Fillable Life Insurance Underwriting Guide 31621 Final (New York Life)

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Life Insurance Underwriting Guide 31621 Final (New York Life)

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Life Insurance
Underwriting Guide
This guide lists all the standard operating guidelines.
For COVID-19 guidelines, please reference the Field News published on Agency Portal.
For Internal Use Only. Not for Distribution to the General Public.
For Internal Use Only. Not for Distribution to the General Public.
Life Insurance
Underwriting Guide
Table ofcontents
I
ntroduction _______________________________________________________________________________ 1
New York Life’s Underwriting Mission __________________________________________________________ 1
Field Underwriter’s responsibility ______________________________________________________________ 1
Underwriter’s responsibility __________________________________________________________________ 1
The life insurance application _________________________________________________________________ 1
Telephone Application (TeleApp) ______________________________________________________________ 1
Life Insurance Fast Track (LIFT) ________________________________________________________________ 2
Additional Oer Program (AOP) _______________________________________________________________ 2
Disability Waiver of Premium (WP) _____________________________________________________________ 3
Accidental Death Benet (ADB) _______________________________________________________________ 3
Chronic Care Rider (CIR – California) ___________________________________________________________ 3
Policy Purchase Option Rider (PPO) ____________________________________________________________ 4
Juvenile Insurance __________________________________________________________________________ 4
Military ___________________________________________________________________________________ 5
Foreign National or Foreign Residents __________________________________________________________ 5
Medical impairment information ______________________________________________________________ 5
Telephone Interview Reports (TIRs) ____________________________________________________________ 5
IRS Form 4506-T ___________________________________________________________________________ 5
Motor Vehicle Reports (MVRs) ________________________________________________________________ 6
Prescription Histories _______________________________________________________________________ 6
Attending Physician Statements (APS) /Medical Records __________________________________________ 6
Meaningful APS / Medical Records _____________________________________________________________ 6
Cover letters ______________________________________________________________________________ 6
New York Life TeleApp Underwriting Chart _____________________________________________________ 7
New York Life Underwriting Chart _____________________________________________________________ 8
Asset Flex AD119 Underwriting Chart __________________________________________________________ 9
Asset Flex AD120 Underwriting Chart ________________________________________________________ 9
Risk Classification Chart ____________________________________________________________________ 10
Income replacement guidelines ______________________________________________________________ 11
Body Mass Index __________________________________________________________________________ 11
Calculating BMI ___________________________________________________________________________ 11
Reinsurance ______________________________________________________________________________ 11
New York Life retention limits ________________________________________________________________ 12
Informal inquiries __________________________________________________________________________ 13
Table of
contents
1
For Internal Use Only. Not for Distribution to the General Public.
Introduction
This underwriting guide is designed to provide you with a comprehensive reference tool to our underwriting
process and it was developed to assist you with the application process. All underwriting rules are subject to
change; therefore, this guide will be refreshed as necessary. To ensure you have the latest underwriting charts and
guidelines, please refer to Agency Portal or contact your underwriting zone ocer.
New York Life’s Underwriting Mission
New York Life’s underwriting mission is to put good business on the books while providing professional
and consistent underwriting service in a timely and ecient manner. This philosophy will contribute to
New York Life’s long-term growth, while at the same time, protect its long-term nancial integrity.
Field Underwriter’s responsibility
One of the primary responsibilities of an agent is to be an eective eld underwriter. The eld underwriter is required
to gather and record accurate and thorough responses to each question on the application. The eld underwriter is
also responsible for providing the company’s Privacy and Information Practices brochures to the client.
Underwriter’s responsibility
The underwriter’s primary responsibility is to provide fair and consistent underwriting decisions that protect the
company’s nancial integrity while accepting prudent risks that serve in the best interests of our policyholders.
The underwriter is responsible for evaluating and categorizing each client’s risk based on medical and nonmedical
information gathered by the agent on the application and from other sources (TeleApp, MVR, MIB, etc).
