application and history.

Paramedical Facilities

American Para Professional Systems (APPS)

Examination Management Services Inc. (EMSI)

ExamOne Portamedic

Oral Fluid Testing Facility*

Heritage Labs International. Oral fluid kits do have

an expiration date. Please make certain kits have not

expired as the lab cannot process oral fluids on an

expired kit.

Blood Profiles/HOS/Oral Fluid*

Blood or oral fluid testing is required for all applicants

age 18 and older. Agent administered oral fluid testing is

available for amounts up to $200,000, up to age 50.

Whenever blood testing is needed, a HOS is also

required in addition to a paramed.

HIV consent forms must be submitted in those

states where required, for all proposed insureds age

18 and older. Completion of these forms is the

agent’s responsibility.

*Oral fluid testing is NOT done on the Select Term or Index

Universal Life Products

Attending Physicians Statements

An APS may be ordered at the discretion of the

underwriter for any amount of coverage. Applicants

age 65 and older must have established care with a

Primary Care Physician (PCP) and must have had a

physical evaluation by their PCP within 18 months

prior to the application date. An APS will be requested

on all applicants age 65 and older. Providing complete

physician information, including telephone number, will

expedite the APS process.

EKG and Treadmill

If a resting EKG and/or Treadmill has been done within

the last six months and the tracing is available to us,

it may not be necessary to repeat the test. Contact the

Company for information.

Trial Applications

If a client has a highly substandard or potentially

uninsurable medical history, an application may be

submitted on a TRIAL basis. These applications should

be sent to and approved by your Administrator prior to

submission to the Home Office. DO NOT collect oral

fluids, order medical requirements or collect money. Let

the client know the application is being submitted for

review on an “informal” basis. Please clearly mark the

New Business Checklist as a TRIAL application.

General Financial Guide

The following financial guide is intended to assist you in

determining maximum coverage. For amounts outside

these parameters, please contact Underwriting.

Formula

Factor x

Purpose Ages Income

1. Personal to Age 35 30

Coverage/ 36-45 25

Income 46-50 20

Continuation 51-55 15

56-65 10

66-70 5

71 and over individual

consideration

2. Estate Tax ½ of net worth

Analysis minus $200,000

3. Key Person 7 to 10 X

Annual Income

4. Buy-Sell % Ownership x corporate value.

5. Business 75% of Loan

Loan

6. Juvenile 50% of what is in force on

parents up to max. of $250,000.

An agent’s cover letter is useful in demonstrating the need

and purpose for the coverage. Also, financial statements

may be required for amounts greater than $1,500,000.

11


Medical Impairments & Questionnaires - All Products

Following is information regarding common medical impairments and the questionnaires

that should be completed to assist with the underwriting process.

Note: The Questionnaires do vary by jurisdiction. Included in this guide are the “standard” versions which are

approved in all states except for the following: Refer to ANI for the proper forms approved in your jurisdiction.

California: Foreign Travel Questionnaire is not allowed.

Connecticut: Alcohol and Drug Questionnaires are state specific.

Florida: All Questionnaires are state specific. Foreign Travel Questionnaire is not allowed.

Georgia: Foreign Travel Questionnaire is not allowed.

Indiana: High Blood Pressure and Heart Disease Questionnaires are state specific.

Louisiana: Alcohol Questionnaire is state specific.

Maine: All Questionnaires are state specific.

Maryland: Alcohol, Avocation & Aviation, Drug and Tobacco Questionnaires are state specific.

Massachusetts: All Questionnaires are state specific.

Minnesota: Drug Questionnaire is state specific.

Missouri: All Questionnaires are state specific.

Nebraska: All Questionnaires are state specific.

New Hampshire: Drug Questionnaire is state specific.

New Jersey: Alcohol, Drug, Tobacco, Respiratory, Diabetes, Cysts/Tumor/Cancer and Stroke /Transient Ischemic

Attack (TIA) Questionnaires are state specific.

North Carolina: Alcohol and Drug Questionnaires are state specific.

Oklahoma: All Questionnaires are state specific.

Puerto Rico: Arthritis, Avocation & Aviation, Cysts/Tumors/Cancer, Diabetes, Disability Income Rider, Foreign

Travel, Heart Disease, High Blood Pressure, Mental Health/Depression/Anxiety, Respiratory, Stroke/

Transient Ischemic Attack (TIA) Questionnaires are state specific.

12


Diabetes

Diabetes is a disease in which the body is either unable

to produce a sufficient amount of insulin or it cannot

use the insulin that is produced. This results in high

levels of glucose in the blood stream.

Type I (insulin dependent diabetes), also known as

Juvenile Onset Diabetes, requires regular insulin

injections to control blood sugars.

Type II (non insulin dependent diabetes), also known as

Adult Onset Diabetes, is usually diagnosed later in life and

can be controlled with close diet monitoring and/or oral

medication. In some cases a Type II diabetic may require

insulin injections in addition to diet and oral medication.

Obesity and family history of diabetes are common risk

factors for the development of this type of diabetes.

Uncontrolled diabetes can lead to vision loss, kidney

failure, circulatory problems, neuropathy and diabetic

coma. Diabetes is also a major risk factor for heart

disease and stroke.

Routine follow up with a physician, close monitoring of

blood sugars and modification of diet are key factors in

the successful control of diabetes. Hemoglobin A1C is

a test commonly used to determine long term control of

blood sugars. The type of diabetes, age of onset, level

of control, and presence of any complications are used

to determine the underwriting rate class.

Please complete a Diabetes Questionnaire.

Heart Disease

Heart Attack, Angina/Chest Pain, Angioplasty/Stent

Placement, Bypass Surgery.

Heart disease occurs when the arteries that supply

blood and oxygen to the heart become blocked and

unable to keep the heart pumping normally.

Heart disease can be caused by:

• A progressive build up of plaque that causes

narrowing of the arteries;

• A clot caused by the rupture of plaque in the artery;

or

• A vasospasm of the artery.

Angina/cardiac chest pain is caused when the heart does

not receive enough oxygen.

A heart attack or myocardial infarction occurs when

there is a profound lack of oxygen to the heart muscle,

which can lead to tissue death.

Heart disease may be a progressive condition that can

be treated but not cured. The most common ways

to treat heart disease are medication, modification of

risk factors, angioplasty/stent placement, and bypass

surgery. Risk factors for heart disease include:

• Family history,

• Elevated cholesterol,

• Diabetes,

• Smoking,

• Obesity,

• High blood pressure/Hypertension

A combination of heart disease and the following

conditions will usually result in a Decline:

• Continued smoking,

• Stroke or TIA,

• Diabetes,

• Peripheral Vascular Disease

• Age at onset under 40

Please complete a Heart Disease Questionnaire.

Cerebrovascular Disease (Stroke/TIA)

A stroke or CVA (cerebrovascular accident) occurs

when there is an inadequate oxygen supply to the brain.

This can be caused by a clot that blocks an artery or a

rupture or an artery (aneurysm) in the brain. A major

stroke can lead to irreversible brain damage or death. A

TIA (transient ischemic attack) is a brief disruption of

blood flow to the brain and the symptoms are usually

reversible. Sometimes a TIA is a precursor to a full

blown stroke, so close monitoring is necessary.

Risk factors for stroke include:

• Uncontrolled high blood pressure/hypertension;

• Smoking;

• Diabetes

• Other vascular disease (i.e. heart disease, peripheral

vascular disease)

A combination of any of the above risk factors and a

history of stroke/TIA will usually result in a Decline.

Please complete a Stroke/Transient Ischemic Attack

(TIA) Questionnaire

High Blood Pressure/Hypertension

High blood pressure or hypertension is a persistent

elevation in blood pressure above what is considered

normal for one’s age and gender. Untreated high blood

pressure can lead to heart enlargement and kidney

damage as well as an increased risk of stroke and heart

disease. The usual treatment for high blood pressure is

medication and diet modification.

When individuals are compliant with treatment and

blood pressure readings are within the normal range, no

rating is necessary.

Please complete a High Blood Pressure Questionnaire.

13


Tumors/Cancer

Cancer or malignant tumors are characterized by

abnormal cell growth that invades healthy tissue and

causes breakdown of normal tissue function. Once a

tumor invades the surrounding tissue, it can then move

into the blood and lymph system and eventually spread

to other organs in the body.

Major risk factors for cancer are family history,

tobacco use, excessive exposure to sunlight, exposure to

environmental toxins, and inflammatory conditions (i.e.

ulcerative colitis, hepatitis).

The prognosis is highly variable with Underwriting risk

classification focusing on type/location of cancer, extent

of invasion and time since treatment was completed.

Please complete Cyst/Tumor/Cancer Questionnaire.

Chronic Respiratory Conditions

Asthma, COPD/Emphysema, Chronic Bronchitis

Asthma is a reversible obstruction of the airways in the

lungs. Common symptoms are shortness of breath,

wheezing and coughing. Lung function between attacks is

usually normal. Treatment focuses on prevention of attacks

and may employ oral as well as inhaled medications.

