Frequently Asked Questions & Answers
If you do not see your question answered below, please contact us using
the "Contact Us" link above.
Use the Quick Links to jump to different sections of the FAQ.
Life Products Questions and Answers
 How much life insurance does my client need?
 The main reason many people purchase a life insurance policy is to replace income lost in the event of death of the insured, often the main bread-winner of the household. Your age and current income level have a direct bearing on your insurance needs. Generally, the younger you are, the more years of income you need to protect. Experts have recommended that you purchase 5-10 times your current annual income level. However, this does not take into consideration current assets or special needs you and your family may have. When considering purchasing a life insurance policy, we recommend that you keep the following examples in mind:
- Your current income level
- Number of years this income will be needed
- The annual interest percentage your investments will earn
- College tuition and related costs
- Hospital, funeral and burial costs
- Retirement needs
- Other special needs for family members
How is my clients "underwriting Class" and resulting rate determined?
Every insurance company uses their own criteria to determine which underwriting class (also called your "Health Class") you fall into and the resulting rates for that classification. It is entirely possible to have one company class you as "Standard" and another company to class you as "Preferred." Whether you are a smoker or non-smoker also plays an important role in your classification.
In order to receive the "Preferred Best" rates, you must be in excellent overall health and lead a healthy lifestyle. Each company determines their limits on weight to height ratios, cholesterol, blood pressure and 'acceptable' health issues. Your family health history is also a factor in qualifying for the lowest preferred rates. You must not use tobacco in any form, must not have a history of substance abuse and you may not be involved in any kind of hazardous activity (i.e. skydiving, scuba, rock climbing, etc.).
How long will this take?
The insurance company cannot begin underwriting your policy until you have completed a free medical exam and they have received a signed application. Generally it takes three to four weeks to complete this process. If the insurance company has to get your doctor's records it will generally take 4 to 7 weeks since the insurance company has to depend upon your doctor's promptness in providing them the records they need.
What are the advantages and disadvantages of term insurance?
Advantages:
- Initial premiums generally are lower than those for permanent insurance, allowing you to buy higher levels of coverage at a younger age when the need for protection often is greatest
- It's good for covering needs that will disappear in time, such as mortgages or car loans.
Disadvantages:
- Premiums increase as you grow older.
- Coverage may terminate at the end of the term or become too expensive to continue.
- The policy generally doesn't offer cash value or paid-up insurance.
What are the advantages and disadvantages of permanent insurance?
Advantages:
- As long as the premiums are paid, protection is guaranteed for life.
- Premium costs can be fixed or flexible to meet personal financial needs.
- The policy accumulates a cash value against which you can borrow. (Loans must be paid back with interest or your beneficiaries will receive a reduced death benefit.) You can borrow against the policy's cash value to pay premiums or use the cash value to provide paid-up insurance.
- The policy's cash value can be surrendered -- in total or in part -- for cash or converted into an annuity. (An annuity is an insurance product that provides an income for a person's lifetime or a specified period.)
- A Provision or "rider" can be added to a policy that gives you the option to purchase additional insurance without taking a medical exam or having to furnish evidence of insurability
Disadvantages:
- Required premium levels may make it hard to buy enough protection.
- It may be more costly than term insurance if you don't keep it long enough.
Individual Health Questions and Answers
When does Central Ohio Group need to receive a completed case in order to get the requested effective date?
Anthem requires that the case be in their home office by the requested effective date, therefore, We needs to receive the case 2 days prior to the requested effective date.
MMOH will honor any requested effective date as long as the case is received within 5 days of that date. They will not, however, issue an effective date of the last 10 days of any quarter except for a qualifying event (see Producer Guidelines).
CRL will give a first of the month effective date as long as they receive the case in their office by the 5th of the month. Otherwise, the earliest effective date available is the date they receive the case in their office.
Do I need to submit a binder check with each case?
Neither MMO nor Anthem requires a binder check with a case. If a binder check is submitted with an MMO case, it will be returned. The client will be billed upon approval. CRL still requires a binder check to be submitted with all cases.
Can an employer pay the premium for an individual policy?
CRL, Anthem , and MMO will allow employees of a company to be list billed to their employer. However, the only legal way for an employer to pay the premium is through payroll deduct or a Section 105 Health Reimbursement Account.
Can clients save money by paying quarterly or semiannually?
Anthem and MMO do not charge administrative fees, so the premium will not change regardless of the billing method chosen. CRL does offer a $10/month savings for monthly bank draft and quarterly billing.
Can I write a child-only policy?
Anthem and MMO will accept child-only cases. The child is to be listed as the contract holder and a separate application is required for each child. CRL no longer writes child-only policies.
Are maternity benefits available on individual policies?
Both Anthem and MMO offer maternity benefits with their policies for an additional charge. Anthem will charge all female dependents on the policy over the age of 14 for the maternity rider. If you receive your quotes directly from Central Ohio Group, rates for maternity will not be included unless specifically requested. CRL does not offer maternity benefits.
Can a client make plan changes after the policy has been issued?
As a general rule, plan changes are not allowed until renewal once a case has been issued. Under extreme circumstances, the carrier may make an exception. A request must be made in writing by the client requesting the change and the reasons for the request. Underwriting will review each case and make a final decision, normally within 1-2 weeks.
Group Health Questions and Answers
When does my case need to be received by Central Ohio Group to hold the requested effective date?
Central Reserve Life, Medical Mutual of Ohio and Unitedhealthcare – by requested effective date Anthem – 5 days prior to the requested effective date
Do I need to submit a premium check with the initial enrollment?
Yes.
Do employees taking life only need to answer medical questions?
Central Reserve Life - YES
Medical Mutual of Ohio and Unitedhealthcare of Ohio - NO
Anthem - for 2-19 eligible, only if applying for amounts greater than $30,000
Anthem -
For 20+ eligible, only if applying for amounts greater than $50,000
What information does Central Ohio Group need to provide a quote for 51-99 eligible employees?
Appropriate carrier Risk Assessment Form completed by employer, census of eligible employees, copy of current renewal showing 2 years of rates, benefits and enrollment (Note: for an Anthem quote, must have a copy of most recent bill.)
What constitutes a full-time eligible employee?
Ohio employers – 25 hours per week
West Virginia employers – 30 hours per week
(Note: Medical Mutual will allow the employer to go down to 20 hours per week)
What tax documents can be used for new group submissions?
If the group files an OBES and all applicants are accounted for, no other tax documents are needed
If all applicants are not on OBES:
q: Are applicants 1099?
a: Not eligible for group coverage in most cases
q: Are applicants owners?
a: Need letter on company letterhead stating hours worked per week.
q: Were applicants hired after OBES period?
a: Review dates for reasonableness.
q: Are applicants on COBRA or continuation of coverage?
a: Must be accounted for on Group Application
q: Are applicants out of state employees?
a: Obtain out of state quarterly wage report.
If the group does not file OBES:
q: Is the group a sole proprietor?
a: Obtain Schedule C.
q: Is the group a partnership?
a: Obtain Form 1065 and K-1's.
q: Is the group incorporated?
a: If a C-corporation, obtain Form 1120.
If an S-corporation, obtain Form 1120 and accompanying K-1's.
q: Is the group a religious entity?
a: Obtain Payroll Register.
If the group has no tax documentation at all due to new business formation:
Obtain Payroll Register if they have W-2 employees.
If no Payroll Register, contact appropriate Southeastern Agency sales rep for further discussion.
|