The life insurance application
The applicati
on is a legal document that represents an agreement between the policy owner and New York Life. As
such, there are rules that must be followed in order to maintain the integrity of the contract:
• Ask each question as stated on the application
• Develop an environment with the client to provide accurate, detailed information
• Obtain the correct state HIV Notice and Consent and replacement forms
• Make sure all parties sign the application
A complete application results in a faster processing time. Missed questions or incomplete information could result
in delays for both you and your client. When possible, use eApp to avoid applications not in good order.
Telephone Application (TeleApp)
TeleApp is an e
cient way for clients to complete the life insurance application Part 2 over the phone. For most
products, Part 2 of the application can be completed through the TeleApp process for clients of all ages and for
all face amounts. (The following are excluded from TeleApp: Employee's Whole Life (EWL), informal inquiries and
contract changes.)
A TeleApp Call Center representative will ask the client the personal and health history questions as stated on the
application along with additional follow-up questions related to admitted medical conditions, record their answers,
and submit the completed Part 2 directly to Underwriting.
TeleApp eliminates cases of “not in good order” due to missing information and reduces follow-up requests to the
agent due to the additional detail collected by the TeleApp representative.
Table of
contents
2
For Internal Use Only. Not for Distribution to the General Public.
Please note that TeleApp is required for new cases with Total Amounts at Risk (TAARs) from $50,000 up to
$99,999, ages 18 through 69, employees of restaurants, nail salons and massage parlors, and applications
submitted through the Additional Oer Program (AOP).
Being well-prepared for the TeleApp interview makes for the best customer experience. In order to help the
interview go smoothly, clients should be prepared and have the following information available:
• Doctors’ names and locations, dates of diagnosis and treatment for the last 10 years
• Prescribed medications and how often they are taken
• Income and Net Worth
• Employment details, employer name, length of employment and job duties
• Details of any foreign travel planned in the next 12 months
• Any adventurous activities (scuba diving, mountain climbing, etc.)
Be sure to properly indicate the primary language and/or dialect your client speaks to ensure that the proper
language interpreter is on the line.
• Phone Number: 1-866-NYL-TAPP/866-695-8277
Life Insurance Fast Track (LIFT):
LIFT is a program that allows certain applicants to bypass the expanded blood draw (EBD) based on data from
traditional underwriting requirements (e.g. Medical Information Bureau, Motor Vehicle Report, Prescription
history and TeleApp). Eligibility parameters are as follows:
• Insured is age 18-39 in all 50 states and DC
• Face amounts (2 year total amount at risk) $100,000 - $1,000,000 in all 50 states and DC
• Insured is age 40-49 in DC and all states except for NY
• Face amounts $100,000-$500,000 in DC and all states except for NY
• All term, whole life and universal life products (EWL, Asset Flex and other guaranteed/simplied issue and hybrid
products are not eligible for LIFT)
• Policies issued via NYL LIFT will not be eligible for the Additional Oer Program (AOP)
• Will buys not available for LIFT
Additional Oer Program (AOP):
The Additional Oer Program (AOP) allows clients who have purchased fully underwritten coverage with NYL and
within the past 36 months to purchase an additional 100% of the original face amount of coverage on a limited
underwriting basis. The original policy MUST:
• Be a minimum of $100,000 face amount
• Be standard or better risk class (select preferred, preferred II, preferred, nonsmoker, select standard, standard)
• Be issued at ages 18 through 60
• Program includes all products except single premium products, EWL and Asset Flex
• Conversions, PPO, GIO or prior additional oer cases are not eligible for this program
• This is not a guaranteed issue program
Table of
contents
3
For Internal Use Only. Not for Distribution to the General Public.
Disability Waiver of Premium (WP)
The Disability Waiver of Premium (WP) rider provides that premiums for the policy will be waived after proof is
furnished that the insured has become totally disabled and that total disability has continued for at least 6 months.
In addition, an appropriate premium refund will be made for any period after the eective date of disability for which
premiums have been paid.