Risk classification is determined by factors such as

frequency and severity of attacks, type of treatment

required and smoking status.

COPD (Chronic Obstructive Pulmonary Disease) is

a general term used to describe a variety of diseases

that cause chronic airway obstruction. Two of the

most common forms of COPD are chronic bronchitis

and emphysema. The symptoms vary and include

difficulty breathing, fatigue, chronic cough, weight

loss, diminished levels of oxygen in the blood. The

development of COPD is strongly associated with

smoking. Treatment may include oral or inhaled

medications and in severe cases, the use of oxygen.

Risk classification is determined by factors such as

degree of respiratory impairment, continued smoking,

and type of treatment required. The current use of

oxygen would result in a Decline.

Please complete a Respiratory Questionnaire.

Alcohol and Drug Abuse

A history of substance abuse (alcohol, illegal drugs, or

street drugs) poses multiple concerns for life insurance.

In addition to being a higher risk due to accidents,

homicide, suicide, and overdose, long-term substance

abuse can lead to serious health problems involving

the brain, heart, liver, GI tract, circulatory system and

major infections (i.e. hepatitis and HIV).

Any current substance abuse is uninsurable. In most

cases, an applicant must be 2 years out from last use

before we can consider him/her for life insurance,

with complete abstinence. Some factors that are more

favorable when considering applicants for life insurance

include participation in a support group, family and

job stability, and a favorable MVR. Factors that

would have a negative impact on underwriting these

individuals are a history of multi-substance abuse (for

example, drugs and alcohol), mental illness in addition

to substance abuse, history of relapse, and participation

in hazardous avocations.

Occasional marijuana use (1-2 times a month) may be

considered at standard tobacco rates. Heavier marijuana

use could lead to sub-standard ratings or a decline.

Please complete an Alcohol and/or Drug Questionnaire.

Additional Questionnaires:

• Arthritis Questionnaire – complete if there is a

history of any type of arthritis.

• Avocation & Aviation Questionnaire – complete if

there is any participation in racing, parachuting, sky

diving, underwater diving or aviation.

• Disability Income Rider Questionnaire – complete

for a client applying for a Disability Income Rider.

• Foreign Travel Questionnaire – complete for any

applicant who has traveled to a foreign country

within the past 2 years or intends to travel to a

foreign country in the next 2 years.

• Mental Health/Depression/Anxiety Questionnaire –

complete if there is a history of, or current treatment

for depression or anxiety.

• Alcohol Questionnaire – complete if applicant has

history of alcohol abuse.

• Drug Questionnaire – complete if applicant has

history of drug abuse.

14


Uninsurable Risks and Highly Substandard Risks –

All Products

Below are some common impairments that normally cause a case to be highly substandard or a decline.

This is not a complete listing and all cases are subject to underwriting review.

Impairment

Alzheimer’s

Cancer: many internal cancers are not insurable until three years after the

date of the last treatment (chemotherapy, radiation or surgery).

Cardiac surgery or heart attack within six months

Chronic liver disease (i.e. Cirrhosis)

Chronic lung disease requiring oxygen

Cocaine or other drug use within two years or daily marijuana use

Defibrillator

Dementia

Diabetes & Heart Disease

Diabetes & Stroke

Early age coronary history (prior to age 40)

Esophageal Varices

Heart Disease & current tobacco use

Heart Disease & Stroke

HIV / AIDS: any treatment or diagnosis

Inpatient alcohol treatment within two years or single DUI within 1 year

Lung disease (COPD/emphysema) with current tobacco use

Mental and Nervous disorders – hospitalizations or suicide attempt within

the past two years

Renal failure surgery dialysis

Stroke within one year

Transplants: heart, liver, lung

Probable Action

Decline

Request tentative quote providing specific type,

site, grade, of tumor, how treated

and dates.

Decline; will reconsider after six months

of recovery.

Decline

Decline

Decline

Decline

Decline

High Substandard or Decline

High Substandard or Decline

Decline

Decline

Usually a Decline

High Substandard or Decline

Decline

Decline

High Substandard or Decline

Decline

Decline

Decline; will reconsider after one full year

of recovery

Decline

31


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Impairment

Probable Action

Select Term / Index Universal Life

AIDS decline decline

Alcohol abuse T 2 to decline standard to decline

Alcoholism¹

5 yrs since complete abstinence - standard

Allergies, hay fever std² standard plus²

ALS (Lou Gehrig’s) decline decline

Alzheimer’s disease decline decline

Amputations

Anemia (not sickle cell

or sideroblastic)

Aneurysm, abdominal¹

Aneurysm, cerebral¹

If due to injury - std²

otherwise, see specific cause/disease

mild - std²

moderate - T 2 to 5

severe - decline

no surgery - probably decline

6 mo since surgery - T 2 to 6

no surgery - $7.50 flat extra to decline

2 yrs since surgery - std

(if multiple cerebral aneurysms or significant

residuals, probably a decline)

Probable Action

Advantage Term / Universal Life

5 yrs since complete abstinence - std plus

If due to injury - std plus²

otherwise, see specific cause/disease

mild - std plus²

moderate - standard to T 5

severe - decline

no surgery - probably decline

6 mo since surgery - standard to T 6

no surgery - $7.50 flat extra to decline

2 yrs since surgery - Std Plus

(if multiple cerebral aneurysms or significant

residuals, probably decline)

Angina pectoris¹ T 4 to decline standard to decline

Anxiety

mild - std²

moderate - std to T 4

severe - T 6 to decline

mild - std plus²

moderate - std

severe - T6 to decline

Atrial fibrillation¹ 1 or 2 episodes - std to T 3

more frequent episodes - T 2 to 6

Arthritis, osteo mild or moderate - std²

severe - possible T 2

Arthritis, rheumatoid¹ mild - std to T 2

moderate - T 2 to 3

severe- T 4 to decline

Aviation

student pilot - $2.50-$3.50 flat extra

licensed pilot - std to $5.00 flat extra

commercial pilot - std²

Asthma mild - standard to T 2²

moderate - T 3 to 8

severe - decline

Back disorder

mild to moderate - std²

severe - possible T 2 to 4

1 or 2 episodes - std

more frequent episodes - std to T 6

mild or moderate - std plus²

severe - std

mild - standard plus or std

moderate - std

severe - std to decline

student pilot - std

licensed pilot - probably std

commercial pilot - std plus²

mild - std plus or std²

moderate - std to T 8

severe - decline

mild to moderate - std plus²

severe - possible std

32

¹ Indicates an Attending Physicians Statement will most likely be needed.

² Indicates the applicant could potentially qualify for preferred rates, assuming they otherwise meet the preferred criteria.


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Impairment

Probable Action

Select Term / Index Universal Life

Probable Action

Advantage Term / Universal Life

Barrett’s esophagus T 2 to decline std to decline

Bell’s Palsy std² std plus²

Bipolar disorder¹ mild - std to T 4

moderate - T 4 to 6

severe - T 8 to decline

mild - std plus to std

moderate - std to T 6

severe - T 8 to decline

Blindness std to T 3² std plus or std²

Breast disorders std²

std plus²

(not Cancer)

Broken bone std² std plus²

Bronchiectesis¹ minimal or mild - std to T 3

moderate - T 4 to 6

severe - T 10 to decline

(could be considered std, if successful

surgery >1 yr out)

minimal or mild - std plus or std

moderate - std to T 6

severe - T 10 to decline

(could be considered std plus, if successful

surgery >1 yr out)

Bronchitis, acute std² std plus²

Bronchitis, chronic

(COPD)¹

mild - std to T 3

moderate - T 4 to 8

severe - decline

(if applicant is using oxygen, would decline)

std to T 2

Bundle branch

block, right

Bundle branch block, T 4 to decline

std to decline

left¹

Bursitis std² std plus²

Cancer (internal organ)¹ 0-7 yrs from last treatment - rated to decline

>7 yrs from last treatment, no recurrence -

usually std

usually std plus

mild - std plus or std

moderate - std to T 8

severe - decline

(if applicant is using oxygen, would decline)

std plus or std

0-7 yrs from last treatment - rated to decline

>7 yrs from last treatment, no recurrence -

Cancer, skin

std²

std plus²

(not Melanoma)

Cardiomyopathy < 3 yrs since diagnosis - decline

>3 yrs since diagnosis - T4 to 8

< 3 yrs since diagnosis - decline

>3 yrs since diagnosis - std to T8

Cataracts std² std plus²

Cerebral palsy¹

very mild & no mental retardation - std

Otherwise, T 4 to decline

very mild & no mental retardation - std

plus Otherwise, std to decline

Cerebral Vascular

Accident, Stroke (CVA)¹


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

34

Probable Action

Impairment

Select Term / Index Universal Life

Cirrhosis (liver) decline decline

Colitis, ulcerative¹

Colitis, other than

ulcerative

Concussion (head injury)