Disability Waiver of Premium has total face amount maximums:
• Ages 0 to 40 total face amount maximum is $5M
• 41to 59 total face amount maximum is $4M
Accidental Death Benet (ADB)
This rider provides that an Accidental Death Benet will be paid to the beneciary upon receiving proof that the
insured’s death was caused directly, and apart from any other cause, by accidental bodily injury and that death
occurred within one year after the injury. ADB is not available on term riders, nor is the benet payable under this
rider if the death occurs before the insured’s rst birthday or after the policy anniversary when the insured is age 70.
ADB max amount:
• Maximum amount of ADB is $300,000 per life, except policies over $1,000,000
• For policies over $1,000,000, the maximum is 30% of the death benet up to $500,000 per life not per policy
• Must not exceed the face amount of the policy
Chronic Care Rider (CIR – California)
The Chronic Care Rider is designed to protect policyholders from the nancial hardships of chronic care. The rider
provides tax-free acceleration of the death benet of a life insurance policy based on the insured becoming chronically
ill for a minimum of ninety (90) days (insured cannot perform 2 of 6 activities of daily living or has a severe cognitive
impairment). The 6 daily living activities are: Bathing, dressing, eating, toileting, transferring, or continence.
• Oers tax free acceleration of a portion of the policy’s base face amount in case the insured becomes permanently
chronically ill.
• Available on WL, CWL, CULG and EWL
• Only available at time of issue
• Policy must have LBR
• Minimum base plan face amount is $100,000
• Minimum rider face amount is $90,000
• Maximum base plan face amount is $1,000,000
Table of
contents
4
For Internal Use Only. Not for Distribution to the General Public.
Policy Purchase Option Rider (PPO)
The Policy Purchase Option Rider gives clients the opportunity to purchase additional coverage without evidence
of insurability. The rider allows you to purchase a new policy every three years on your policy’s anniversary date.
These scheduled option dates are the policy anniversaries when the insured’s age is 22, 25, 28, 31, 37, 40, 43, and
46. The option is not available after age 46.
• Products featuring rider: Custom Whole Life, Whole Life, Level Premium Convertible Term 10-20, and Yearly
convertible Term
• The rider must be selected upon issue of the original policy. Some illnesses or occupations may disqualify
applications for coverage or make premiums more expensive.
• Charges for the Policy Purchase Option Rider will vary based on the payer’s risk class and face amount.
• Lifetime maximum PPO for a PI is $150,000
• Answer Smoker question / Part 2 to get a non-smoker rating when exercising PPO
Age at Original
Policy’s Issue
N
umber of
Options Left
Option Available
at These Ages
M
aximum Option Amount*
at Each Option Date is the
Lesser of:
0-21 9 22, 25, 28, 31, 34, 37, 40, 43, 46 $150,000 or 5X face amount
22-24 8 25, 28, 31, 34, 37, 40, 43, 46 $150,000 or 2X face amount
25-27 7 28, 31, 34, 37, 40, 43, 46 $150,000 or 2X face amount
28-30 6 31, 34, 37, 40, 43, 46 $150,000 or 2X face amount
31-33 5 34, 37, 40, 43, 46 $150,000 or 2X face amount
34-36 4 37, 40, 43, 46 $150,000 or 2X face amount
37 3 40, 43, 46 $150,000 or 2X face amount
38-39 3 40, 43, 46 $150,000 or 2X face amount
40-42 2 43, 46 $150,000 or 1X face amount
43 1 46 $150,000 or 1X face amount
* If you wish, you can select an option amount smaller than the maximum option amount shown above as long as it is at least $25,000. In determining the maximum
option amount, in-force insurance must be taken into account. Ask your New York Life agent to help you determine the maximum option amount for each policy.
Juvenile Insurance
Juveniles are dened as clients 0 to 17 years of age. For juvenile insurance the parents should have at least the
same amount of insurance in force or pending as applied for the child, unless the parent is uninsurable. All siblings
should have the same amount of insurance in force or applied for.
If the jurisdiction of the policy is NY, then the NY 2x4x rule applies on juveniles.
• For children aged 4 years 6 months and under, the child’s coverage must be no more than 25% of the amount of
life insurance in force on the parent/guardian owner.