Congestive Heart

Failure (CHF)¹

Convulsions, seizures¹

Coronary Artery Disease¹

(including bypass or

stent placement)

Criminal activity

Crohn’s disease¹

5 yrs since diagnosis or attack - std

std²

mild - postpone 6 mo and then std (if no

residuals)²

moderate - postpone 1 yr, then std (if no

residuals)

severe - postpone 2 yrs, then std (if residuals)


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Impairment

Drug Abuse, other

than Marijuana¹

Probable Action

Select Term / Index Universal Life

current use or use within last 3 yrs - decline

3-6 yrs since complete abstinence - $7.50

flat extra

Probable Action

Advantage Term / Universal Life

current use or use within last 3 yrs - decline

3-6 yrs since complete abstinence - $7.50

flat extra

Eczema std² std plus²

Emphysema¹ mild std to T 3

moderate - T 4 to 8

severe - decline

(if applicant is using oxygen, would decline)

mild - std plus to std

moderate - std to T 8

severe - decline

(if applicant is using oxygen, would decline)

Endocarditis postpone 1 yr, then std (if no residuals)² postpone 1 yr, then std plus (no residuals)²

Epilepsy, petit mal¹


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Probable Action

Impairment

Select Term / Index Universal Life

Headache, migraine std²

std plus²

or tension

Hearing impairment std² std plus²

Heart attack¹

Heart bypass surgery¹

(see coronary artery disease)

Heart valve replacement¹

Heart valve surgery¹

6 mo since attack - T 4 to decline

6 mo since surgery - Table 4 to decline

6 mo since surgery - T 4 to decline

6 mo since surgery - T 2 to decline

Probable Action

Advantage Term / Universal Life

6 mo since attack - std to decline

6 mo since surgery - std to decline

6 mo since surgery - std to decline

6 mo since surgery - std to decline

Heartburn std² std plus²

Hemorrhoids std² std plus²

Hepatatis A std, if fully recovered² std plus, if fully recovered²

Hepatitis B

Hepatitis C¹

one episode, fully recovered - std²

Chronic - T 2 to decline

T 2 to decline - current liver functions must be

within normal ranges

One episode, fully recovered - std²

Chronic - std to decline

std to decline - current liver functions must be

within normal ranges

Hernia std² std plus²

Herniated disc std² std plus²

High blood pressure,

Hypertension

usually std (if under control)²

usually std plus (if under control)²

Histoplasmosis

Hodgkin’s disease¹

Huntington’s disease

Hydronephrosis

Hypertension, high

blood pressure

if present - postpone for at least 6 mo

Recovered w/o residuals - std²

w/ residual lung impairment - T 2 to decline

8 yrs from treatment - T 2

present - decline

family history of - $2.50-$10.00 flat extra

resolved or cause corrected - std

cause still present - T 2 to decline

usually std (if under control)²

if present - postpone at least 6 mo

Recovered with no residuals - std plus²

With residual lung impairment - std to decline

8 yrs from treatment - std

Present - decline

family history of - std to $10 flat extra (on UL)

resolved or cause corrected - std plus

cause still present - std to decline

usually std plus (if under control)²

Hysterectomy (benign) std² std plus²

Ileitis¹

5 yrs - std

5 yrs from diagnosis or major attack - std plus

Indigestion std² std plus²

36

¹ Indicates an Attending Physicians Statement will most likely be needed.

² Indicates the applicant could potentially qualify for preferred rates, assuming they otherwise meet the preferred criteria.


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Probable Action

Impairment

Select Term / Index Universal Life

Kidney failure, dialysis decline decline

Kidney infection, std²

std plus²

recovered

Kidney removal

std to decline (depending on cause & current

renal function)²

Probable Action

Advantage Term / Universal Life

std plus to decline (depending on cause and

current renal function)²

Kidney stones usually std (frequent attacks may require rating)² usually std plus (frequent attacks may require

std rate)²

Kidney transplant¹ T 6 to decline T 6 to decline

Leukemia¹ -

chronic lymphoid

leukemia, hairy cell

leukemia

Leukemia -

forms other than above

< 2 yrs since last treatment - postpone

2-8 yrs from treatment - $7.50 flat extra

to decline

> 8 yrs from treatment - std to T 2

highly sudstandard - decline

8 yrs from treatment - std plus to std

highly sudstandard - decline

Lou Gehrig’s disease (ALS) decline decline

Lupus, discoid std to decline std plus to decline

Lupus, systemic¹


38

Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Impairment

Mountain climbing

Probable Action

Select Term / Index Universal Life

23,000 ft - decline

Multiple Sclerosis (MS)¹ mild - T 2 to 4

moderate - T 4 to 6

severe - T 8 to decline

Myasthenia Gravis¹ 7 yrs since diagnosis - T 2 to 4

Myocarditis¹

2 yrs since diagnosis, fully recovered std to T2

Muscular dystrophy, decline

Duchenne

Muscular dystrophy, T 10 to decline

Becker or limb girdle¹

Muscular dystrophy,

Facioscapulohumeral¹

Nephrectomy

std to decline (depending on cause &

renal function)²

Nephritis, acute

1 episode, fully recovered - std²

multiple episodes - std to T 3

Neurosis, anxiety mild - std²

moderate - T 2 to 4

severe - T 6 to decline

Non-Hodgkin’s

lymphoma¹

Non-US citizens

Occupations with

special hazards

Operating While

Intoxicated (OWI)

Osteoarthritis

Probable Action

Advantage Term / Universal Life

23,000 ft - decline

mild - std

moderate - std to T 6

severe - T 8 to decline

7 yrs since diagnosis - std

2 yrs since diagnosis, fully recovered - std

decline

T 10 on UL to decline

std to T 6 std plus to T 6

8 yrs from treatment - T 2

with green card or permanent residency - std²

with temporary visa (i.e student, tourist, etc)

- decline

in process of applying for green card or

citizenship, call home office for possible

consideration

call home office

5 yrs since occurrence - std²

(if history of multiple DUI’s, probably decline)

mild or moderate - std²

severe - possible T 2

Osteomyelitis, chronic std to T 4 std

std plus to decline (depending on cause &

renal function)²

1 episode, fully recovered - std plus²

multiple episodes - std plus to std

mild - std plus²

moderate - std

severe - T 6 to decline

8 yrs from treatment - std

with green card or permanent residency - std plus²

with temporary visa (i.e student, tourist, etc)

- decline

in process of applying for green card or

citizenship, call home office for possible

consideration

call home office

5 yrs since occurrence - std plus²

(if history of multiple DUI’s, probably decline)

mild or moderate - std plus²

severe - possible std

¹ Indicates an Attending Physicians Statement will most likely be needed.

² Indicates the applicant could potentially qualify for preferred rates, assuming they otherwise meet the preferred criteria.


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Impairment

Probable Action

Select Term / Index Universal Life

Probable Action

Advantage Term / Universal Life

Pacemaker¹ T 3 to decline std to decline

Pancreatitis


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Probable Action

Impairment

Select Term / Index Universal Life

Rheumatoid arthritis¹ mild - std to T 2

moderate - T 2

severe - T 4 to decline

Sarcoidosis¹ std to decline std plus to decline

Sebaceious cyst std² std plus²

Sciatica std² std plus²

Schizophrenia¹

Scuba diving

10 yrs since diagnosis/episode - std

100 feet or less - std²

101-250 feet - $2.50 to $5.00 flat extra

>250 feet - $7.50 - $10.00 flat extra

Probable Action

Advantage Term / Universal Life

mild - std plus or std

moderate - std

severe - std to decline

10 yrs since diagnosis/episode - std plus

100 feet or less - std plus²

101-250 feet - possibly std

>250 feet - $7.50 - $10.00 flat extra on UL

Sinusitis std² std plus²

Sky diving $5.00 - $7.50 flat extra std to $7.50 flat extra

Sleep apnea

mild - std

moderate - std to T 3

severe - T 2 to 4

mild - std plus

moderate - std plus or std

severe - std

Stent/Coronary Artery

Desease/Surgical

Intervention

Stroke (CVA)¹

Suicide attempt¹

6 mo since event or surgery - T 2 to decline

7 yrs from last treatment, no recurrence, no

spread to lymph nodes - usually std

6 mo since event or surgery - std to decline

7 yrs from last treatment, no recurrence, no

spread to lymph nodes - usually std plus

40

¹ Indicates an Attending Physicians Statement will most likely be needed.

² Indicates the applicant could potentially qualify for preferred rates, assuming they otherwise meet the preferred criteria.


Alliance Solutions Probable Actions for Underwriting

Conditions

T = table rating std =standard std plus = standard plus

This is a guideline to assist with field underwriting; final decisions are at underwriter discretion.

Refer to the Table Rating Guide at end of document for additional information.