• For children aged over 4 years 6 months to 14 years 6 months, the child’s coverage must be no more than 50% of
the amount of life insurance in force on the parent/guardian owner.
• Only the amount of insurance coverage on the parent/guardian who owns the policy may be considered.
• If both parents own the policy, the amount of coverage may be combined in determining the amount for the child.
• If there is no coverage on the owner/parent, the maximum allowable coverage is $50,000.
• When a grandparent is named owner, the NY state regulation does not apply, but it is expected that the parents
should have at least an equal amount of insurance in force.
Table of
contents
5
For Internal Use Only. Not for Distribution to the General Public.
Military
It is acceptable for agents to write active military personnel.
• Select Preferred, Preferred, Preferred II are available if otherwise qualied with the exception of those engaged in
high risk specialties
• Military aviation or deployment to a war zone can be considered, however, the maximum allowable coverage is
$100,000 (except for VA residents)
Foreign Nationals or Foreign Residents
For detailed guidelines on Foreign Nationals and/or Residents you can access the “Foreign Nationals Guide” on
Agency Portal or contact your underwriting zone ocer.
Medical Impairment Information
If the proposed insured has a known medical condition and you would like to make a preliminary assessment, please
reference the Agent’s Medical Underwriting Guide or contact your underwriter with the following information:
• Specic diagnosis of the impairment
• Date of diagnosis or onset
• Treatment, including date and specic medication prescribed or procedure performed
• Frequency and duration of episodes
• Date of most recent episode
• Tests completed, including date and results
• Date of the last visit to the treating physician
• Full recovery date
Telephone Interview Reports (TIRs)
The Telephone Interview Report (TIR) is an in-house service provided on cases not using TeleApp with total risk
amounts of $500,000 ($2,500,001 for select agents) and above
Note:
• TIRs may be randomly conducted on cases below $500,000
• Amounts over $5,000,000 require external nancial conrmation
To ensure smooth TIR processing:
• Inform your client that he or she will receive a call from a New York Life representative (at the phone number and
best time to call provided on the application)
• During the call, your client will be asked a range of questions (i.e. employment, nancial, medical history, etc.) all
responses will be condential and used only for underwriting purposes
• Be sure to properly indicate the primary language and/or dialect your client speaks on the application to ensure
that the proper language interpreter is on the line.
IRS Form 4506-T
An IRS Form 4506-T is required on all proposed insureds age 65 and older with a total risk of $250,000 or more and
may be requested on other cases for cause. Form 4506-T is also required at all ages when the face amount is equal
to or over $5,000,000.
This form allows a copy of the proposed insured’s tax returns from the past two years to be obtained directly from
the IRS.
Table of
contents
6
For Internal Use Only. Not for Distribution to the General Public.
Age at Application Amount
0–29 years* $1,000,001 and over
30–40 years old $1,000,000 and over
41–45 years old $500,000 and over
46–50 years old $250,000 and over
51–65 years old $200,000 and over
66–69 years old $50,000 and over
70 years old and over All amounts
*Medical records are required at all amounts for insured younger than 24 months who were born prematurely.
We only accept medical records secured through an approved NYL vendor.
Motor Vehicle Reports (MVRs)
A Motor Vehicle Report (MVR) will be obtained on all cases (except SPUL and EWL) with a total risk amount of
$100,000 and more, at issue ages 16 and over. No action required from the agent; Underwriter will order MVRs.
Prescription Histories
A prescription history will be obtained on all applications for proposed insureds age 18 and older with a total risk
of $50,000 or more and may be requested on other applications for cause. No action required from the agent;
Underwriter will order the prescription history.
Attending Physician Statements (APS) / Medical Records
An APS or medical records may be obtained for cause at the underwriter’s discretion. A routine age and
amount APS, however, will be requested under the following circumstances:
Cover Letters
Cover letters are especially helpful to an underwriter and should be used whenever you feel there is information
that may need clarication. This is your opportunity to provide greater detail to help the underwriter better
understand the risk presented by your prospective client.