Impairment

Ulcerative colitis¹

Probable Action

Select Term / Index Universal Life

5 yrs since diagnosis or attack - std

Ulcer, stomach std² std plus²

Upper respiratory tract std²

std plus²

infection, cold

Urinary bladder

std²

std plus²

infection, acute

Varicocele, hydrocele, std²

std plus²

cystocele

Varicose veins std² std plus²

Probable Action

Advantage Term / Universal Life

5 yrs since diagnosis or attack - std plus

Table Rating Guide

2 / B = 50%

3 / C = 75%

4 / D = 100%

5 / E = 125%

6 / F = 150%

8 / H = 200%

10 / J = 250%

12 / L = 300%

¹ Indicates an Attending Physicians Statement will most likely be needed.

² Indicates the applicant could potentially qualify for preferred rates, assuming they otherwise meet the preferred criteria.

41


Alliance Solutions Universal Life and Advantage Term

Tentative Rating for Diabetes

This is a guideline to assist with field underwriting; final decisions are at the underwriter’s discretion.

These rates are assuming good control of diabetes, average height/weight and no complications such as

neuropathy, nephropathy, etc.

Years since

Diagnosis

Current Age

Years since

Diagnosis

Current Age

Type 1 Diabetes

(Juvenile onset/Insulin dependent)

0 - 5 6 - 15 >15

70 Standard / Standard Standard / Standard Standard / Standard

Type 2 Diabetes

(Diet/Oral medication)

0 - 5 6 - 15 >15

70 Standard Plus / Standard Standard / Standard Standard / Standard

*call home office, probably decline

NonTobacco / Tobacco NonTobacco / Tobacco NonTobacco / Tobacco

NonTobacco / Tobacco NonTobacco / Tobacco NonTobacco / Tobacco

Table Rating Guide

2 / B = 50%

3 / C = 75%

4 / D = 100%

5 / E = 125%

6 / F = 150%

8 / H = 200%

10 / J = 250%

12 / L = 300%

42


Alliance Solutions Select Term and Index Universal Life

Tentative Rating for Diabetes

This is a guideline to assist with field underwriting; final decisions are at the underwriter’s discretion.

These rates are assuming good control of diabetes, average height/weight and no complications such as

neuropathy, nephropathy, etc.

Years since

Diagnosis

Current Age

Type 1 Diabetes

(Juvenile onset/Insulin dependent)

0 - 5 6 - 15 >15

NonTobacco / Tobacco NonTobacco / Tobacco NonTobacco / Tobacco

70 Table B / Table D Table B / Table D Table E / Table F

Years since

Diagnosis

Current Age

Type 2 Diabetes

(Diet/Oral medication)

0 - 5 6 - 15 >15

NonTobacco / Tobacco NonTobacco / Tobacco NonTobacco / Tobacco

70 Standard / Table B Table B / Table D Table B / Table D

*HO - call home office, probably decline

Table Rating Guide

2 / B = 50%

3 / C = 75%

4 / D = 100%

5 / E = 125%

6 / F = 150%

8 / H = 200%

10 / J = 250%

12 / L = 300%

43


Disability Income Rider (DIR) – Occupation Listing

The two disability income riders are available on the Alliance Solutions Advantage Term, Universal Life and Select

Term products.

Part time employees (less than 30 hours/week) and certain occupations are not eligible for DIR. Ineligible occupations

may be due to hazards, persistency of business, seasonal/migrant work, or based on claims experience within the

industry or company. Self-employed persons applying for DIR are considered on an individual basis by the Underwriter.

Federal, State and Municipal employees are normally not eligible for DIR. Clients stating that they have no disability

benefits would need to provide written documentation from the employer stating that no disability benefits are in place.

Total disability rider coverage should not exceed 66% of the insured’s income.

This includes coverage provided by group or individual disability plans. The total line of disability income, inforce

and applied for, may not exceed $10,000.

Applicants must be employed in an occupation for salary commission or profit, and must work full-time for at least

30 hours a week, 10 months a year.

Key

B = Eligible for both 2 Year and 5 Year

2 = Eligible for 2 Year DIR Only

N = Not Available for 2 or 5 Year DIR

** = Call Home Office regarding Municipal and State Employees. For Federal and Government Employees, the following apply:

- Employment with the federal government of 10 years or less.

- Normal occupational guidelines apply. (Ineligible occupations will still be uninsurable, even though employed by

the federal government.)

- Maximum benefit of $2,000/month subject to normal income guidelines and amount of coverage in force with

other carriers.

- Maximum 2 year benefit and 90 day elimination.

- We will not offer coverage to an employee with any branch of the U.S. Military.

Abstractor................................................................................................... B

Academic Dean .......................................................................................... B

Accountant ................................................................................................ B

Actor/Actress..............................................................................................N

Actuary........................................................................................................ B

Acupuncturist (not MD).............................................................................. B

Administrative Assistant............................................................................ B

Advertising Firm (Executive, Supervision, Other)....................................... B

Aerobics Instructor..................................................................................... 2

Aeronautical Engineer................................................................................ B

Agriculture (Farms, Orchards, Ranches, Nurseries,

Dairy Farms, Hatcheries) or Manager, Foreman........................... B

Agriculture Hired Hand............................................................................... 2

Air Conditioning Installer, Mechanic, Servicer........................................... B

Air Traffic Controller...................................................................................N

Aircraft Mechanic....................................................................................... B

Alarm Installer/Servicer............................................................................. B

Ambulance Driver, Attendant..................................................................... B

Amusement/Sports.....................................................................................N

Amusement Park Employee........................................................................N

Anesthesiologist......................................................................................... B

Anesthetist ................................................................................................. B

Animal Care Technicians/Vet Aides........................................................... B

Animator..................................................................................................... B

Announcer (Radio & TV)............................................................................. B

Answering Service...................................................................................... B

Antenna Erector and Maintenance............................................................ 2

Antique Dealer ........................................................................................... B

Apartment Building Manager..................................................................... B

Appliance Repair, Install, Service............................................................... B

Appraiser (Insurance, Real Estate, Merchandise, Art)............................... B

Architect..................................................................................................... B

Armed Forces Personnel.............................................................................N

Armored Car Driver or Guard...................................................................... 2

Art Director................................................................................................. B

Art Gallery (Owner)..................................................................................... B

Art Restorer................................................................................................ B

Artist...........................................................................................................N

Asbestos Worker........................................................................................N

Asphalt Pavor/Worker................................................................................ 2

Assayer....................................................................................................... B

Assessor..................................................................................................... B

Athlete (Professional or Semi-Professional)..............................................N

Athletic Coach/Trainer – not Professional.................................................N

Attorney...................................................................................................... B

Auctioneer (Livestock, Other)..................................................................... B

Audiologist ................................................................................................. B

Auditor........................................................................................................ B

Author, Journalist, Writer (Freelance)........................................................ 2

Author, Journalist, Writer (no Freelance)................................................... B

Auto Body Repair (Painter, Customizer, Pinstriper)....................................N

Auto Mechanic ........................................................................................... 2

Auto Rental (Executive, Supervision)......................................................... B

Auto, Trailer and Mobile Home Sales and Service (Owners)..................... B

Aviation (Pilots, Flight Attendants).............................................................N

Aviation (See Transportation).......................................................................

Bail Bondsman ........................................................................................... B

Bailiff..........................................................................................................N

Bakeries...................................................................................................... B

Banking....................................................................................................... B

Barber......................................................................................................... 2

Barber Shops, Beauty Parlors..................................................................... 2

Bartender.................................................................................................... 2

Beautician................................................................................................... 2

44


Bellboy, Bellhop, Bell Captain.................................................................... 2

Bicycle Repair/Mechanic............................................................................ 2

Billboard Erector.........................................................................................N

Blacksmith.................................................................................................. 2

Blaster.........................................................................................................N

Bond Trader................................................................................................. B

Bonding Company (Owner)......................................................................... B

Bookkeeper................................................................................................. B

Boom Operator (Motion Pic./TV)................................................................ 2

Bowling Alley Manager or Cashier............................................................N

Bricklayer.................................................................................................... 2

Bridge or Dam Worker................................................................................N

Broker (not on Trading Floor)...................................................................... B

Broker (on Trading Floor)............................................................................. 2

Building Inspector....................................................................................... B

Building Mover or Wrecker Foreman......................................................... B

Building Mover or Wrecker Other.............................................................. 2

Building Services (Superintendent)............................................................ B

Building Services (Other)............................................................................ 2

Bulldozer Operator...................................................................................... 2

Burglar Alarm Installer, Servicer................................................................ B

Bus Boy.......................................................................................................N

Bus Companies........................................................................................... B

Bus Driver...................................................................................................N

Business Agent/Broker............................................................................... B

Business Machine...................................................................................... B

Butcher........................................................................................................ 2

Buyer........................................................................................................... B

Cab Driver...................................................................................................N

Cabinetmakers ........................................................................................... B

Cable TV Company...................................................................................... B

Camera Operator (Motion Pic./TV)............................................................. B

Car Rental/Leasing..................................................................................... B

Car Wash (Office)........................................................................................ B

Car Wash (Other)........................................................................................ 2

Caretaker (Groundskeeper)......................................................................... 2

Carpenter.................................................................................................... 2

Carpets/Rugs/Flooring Clean, Repair......................................................... 2

Carpet Floor Installer..................................................................................N

Cartographer............................................................................................... B

Cashier........................................................................................................ B

Casino Worker............................................................................................N

Catering Services (Office/Supervisor)........................................................ B

Catering Services (Other)............................................................................ 2

Cement & Concrete Finisher....................................................................... 2

Cemetary Manager, Office Duties.............................................................. B

Census Taker............................................................................................... 2

Chaplain...................................................................................................... B

Chauffer......................................................................................................N

Check Cashing Service............................................................................... 2

Chef............................................................................................................. B

Chemical Engineer...................................................................................... B

Chemist, Biologist....................................................................................... B

Child Care Worker...................................................................................... 2

Chimney Sweep.............................................................................. 2

Chiropodist...................................................................................... B

Chiropractor.................................................................................... B

Choreographer................................................................................ B

Cinematographer............................................................................ B

Circus Employee.............................................................................N

Civil Engineer (not Government Employee).................................... B

Claims Examiner............................................................................. B

Cleaners & Dryers, Laundries (Office)............................................ B

Cleaners & Dryers, Laundries (Other)............................................. 2

Clergy Member............................................................................... B

Clerk................................................................................................ B

Clock & Watch Repair.................................................................... B

Coach .............................................................................................N

Collection Agency (Office).............................................................. B

Collection Agency (Other)............................................................... 2

Commercial Artist (not at Home or Freelance)............................... B

Commercial Photographers............................................................ B

Commodity Broker/Floor Trader...................................................... 2

Composer........................................................................................ 2

Computer Related Occupations...................................................... B

Concrete & Cement Finisher........................................................... 2

Conservation Technician (Museums).............................................. B

Construction (Exec.,Mgmt., Inspectors, Skilled Trade)................... B

Construction (Unskilled Labor)........................................................ 2

Cooks & Chefs................................................................................ B

Copy Writer (Advertising)............................................................... B

Coroner........................................................................................... B

Correction Officer............................................................................N

Cosmetologist................................................................................. 2

Counselor/Psychologist.................................................................. B

Couriers/Express Mail Services.....................................................N

Craneman, Crane Operator............................................................. 2

Curator – Museum or Art Gallery................................................... B

Custodian........................................................................................ 2

Custom House Broker..................................................................... B

Dairy Farmer................................................................................... B

Dairy Products Processing.............................................................. B

Dairy Scientist................................................................................ B

Day Care Center (not at Home) (Office/Supervisor)....................... B

Day Care Center (not at Home) (Other)........................................... 2

Decorator, Interior, Window and Display (Outside of Home)......... B

Deliveryman (Short Haul, Home Every Night)................................ 2

Demolition Specialist.....................................................................N

Dental Assistant............................................................................. B

Dental Hygienist............................................................................. B

Dental Lab Owner........................................................................... B

Dental Lab Technician.................................................................... B

Dentist............................................................................................ B

Detectives, Private.......................................................................... 2

Dialysis Technician......................................................................... B

Diamond Cutter, Polisher, or Sales................................................. B

Dietary Aide.................................................................................... B

Dietician.......................................................................................... B

Disc Jockey..................................................................................... B

Dishwashers, Busboys....................................................................N

Dispatcher....................................................................................... B

Display Designer............................................................................. B

Diver................................................................................................N

Dock Workers................................................................................. 2

Dog Groomer (Handler, Kennel Operator, Trainer).......................... B

Domestic Servant...........................................................................N

Door & Window Installer................................................................ B

Draftsman....................................................................................... B

Dressmaker..................................................................................... B

45


Driver (Local Delivery and Short Haul Deliveryman,

Home Every Night).......................................................................... 2

Driver (All Other).............................................................................N

Drug Stores..................................................................................... B

Dry Cleaner (Office)......................................................................... B

Dry Cleaner (Other)......................................................................... 2

Drywall Installer............................................................................. B

Editor............................................................................................... B

Electrical Appliance Repair............................................................ 2

Electrical (Powerline, Foreman & Inspectors)................................ B

Electrical (Powerline, Other)........................................................... 2

Electrician....................................................................................... B

Electrologist.................................................................................... B

Electroplater................................................................................... B

Electrotyper .................................................................................... B

Elevator Installer or Repairman...................................................... B

Elevator Operator............................................................................ B

Embalmer........................................................................................ B

Emergency Medical Technician...................................................... B

Employment Agencies.................................................................... B

Endodontist..................................................................................... B

Engineer.......................................................................................... B

Engraver.......................................................................................... B

Escort Service.................................................................................N

Etcher.............................................................................................. B

Executive Recruiter......................................................................... B

Exercise Instructor.......................................................................... 2

Exotic Dancer..................................................................................N

Explosive Handler...........................................................................N

Exporter/Importer........................................................................... B

Express Mail Delivery.....................................................................N

Exterminator................................................................................... B

Eye Glass/Lens Cutter, Grinder....................................................... B

Farmer............................................................................................. B

Fashion Designer............................................................................ B

Fashion Model................................................................................N

Federal Marshal..............................................................................N

Federal Employee......................................................................... **

Fence Erector/Installer................................................................... B

Film Developer/Processor............................................................... B

Film Editor....................................................................................... B

Film or Tape Librarian..................................................................... B

Financial Consultant....................................................................... B

Financial Service............................................................................. B

Fire Alarm Installer, Repairman...................................................... B

Fire Extinguisher (Refill/Service).................................................... B

Fire Fighter......................................................................................N

Fire Marshall...................................................................................N

Fish & Game Warden.....................................................................N

Fish Farm/Hatchery......................................................................... B

Fish Processing Plant...................................................................... B

Fisherman.......................................................................................N

Flight Attendant..............................................................................N

Flight Instructor............................................................................... 2

Floral Arranger/Designer................................................................ B

Florist ............................................................................................. B

Forest Ranger/Forester...................................................................N

Freight Solicitor.............................................................................. B

Funeral Director.............................................................................. B

Furnace Installer, Repairman.......................................................... B

Furniture Designer.......................................................................... B

Furniture Mover.............................................................................. 2

Furniture Restorer........................................................................... 2

Furniture Upholster......................................................................... 2

Furrier.............................................................................................. 2

Gambling Casino (Owner)...............................................................N

Game Warden.................................................................................N

Garage Foreman or Manager......................................................... B

Garbage Collector........................................................................... 2

Garbage Mechanic......................................................................... 2

Gardener (Full Time, not Seasonal)................................................ 2

Garment Sales................................................................................ B

Gas Station Attendant.................................................................... 2

Gem Cutter/Polisher....................................................................... B

Gemologist...................................................................................... B

Geologist......................................................................................... B

Glass Installation............................................................................ B

Glazier............................................................................................. B

Golf Course Manager..................................................................... B

Goldsmith ....................................................................................... B

Golf Instructor/Pro..........................................................................N

Government Employee.................................................................. **

Graphic Artist/Designer (Freelance)............................................... 2

Graphic Artist/Designer (not Freelance or Working From Home)..... B

Greens Keeper................................................................................ 2

Grounds Keeper.............................................................................. 2

Guard..............................................................................................N

Guidance Counselor........................................................................ B

Guide (Travel/Tour).......................................................................... 2

Gunsmith......................................................................................... B

Hairdresser..................................................................................... 2

Hairstylist ....................................................................................... 2

Harbor Master................................................................................ B

Hazardous Waste Disposal (Executives, Office Only).................... B

Health Club Manager..................................................................... 2

Hearing Aid Technician................................................................... B

Heating Installer/Repairman.......................................................... B

Heavy Equipment Operator............................................................. 2

Helicopter Mechanic...................................................................... B

Helicopter Pilot...............................................................................N

Home Health Care Worker.............................................................N

Horse Tender/Trainer (not Riding).................................................. 2

Hospital Administrator................................................................... B

Hospital Attendant, Orderly or Aide............................................... 2

Hospital Laboratory........................................................................ B

Hotels and Motel (Office, Manager, Clerk)..................................... B

Hotels and Motel (Housekeeper, Bellboy)...................................... 2

Housewives, Homemakers, Housekeeping....................................N

Hypnotherapist............................................................................... B

Hypnotist......................................................................................... B

Illustrator (Freelance)...................................................................... 2

Illustrator (not Freelance)............................................................... B

Importer/Exporter........................................................................... B

Incinerator Plant............................................................................. B

46


Income Tax Services....................................................................... B

Industrial Water Softening............................................................. B

Insulation Therapist........................................................................ B

Insurance Adjuster.......................................................................... B

Insurance Agent, Broker................................................................. B

Interior Decorator........................................................................... B