Example of details to include are:
• How well you know the client
• How the sale developed, the purpose of insurance, and the determination of face amount
• Unusual or extensive medical histories or nancial situations
• Clarication of an unusual beneciary or ownership arrangement
• Discussions with the underwriter prior to the application submission
• If there are other insurers involved or if the case is known to be substandard
• Any information that may be unclear on the application
• Foreign National/Recent immigrants employed overseas – refer to Foreign Guide for more info (ref. agency portal)
Meaningful APS/Medical Records
A meaningful APS contains records that demonstrate a proposed insured has established ongoing medical care.
For proposed insureds age 60 and older, a meaningful APS is required, and the lack of such may result in adverse
underwriting action.
Table of
contents
7
For Internal Use Only. Not for Distribution to the General Public.
Amount Ages 0–17 Ages 18–29 Ages 30–39 Ages 40–49 Ages 50–59 Ages 60–69 70 and over
$0–$49,999 TeleApp TeleApp TeleApp TeleApp TeleApp TeleApp TeleApp
$50,000–
$99,999
TeleApp TeleApp TeleApp TeleApp TeleApp TeleApp TeleApp,
EBD, ECG
$100,000–
$250,000
TeleApp TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp,
EBD, ECG
TeleApp,
EBD, ECG,
Sr. Supp
$250,001–
$500,000
TeleApp TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp,
EBD, ECG
TeleApp,
EBD, ECG,
Sr. Supp
$500,001–
$1,000,000
TeleApp TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp, EBD,
ECG
(if smoker)
TeleApp,
EBD, ECG
TeleApp,
EBD, ECG,
Sr. Supp
$1,000,001–
$2,500,000
TeleApp TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp,
EBD, ECG
TeleApp,
EBD, ECG
TeleApp,
EBD, ECG,
Sr. Supp
$2,500,001–
$5,000,000
TeleApp TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp,
EBD, ECG
TeleApp,
EBD, ECG
TeleApp,
EBD, ECG,
Sr. Supp
$5,000,001–
$10,000,000
TeleApp
TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp,
EBD, ECG
TeleApp,
EBD, ECG
TeleApp,
EBD, ECG,
Sr. Supp
$10,000,001
and over
TeleApp TeleApp, EBD TeleApp, EBD TeleApp, EBD TeleApp,
EBD, ECG
TeleApp,
EBD, ECG
TeleApp,
EBD, ECG,
Sr. Supp
New York Life TeleApp Underwriting Chart
Legend
Expanded Blood Draw(EBD): Blood draw, urine, physical measurements, and minimal medical history questions.
Senior Supplement (Sr.Supp): Cognitive and physical function test.
For ECG, smokers are dened as individuals who have smoked cigarettes within the previous 12 months.
Note:
For non-TeleApp age and amount requirements, see the chart on page 8. (TeleApp is required at ages 18-69,
amounts of $50,000 to $99,999.)
For Asset Flex age and amount requirements, see the chart on page 9.
TeleApp is required for employees in the following industries: restaurants, nail salons, and massage parlors.
Attending Physician Statements (APSs)
Age at Application Amount
0–29 years* $1,000,001 and over
30–40 years old $1,000,000 and over
41–45 years old $500,000 and over
46–50 years old $250,000 and over
51–65 years old $200,000 and over
66–69 years old $50,000 and over
70 years old and over All amounts
* An APS is required at all amounts for insureds younger than 24 months old who were born prematurely.
Table of
contents
8
For Internal Use Only. Not for Distribution to the General Public.
New York Life Underwriting Chart
Amount Ages 0–14 Ages 15–17 Ages 18–29 Ages 30–39 Ages 40–49 Ages 50–59 Ages 60–69 70 and over
$0–$49,999 Part 2 –
Section C
Part 2 –
Section A+B
Part 2 –
Section A+B
Part 2 –
Section A+B
Part 2 –
Section A+B
Part 2 –
Section A+B
Part 2 –
Section A,
Paramed,
Urine
Part 2 –
Section A,
Paramed,
Urine
$50,000–
$99,999
Part 2 –
Section C
Part 2 –
Section A+B
TeleApp TeleApp TeleApp TeleApp TeleApp Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
$100,000–
$250,000
Part 2 –
Section C
Part 2 –
Section A+B
Part 2 –
Section A+B,
EBD
Part 2 –
Section A+B,
EBD
Part 2 –
Section A+B,
EBD
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG,
Sr. Supp
$250,001–
$500,000
Part 2 –
Section C
Part 2 –
Section A+B
Part 2 –
Section A+B,
EBD
Part 2 –
Section A+B,
EBD
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG,
Sr. Supp
$500,001–
$1,000,000
Part 2 –
Section C
Part 2 –
Section A+B
Part 2 –
Section A+B,
EBD
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed,
Blood, Urine,
ECG (if smoker)
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG,
Sr. Supp
$1,000,001–
$2,500,000
Part 2 –
Section C
Part 2 –
Section A+B
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG,
Sr. Supp
$2,500,001–
$5,000,000
Part 2 –
Section C
Part 2 –
Section A+B
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed, Blood,
Urine
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG,
Sr. Supp
$5,000,001–
$10,000,000
Part 2 –
Section C
Part 2 –
Section A+B
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed, Blood,
Urine
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG,
Sr. Supp
$10,000,001
and over
Part 2 –
Section C
Part 2 –
Section A+B
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed,
Blood, Urine
Part 2 –
Section A,
Paramed, Blood,
Urine
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG
Part 2 –
Section A,
Paramed, Blood,
Urine, ECG,
Sr. Supp
Legend
Part 2 = Personal Health History (PHH)
Medical history questions, formerly referred to as a Non-Med or Section P of the application.
Expanded Blood Draw(EBD): Blood draw, urine, physical measurements, and minimal medical history questions.
Senior Supplement(Sr.Supp): Cognitive and physical function test.
For ECG, smokers are dened as individuals who have smoked Cigarettes within the previous 12 months.
• For TeleApp age and amount requirements, see the chart on page 4. (TeleApp is required at ages 18-69, amounts
of $50,000to$99,999.)
• For Asset Flex age and amount requirements, see the chart on page 5.
• Amounts over $5M require external nancial conrmation.
Time Period of Requirements
Blood & Urine One Year
TeleApp One Year with Personal Health History (PHH)
Paramedical One Year with current PHH
TIR Six Months
CCR Supplement Six Months
PHH Three Months
Table of
contents
Asset Flex AD119 Underwriting Chart
Asset Flex AD120 Underwriting Chart
Note:
Attending Physician Statement (APS)/medical records requirements for Asset Flex as
indicated above differ from other life products as noted on page 7; an APS may also be
obtained for cause at the underwriter’s discretion.
EMST is a memory exercise that performs a cognitive screening and is completed during the
TeleApp interview. For TeleApp age and amount requirements, see the chart on page 7.
Table of
contents
10
For Internal Use Only. Not for Distribution to the General Public.