Interior Designer............................................................................. B

Internal Revenue Agent..................................................................N

Interpreter....................................................................................... B

Investigator (Private)....................................................................... B

Investment Analyst, Broker (not on Trading Floor)......................... B

Iron, Steel Worker (Structural).......................................................N

Jailer...............................................................................................N

Janitors........................................................................................... 2

Jewelry Stores................................................................................ B

Jockey.............................................................................................N

Journalist (Freelance)..................................................................... 2

Journalist (no Freelance)................................................................ B

Junk Dealer/Owner/Yardworker.................................................... 2

Kennel............................................................................................. 2

Key Maker ...................................................................................... B

Kidney Dialysis Technician............................................................. B

Lab Technician................................................................................ B

Labor Unions (Organizer/Official)................................................... B

Landscape Architect....................................................................... B

Landscape/Horticulture Services (Office, Supervision, Foreman).. B

Landscape/Horticulture Services (Other)....................................... 2

Lawyer............................................................................................ B

Leasing Companies......................................................................... B

Legal Assistant............................................................................... B

Legal Stenographer........................................................................ B

Legal Transcriber............................................................................ B

Librarian.......................................................................................... B

Lifeguard.........................................................................................N

Limousine Service (Office Only)...................................................... B

Lineman.......................................................................................... 2

Liquor Distribution (Manager, Sales, Distribution)......................... B

Liquor Distribution (Warehouse).................................................... 2

Liquor Distribution (Drivers, Delivery)............................................N

Liquor Manufacture (Administrative, Sales, Skilled Workers)....... B

Liquor Manufacture (Laborer, Unskilled Workers)......................... 2

Liquor Sales (Managers, Cashiers, Chefs, Cooks).......................... B

Literary Agent................................................................................. B

Lithographer Printer........................................................................ B

Livestock (Sales, Auctioneer, Buyer, etc.)....................................... B

Livestock (Sheepherder, Shearer, Other)........................................ 2

Lobbyist........................................................................................... B

Locksmith ....................................................................................... B

Longshoreman................................................................................ 2

Lumber Industry..............................................................................N

Lumberyard Workers (Administrative, Millwright, Graders).......... B

Lumberyard Workers (Loaders, Truckers, Pilers, Other)................. 2

Machine Shop (Owner)................................................................... B

Magistrate...................................................................................... B

Mail Carrier.....................................................................................N

Mail Clerk/Sorter (not Employed by Government)......................... B

Maintenance Man/Engineer.......................................................... B

Management Consultant................................................................ B

Manicurist ...................................................................................... 2

Manufacturer’s Representative/Agent........................................... B

Marine Industry: Marine Managers............................................... B

Marine Industry: Merchant Seaman..............................................N

Marine Industry: Ocean Going Ships: Physicians,

Quartermaster, Radio Operator, Purser.............................. B

Marine Industry: Ocean Going Ships, Tugs, Barges: Captains,

Chief Officers, Engineers.................................................... B

Marine Industry: Other (no Commercial Fishermen)...................... 2

Marine Industry: Other Workers..................................................... 2

Market Research............................................................................ B

Mason............................................................................................. 2

Masseur/Masseuse........................................................................ 2

Meat Pack Plant (Management, Foreman)..................................... B

Meat Pack Plant (Others)................................................................ 2

Mechanic ....................................................................................... B

Medical Assistant........................................................................... B

Medical Intern, Resident................................................................ B

Medical Lab Worker....................................................................... B

Medical Laboratory (Owner)........................................................... B

Medical Records Clerk.................................................................... B

Medical Services............................................................................ B

Medical Technician......................................................................... B

Medical Technologist..................................................................... B

Medical Transcriptionist................................................................. B

Meter Installer, Reader, Repairer................................................... B

Midwife, Certified........................................................................... B

Migrant Worker..............................................................................N

Military Personnel..........................................................................N

Mining Industry...............................................................................N

Minister.......................................................................................... B

Model..............................................................................................N

Modeling Agency Owner................................................................ B

Monument Workers........................................................................ B

Mortgage Bankers.......................................................................... B

Mortician........................................................................................ B

Motivational Speaker.....................................................................N

Movie Theaters (Management only).............................................. B

Moving & Storage Companies (Executive, Foreman,

Checker, Watchman)............................................................... B

Moving & Storage Companies (Packer, Others, not Driving)......... 2

Municipal Employee..................................................................... **

Musical Instrument Repair............................................................. B

Musician (Conductor, Radio, TV Studio, Fulltime).......................... B

Musician (Others)...........................................................................N

Nanny.............................................................................................. 2

Newspaper Industry....................................................................... B

Notary............................................................................................. B

Nuclear Pharmacist ...................................................................... B

Nuclear Power Plant....................................................................... B

Numismatists (Coin Collectors)...................................................... B

Nurse (Private Duty)........................................................................N

Nurse (RN, LPN).............................................................................. B

Nurse (Nurses Aide, CNA, not in Home)........................................ 2

Nurseries........................................................................................ B

Nursing Assistant........................................................................... 2

47


Nutritionist...................................................................................... B

Occupational Therapist................................................................... B

Office Machine Repair.................................................................... B

Office Manager, Supervisor............................................................ B

Office Workers................................................................................ B

Off Shore Workers.......................................................................... 2

Oil & Natural Gas Industry............................................................. B

Operator-Switchboard or Telegraph............................................... B

Optician........................................................................................... B

Optometrist..................................................................................... B

Optometrist Assistant..................................................................... B

Oral Hygienist................................................................................. B

Oral Surgeon .................................................................................. B

Orderly (Hospital)............................................................................ 2

Orthodontist.................................................................................... B

Orthotist, Prosthetist...................................................................... B

Ostepath......................................................................................... B

Otologist......................................................................................... B

Packing & Slaughter House (Supervision)...................................... B

Packing & Slaughter House (Other)................................................ 2

Painter............................................................................................. B

Paperhanger.................................................................................... B

Paralegal Services ......................................................................... B

Paramedic....................................................................................... B

Park Superintendent, Ranger..........................................................N

Parking Lot Attendant..................................................................... 2

Parole Officer..................................................................................N

Parts Clerk ...................................................................................... B

Pastor.............................................................................................. B

Pawnbrokers ................................................................................ B

Pedodontist..................................................................................... B

Perfusionist..................................................................................... B

Periodontist..................................................................................... B

Personnel Manager........................................................................ B

Personnel Recruiter........................................................................ B

Pet Supply and Grooming............................................................... B

Pharmacist...................................................................................... B

Photoengraver ................................................................................ B

Photofinishing Laboratories (Owner).............................................. B

Photographer (Commercial, Motion Picture).................................. B

Photographer (Freelance)................................................................ 2

Physiatrist....................................................................................... B

Physical Medicine/Rehab............................................................... B

Physical Therapist........................................................................... B

Physician......................................................................................... B

Physician’s Assistant...................................................................... B

Physicist.......................................................................................... B

Piano Tuner, Technician.................................................................. B

Piano/Safe Mover...........................................................................N

Picture Framers............................................................................... B

Pilot.................................................................................................N

Podiatrist......................................................................................... B

Police Officer, Inspector, Chief, Deputy, Detective.........................N

Porter.............................................................................................. 2

Post Office Employees....................................................................N

Powerhouse Workers..................................................................... B

Preacher.......................................................................................... B

Principal.......................................................................................... B

Printers/Lithographers.................................................................... B

Printing and Publishing................................................................... B

Prison Warden................................................................................N

Private Investigator......................................................................... 2

Probation Officer.............................................................................N

Production Assistant Coordinator................................................... B

Professional Office Managers........................................................ B

Professor ....................................................................................... B

Program Director, Manager............................................................ B

Prosthetist ...................................................................................... B

Prosthodontist................................................................................. B

Psychiatrist..................................................................................... B

Psychological Counseling............................................................... B

Psychologist.................................................................................... B

Public Relations ............................................................................. B

Publicity Agent................................................................................ B

Pump Station Operator................................................................... B

Purchasing Agent............................................................................ B

Quarry Workers (Skilled, Other)...................................................... 2

Quartermaster (Marine Industry).................................................... B

Rabbi............................................................................................... B

Racing Employee............................................................................N

Radio/TV Communications............................................................. B

Radiologist...................................................................................... B

Real Estate Agent........................................................................... B

Real Estate Sales............................................................................ B

Receptionist.................................................................................... B

Recording Engineer......................................................................... B

Recording/Production Owner......................................................... B

Recruiter ........................................................................................ B

Reducing Salon............................................................................... 2

Referee...........................................................................................N

Rehabilitation Therapist................................................................. B

Rental/Leasing Companies............................................................. B

Reporter.......................................................................................... B

Rerecording Mixer ......................................................................... B

Respiratory Therapist..................................................................... B

Restaurants (Owner/Manager)....................................................... B

Restaurants (Other)......................................................................... 2

Rodeo Performer.............................................................................N

Roofer.............................................................................................N

Rug Cleaner.................................................................................... 2

Rug Sales ....................................................................................... B

Sales Management........................................................................ B

Sanitation Worker.......................................................................... 2

School Superintendent................................................................... B

Scrap Metal Dealer........................................................................ B

Screenwriter (freelance).................................................................N

Script Supervisor............................................................................ B

Scriptwriter..................................................................................... B

Sculptor...........................................................................................N

Seamstress (Not in Home).............................................................. B

Secretary......................................................................................... B

Security Alarm System................................................................... B

Security Guard................................................................................N

Set Designer .................................................................................. 2

48


Sheet Metal Worker....................................................................... B

Sheriff.............................................................................................N

Shipping & Receiving Clerk............................................................ B

Shoe Repair.................................................................................... B

Shoe Shine Parlors ........................................................................ 2

Short-wave Radio Operators.......................................................... B

Signs and Billboards (Supervisors)................................................. B

Signs and Billboards (Other)...........................................................N

Silversmith...................................................................................... B

Singer..............................................................................................N

Skating Rink Employee...................................................................N

Skiing Instructor..............................................................................N

Small Appliance Repairer............................................................... B

Sound Mixer/Technician................................................................. B

Speech Therapist............................................................................ B

Sports Team....................................................................................N

Sprinkler/Irrigation System............................................................ B

Stable Owner/Operator.................................................................. B

State Employee..............................................................................**

Steam Fitter.................................................................................... B

Steel Worker, Structural.................................................................N

Steeplejack.....................................................................................N

Stenographer.................................................................................. B

Steward, Stewardesss, Airline.......................................................N

Stock Clerk...................................................................................... B

Stockbroker..................................................................................... 2

Street Cleaner................................................................................. 2

Stucco Worker................................................................................ 2

Studio Engineer/Technician............................................................ B

Subway/Tunnel Construction.........................................................N

Superintendent – Schools.............................................................. B

Supply Clerk.................................................................................... B

Surgeon........................................................................................... B

Surgical Technician......................................................................... B

Surveyor, Not Arial......................................................................... B

Swimming Pool Service.................................................................. B

Switchboard Operator.................................................................... B

Tailors (Not in Home)...................................................................... B

Tanner............................................................................................. 2

Tax Agent/Official...........................................................................N

Taxicab Companies (Office Only).................................................... B

Taxicab Companies (Others)...........................................................N

Taxidermist..................................................................................... B

Teachers.......................................................................................... B

Technical Writer............................................................................. B

Technician....................................................................................... B

Telegraph Operator......................................................................... B

Telemarketer .................................................................................. B

Telephone Answering Service........................................................ B

Telephone Installer......................................................................... B

Telephone Operator........................................................................ B

Television Announcer..................................................................... B

Television Producer, Director.......................................................... B

Television Station Manager........................................................... B

Teller............................................................................................... B

Tennis Club Manager...................................................................... B

Theater Industry Employee.............................................................N

Therapist......................................................................................... B

Therapist (Physical, Speech, Occupational, etc.)........................... B

Tile Setter ....................................................................................... 2

Tire Repairer or Changer................................................................. 2

Title Abstractor............................................................................... B

Title Searcher.................................................................................. B

Tour Guide....................................................................................... 2

Tow Truck Driver............................................................................. 2

Towing Service............................................................................... B

Town Clerk......................................................................................N

Trailer Park Operator....................................................................... B

Transmitter Operator...................................................................... B

Transportation Industry (Rail, Bus, Air): Baggage Handlers,

Porters, Conductors, Engineers, Mechanics,

Track Workers, Other Skilled Workers............................... 2

Transportation Industry (Rail, Bus, Air): Office Duties, Ticket

Agents, Inspectors, Bagging Agents.................................. B

Transportation Industry (Rail, Bus, Air): Station/

Terminal Executives............................................................ B

Transportation Industry (Rail, Bus, Air): Truck Drivers,

Bus Drivers.........................................................................N

Trapper............................................................................................ 2

Trash Collector................................................................................ 2

Travel Agencies.............................................................................. B

Tree Surgeon, Pruner, Trimmer....................................................... 2

Truck Drivers...................................................................................N

Typesetter ....................................................................................... B

Typist............................................................................................... B

Ultrasound Technician.................................................................... B

Umpire............................................................................................N

Undertaker...................................................................................... B

Upholsterer..................................................................................... 2

Usher............................................................................................... 2

Varnisher......................................................................................... B

Vending Machine Worker...............................................................N

Veterinarian.................................................................................... B

Video Arcades................................................................................. 2

Video Machine Repair.................................................................... B

Vocalist...........................................................................................N

Waiters/Waitress........................................................................... 2

Wardrobe Assistant........................................................................ B

Warehouseman.............................................................................. 2

Waste/Water Disposal................................................................... B

Watch Repair.................................................................................. B

Watchman ......................................................................................N

Waterworks Employees.................................................................. B

Weather Observers......................................................................... B

Welder (Ground, Platform).............................................................. 2

Welder (Structural Work)...............................................................N

Welfare Workers............................................................................N

Well Driller..................................................................................... B

Wholesale ...................................................................................... B

Window & Door Installer................................................................ B

Window Decorator......................................................................... B

Window Washer............................................................................. 2

Xenographer................................................................................... B

X-Ray Technician, Inspector, Repair............................................... B

Zoologist......................................................................................... B

49


Disability Income Rider (DIR) – Medical Impairments

Below is a listing of common impairments and the probable action for the Disability Income Riders.

Note: Exclusion riders may not be available for all jurisdictions.

Impairment

Probable Action

Impairment

Probable Action

Abscess............................................................................................. Standard

Adhesions, post-op, abdominal........................................................ Standard

AIDS ....................................................................................................Decline

Alcoholism...........................................................................................Decline

Allergy/allergies (not asthma).......................................................... Standard

Allergic reaction (not asthma).......................................................... Standard

ALS (Lou Gehrigs Disease)..................................................................Decline

Alzheimers disease..............................................................................Decline

Amputations, if not due to peripheral vascular disease........ Exclusion Rider

................................................................................................or Decline

Anemia.................................................................................................Decline

Aneurysm, abdominal

Present........................................................................................Decline

History(with surgical repair).........................Exclusion Rider or Decline

Aneurysm, cerebral..............................................................................Decline

Angina pectoris....................................................................................Decline

Anxiety, mild....................................................................Standard or Decline

Aortic insufficiency murmur.................................................................Decline

Appendectomy; appendicitis; appendix........................................... Standard

Atrial fibrillation...................................................................................Decline

Arthritis, osteo.......................................................Exclusion Rider or Decline

Arthritis, rheumatoid...........................................................................Decline

Arthoscopic knee surgery

Within one year............................................................. Exclusion Rider

After one year – full recovery.................... Standard or Exclusion Rider

Asthma (depends on age, attacks, medications)........ Exclusion Rider or Decline

Back disorder.........................................................Exclusion Rider or Decline

Bartholin cyst.................................................................................... Standard

Bells palsy

Fully recovered......................................................................... Standard

Present..........................................................Exclusion Rider or Decline

Blindness (depends on cause)................................................ Exclusion Rider

Bone or joint disorder............................................Exclusion Rider or Decline

Bone spur

Present........................................................................... Exclusion Rider

Surgically corrected................................................................. Standard

Breast disorders, not cancer............................... Standard or Exclusion Rider

Broken bone

Fully recovered........................................... Standard or Exclusion Rider

Not recovered or pins/plates inserted.........Exclusion Rider or Decline

Bronchiectesis (depends on severity)....................Exclusion Rider or Decline

Bronchitis (acute).............................................................................. Standard

Bronchitis (chronic)................................................Exclusion Rider or Decline

Bundle branch block, right/incomplete............................................ Standard

Bundle branch block, right/complete..............................Standard or Decline

Bundle branch block, left/complete....................................................Decline

Bursitis...................................................................Exclusion Rider or Decline

Cancer, internal....................................................................................Decline

Cancer, skin, not melanoma (removed-recovered)................. Exclusion Rider

Cancer, skin, melanoma.......................................................................Decline

Cartilage – torn

Present........................................................................... Exclusion Rider

Fully recovered........................................... Standard or Exclusion Rider

Cataracts

No surgery or surgery on one eye................................. Exclusion Rider

Bilateral surgery...................................................................... Standard

Cerebral palsy......................................................................................Decline

Cerebral vascular accident (CVA), stroke............................................Decline

Cervicitis........................................................................................... Standard

Chronic fatigue syndrome ...................................................................Decline

Chronic obstructive lung disease (COPD)............................................Decline

Cirrhosis of the liver............................................................................Decline

Colitis, spastic.................................................... Standard or Exclusion Rider

Colitis, ulcerative (full details)...............................Exclusion Rider or Decline

Concussion, cerebral

Within six months.................................................................... Postpone