Minimum age: 18
Minimum face amount: $100,000
Risk Classication Chart
Criteria Age (if applicable) Select Preferred
Nicotine No nicotine use of any
kind within the last 5
years
Body Mass Index
(BMI Calculator on
P
age 11)
18–69 19.5–27.4
70 & up 19.5–27.4
Cholesterol 18–69 Maximum of 275
70 & up Minimum of 140
—
M
aximum of 275
TC/HDL Ratio ≤4.5
Family
History
(Negative cardiac
testing within two
years may oset
family history)
18–59 No cardiovascular
disease or death in a
parent/sibling under
age 60
Blood
Pressure
Maximum
18–59 13
0/80
60–69 140/85
70 & up 145/85
Prescription
Medications
(Not an all-
inclusive list)
Any combination of the
following is permitted:
• T
hyroid replacement
• Osteoporosis/osteopenia
medications
• Sleep aids (intermittent)
• Allergy medications
• GERD medications
• Nasal steroid spray
(permitted only if used
seasonally for allergies)
Attending
Physician’s
Statement
(APS)
60 & up
Alcohol/
Drug
Hi
story
Motor
Vehicle
Record
Preferred/
Select Standard
Preferred II Nonsmoker
• Preferred: Nicotine
use within the
last 5 years is not
permitted (with
the exception of
occasional cigar
use with negative
nicotine screening)
•
S
elect Standard:
Nicotine use
is permitted
• No nicotine use of
any kind within the
last 24 months
•
W
ill allow
occasional cigar
use with negative
nicotine screening
• Not in the last
12 months
•
W
ill allow
occasional cigar or
oth
er non-cigarette
use with negative
nicotine screening
2
7.5–30.9 31.0–33.5 33.6–34.9
27.5–32.9 33.0–35.5 35.6–36.9
Maximum of 300
Greater than 300
Minimum of 140—Maximum of 300
4.6–6.0 6.1–6.5 6.6–7.0
No cardiovascular
death in a parent/
sibling under age 60
No cardiovascular
death in a parent/
sibling under age 60
In parents/siblings, no
more than:
- One cardiovascular
death under age 60
OR
-
Two persons with
cardiovascular disease
under age 60
135/85 145/90 No ratable
blood pressure
150/90 155/90
155/90 160/90
One blood pressure
medication is
permitted in addition
to any combination of
medications listed for
Select Preferred
No restrictions
on medications
unless used for
a ratable impairment
or purpose
No restrictions on
medications unless
used for a ratable
impairment or purpose
Follow Age
and Amount
APS guidelines
No history of alcohol
or drug abuse or
treatment within the
last 7 years
Insurability and rating
depend on history
•
Insur
ability and
rating depend
on history
•
N
o alcohol-related
driving violations in
the last 5 years
Insurability and rating
depend on history
No history of alcohol or drug abuse or
treatment within the last 10 years
Meaningful doctor’s statement to document good health
•
N
o more than two moving violations in the
last 3 years
•
N
o alcohol-related driving violations in the
last 5 years
Table of
contents
11
For Internal Use Only. Not for Distribution to the General Public.
Personal Insurance Income replacement guidelines
Income replacement is simply intended to replace the earnings of the insured, should he or she die prematurely.
Generally, only earned income should be used in determining the amount of insurance needed. If unearned income
stops upon the death of the insured, then it too should be used in determining the replacement income. If the
unearned income, such as that from investments, continues upon the death of the insured, then it should not be
taken into consideration in determining the amount of insurance.
When evaluating a prospective client’s nancial situation, the underwriter considers many factors, such as earned
income, unearned income, net worth, occupation, age, and future income potential. We can consider amounts up
to the multipliers in the chart below:
Body Mass Index
BMI (Body Mass Index) is used to assess body fat content based on a client’s weight in relation to their height. BMI
results assist in determining whether a client is underweight, normal weight, overweight, or obese.
Maintaining a normal BMI is important for a client’s overall long-term health. If BMI increases, the risk of developing
certain health conditions (e.g. high blood pressure, heart disease, stroke, and/or diabetes) also increases – this
could lead to higher premium rates and sub-standard risk classications.
Calculating BMI
The following online BMI calculator can be used to determine your clients’ BMI: Online BMI Calculator. Please refer
to the Risk Classification Chart for preferred classes. For a BMI of 35 or higher, please contact your underwriting
team.
Reinsurance
Reinsurance is a process utilized by insurance companies to transfer a portion of the risk on their insurance
policies. NYL uses reinsurance for several reasons, including to:
• Reduce the risk on certain individuals or products
• Increase protability/competitiveness of products
• Enable the sale of large policies above the permitted level
• Obtain underwriting guidance and expertise
• Leverage reinsurers’ industry and product knowledge
There are two primary types of reinsurance:
• Automatic Reinsurance is a type of reinsurance where reinsurers do not review any evidence of insurability on the
cases that are reinsured (i.e. they do not separately underwrite the policies). Instead reinsurers are obligated to
reinsure these policies, if certain underwriting criteria and program limits are adhered to by NYL.