After six months – no residuals................ Standard or Exclusion Rider

Congestive heart failure......................................................................Decline

Convulsions..........................................................................................Decline

Coronary artery disease.......................................................................Decline

Crohns disease....................................................................................Decline

Cyst-sebaceous, Bartholin................................................................ Standard

Cystic fibrosis.......................................................................................Decline

Cystitis.............................................................................................. Standard

Cystocele, rectocele

Surgically corrected................................................................. Standard

Present........................................................................... Exclusion Rider

D & C (dilatation and curettage) – begin results

First year.......................................................Exclusion Rider or Decline

After on year – no recurrence................................................. Standard

Depression...........................................................................................Decline

Dermatitis – atopic........................................................................... Standard

Diabetes mellitus.................................................................................Decline

Dislocation

One occurrence – fully recovered............................................ Standard

Others............................................................................ Exclusion Rider

Diverticulitis and diverticulosis.............................Exclusion Rider or Decline

Drug abuse...........................................................................................Decline

Eczema.............................................................................................. Standard

Elbow – tennis

Acute attack – first year................................................ Exclusion Rider

After one year – no recurrence................. Standard or Exclusion Rider

Emphysema (full details).....................................................................Decline

Endocarditis(over 3 years – no residuals)........................................ Standard

Epilepsy................................................................................................Decline

Esophageal stricture, good nutrition.....................Exclusion Rider or Decline

Eye disorder (minor) – i.e. pink eye, conjunctivitis, stye.................. Standard

Fibrositis, myositis – present..............................................................Decline

Fibromyalgia........................................................................................Decline

Fistula and fissure, anal...................................... Standard or Exclusion Rider

Fractured skull, no after effect......................................................... Standard

Fracture (other than skull)

Full Recovery............................................................................ Standard

Not recovered or pins/plates inserted.........Exclusion Rider or Decline

Gall bladder disorder

Present..........................................................Exclusion Rider or Decline

Surgically corrected................................................................. Standard

50


Gastroenteritis.................................................................................. Standard

Genitourinary disorder

Minor bladder or cervical infections....................................... Standard

Glaucoma...............................................................Exclusion Rider or Decline

Gout ....................................................................................... Exclusion Rider

GERD (gastro-esophageal reflux disease)........................................ Standard

Hay fever – seasonal, no disability.................................................. Standard

Headache, migraine, sinus and tension................................. Exclusion Rider

Hearing impaired.................................................................... Exclusion Rider

Heart attack.........................................................................................Decline

Heart bypass surgery...........................................................................Decline

Heart valve replacement.....................................................................Decline

Heartburn.......................................................................................... Standard

Hemorrhoids..................................................................................... Standard

Hepatitis, acute (depends on cause)

0-3 months from onset............................................................ Postpone

4 months and thereafter...............................Exclusion Rider or Decline

Hepatitis A........................................................................................ Standard

Hepatitis, chronic

Hep. B.........................................................................................Decline

Hep. C.........................................................................................Decline

Hernia....................................................................Exclusion Rider or Decline

Herniated disc......................................................................... Exclusion Rider

High blood pressure – controlled..................................................... Standard

Hip disorder...........................................................Exclusion Rider or Decline

Histoplasmosis, nonsystemic, six months after recovery................ Standard

Histoplasmosis, systemic, two years after recovery........................ Standard

................................................................................... or Exclusion Rider

Hodgkins disease.................................................................................Decline

Hydronephrosis (depends on cause)......................Exclusion Rider or Decline

Hysterectomy

Definitely benign...................................................................... Standard

Others (full details and pathology)...............Exclusion Rider or Decline

Ileitis, regional.....................................................................................Decline

Indigestion........................................................................................ Standard

Kidney failure, dialysis........................................................................Decline

Kidney infection (pyelonephritis)

Ok if no recurrence in two years............................................. Standard

Kidney removal (depends on cause)................................Standard or Decline

Kidney stones..................................................... Standard or Exclusion Rider

Leukemia..............................................................................................Decline

Ligament injury – full recovery........................... Standard or Exclusion Rider

Lou Gehrigs Disease – ALS.................................................................Decline

Lupus, systemic...................................................................................Decline

Lupus, discoid (skin only).................................................................. Standard

Lymphoma............................................................................................Decline

Malaria – single attack.................................................................... Standard

Mastitis, chronic cystic....................................... Standard or Exclusion Rider

Melanoma............................................................................................Decline

Menieres disease................................................................... Exclusion Rider

Meningitis (full recovery).................................................................. Standard

Menisectomy.......................................................................................Decline

Mental retardation..............................................................................Decline

Mitral insufficiency murmur................................................................Decline

Mitral stenosis murmur.......................................................................Decline

Mitral valve prolapse.......................................................Standard or Decline

Mononucleosis (infectious)

Uncomplicated recovery, prompt recovery.............................. Standard

Multiple sclerosis................................................................................Decline

Myasthenia gravis...............................................................................Decline

Myocarditis, single episode, over 1 year, no residuals.................... Standard

Myositis, fibrositis...............................................................................Decline

Muscular dystrophy.............................................................................Decline

Nephrectomy (depends on cause)...................................Standard or Decline

Nephritis

Single episode and no complications........ Standard or Exclusion Rider

Others.........................................................................................Decline

Neurosis...............................................................................................Decline

Organic brain syndrome.......................................................................Decline

Osteomyelitis, recovered..........................................Possible Exclusion Rider

Pacemaker...........................................................................................Decline

Pancreatitis..........................................................................................Decline

Paraplegic............................................................................................Decline

Parkinsons disease..............................................................................Decline

Pericarditis (depends on cause).............................Exclusion Rider or Decline

Peripheral vascular disease.................................................................Decline

Pharyngitis........................................................................................ Standard

Phlebitis

Full recovery................................................................... Exclusion Rider

Multiple episodes (depends on cause).......................................Decline

Pilonidal cyst..................................................................................... Standard

Pleurisy

Single episode and recovered................................................. Standard

Others.........................................................................................Decline

Pneumoconiosis (depends on cause).....................Exclusion Rider or Decline

Pneumonia

Present..................................................................................... Postpone

Full recovery, no further work up needed................................ Standard

Pregnancy – current

No current or past complications............................................ Postpone

With history of complications......................Exclusion Rider or Decline

Prostatitis

Acute episode – no recurrence for 3 years............................. Standard

Recurrent/chronic.........................................Exclusion Rider or Decline

Psychosis.............................................................................................Decline

Pyelonephritis

Acute episode, full recovery, no recurrence

for two years............................................................................ Standard

Multiple episodes.........................................Exclusion Rider or Decline

Quadriplegic.........................................................................................Decline

Raynauds disease (full recovery – over five years).......................... Standard

Raynauds phenomenon (depends on cause).........Exclusion Rider or Decline

Rheumatic fever, no heart damage.................................................. Standard

Rheumatism............................................................................ Exclusion Rider

Sarcoidosis..........................................................................................Decline

Sebaceous cyst – removed............................................................... Standard

Sciatica................................................................................... Exclusion Rider

Sinusitis............................................................................................ Standard

Sleep Apnea........................................................................................Decline

Strabismus (cross-eyed)................................................................... Standard

Stroke...................................................................................................Decline

Suicide attempt...................................................................................Decline

Tennis elbow

Acute attack – first year................................................ Exclusion Rider

After one year – no recurrence............................................... Standard

Thyroid disorder

Hyperthyroid – if medically stable................................ Exclusion Rider

Hypothyroid – controlled with medication.............................. Standard

Transient ischemic attack (TIA)...........................................................Decline

Transurethral resection of prostate (TURP)

Malignancy ruled out................................. Standard or Exclusion Rider

Tuberculosis (full recovery)..............................................Standard or Decline

Tumors (not cancer), outside nervous system.................Standard or Decline

Ulcer ....................................................................................... Exclusion Rider

Upper respiratory infection............................................................... Standard

Urinary bladder infection (cystitis – acute)...................................... Standard

Varicocele, hydrocele........................................................................ Standard

Vasectomy......................................................................................... Standard

Varicose veins...........................................................Possible Exclusion Rider

51


Alliance Solutions Select Term (Policy Form #TL03 1005), Alliance

Solutions Advantage Term (Policy Form #TL12 0709) are level term

insurance policies, and Alliance Solutions UL (Policy Form #UL01

1005), WRL Freedom Index Universal Life (Policy Form # EIUL02

0707) and WRL Freedom Global IUL SM (Policy Form # IUL03 1208)

are universal life insurance policies, all issued by Western Reserve Life

Assurance Co. of Ohio, Columbus, OH.

Policy and rider form numbers may vary, and these products

may not be available in all jurisdictions. Insurance eligibility and

premiums are subject to underwriting.

PRODUCER USE ONLY.

NOT FOR PUBLIC DISTRIBUTION.

Home Office: Columbus, OH

Administrative Office: 4333 Edgewood Road NE

Cedar Rapids, Iowa 52499

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