• Facultative Reinsurance is a type of reinsurance where NYL can choose to submit individual cases to one or more
reinsurers for their independent evaluation. Reinsurers have the option of providing oers that agree with NYL’s
underwriting assessment, provide a counter-proposal or decline to accept the risk. Facultative reinsurance is
generally used to obtain reinsurance on large policies or substandard risks.
Age Amount
0–40 35x
41–50 25x
51–60 20x
61–65 10x
66+ 5x
Table of
contents
12
For Internal Use Only. Not for Distribution to the General Public.
NYL has three separate facultative reinsurance programs in place, as described below:
• Facultative Over Retention Program – NYL issues insurance coverage to clients, subject to certain limits based
on each specic client’s age and the product(s) being purchased. These limits, called retention limits, are
determined by NYL’s Executive Management and are subject to maximums approved by NYL’s Board of Directors.
The Facultative Over-Retention Program is a reinsurance program that has been put in place to allow NYL to issue
policies to clients who exceed the permitted retention limits.
• Facultative Impaired Risk Program – The Facultative Impaired Risk Program, also called the Facultative Shopping
Program, is a reinsurance program that reinsures substandard policies that are rated Substandard Class 5
or higher by NYL (with the exception of Asset Flex and EWL). The Facultative Impaired Risk Program allows
more favorable underwriting ratings to be obtained for many clients than NYL could oer. Unlike many of our
competitors, NYL will honor its original underwriting assessment, even when the reinsurance oers are less
favorable for the client. This ensures that the client receives the best possible oer. The minimum face amount
for consideration in the Facultative Impaired Risk Program is $100,000.
• ASAP – The Automated Selection and Assessment Program (ASAP) is a reinsurance program oered by RGA,
our largest reinsurance partner. ASAP considers policies on insureds that NYL has determined to be slightly
substandard (i.e. Substandard Classes 2-4 after taking account of all available credits in the underwriting
process). Excluding the impairment(s) that will be evaluated through ASAP, NYL’s risk class for the insured would
need to have been Standard or Non-smoker to be considered for this program. In general, RGA will provide a
more favorable underwriting rating for the policies that go through the ASAP program. This program allows NYL
to issue these policies at better ratings than the Company would otherwise be able to oer.
New York Life retention limits
Retention limit is dened as the maximum amount of life insurance, in force and applied for, that New York Life is
able to retain without the need for reinsurance. Retention limits are set by the Board of Directors.
Single Life Maximum Limits
Issue Age WL ($M) UL/Term/VUL ($M)
0–60 $40 $25
61–65 $30 $25
66–75 $20 $15
76–79 $10 $7.5
80–85 $5 $5
86+ $5 $5
Issue Age SWL ($M) SUL/SVUL ($M)
0–60 $50 $40
61–65 $40 $30
66–75 $30 $25
76–79 $15 $10
80–85 $7.5 $7.5
86+ $7.5 $7.5
Joint Life Second-to-Die Maximum Limits
The Joint Life Second-to-Die Maximum Retention Limits will be reduced by the total amount of insurance
coverage on the two insureds already issued by all New York Life companies.
Table of
contents
13
For Internal Use Only. Not for Distribution to the General Public.
Informal inquiries
Informal inquiries remain an important part of your business. An informal inquiry is used to determine whether or not a
client is insurable, and at which possible risk class, before an application is formally taken.
There are two types of informal inquires: pre-trust or insurability. For a pre-trust case, a formal application is not
used because the trust has not yet been nalized. Insurability cases are those where the intention is to determine
the likelihood of a client’s insurability based upon the information submitted.
The agent should fully complete the informal inquiry form (22078.100) and identify whether the inquiry is for
insurability or pre-trust. This two-page form includes a special authorization to allow the Company to check the
Medical Information Bureau (MIB) and to obtain medical records, as needed.
Important note: Deposit premiums and temporary coverage should never be accepted or provided on these cases.
For an insurability case, the underwriter will review the history and advise the General Oce to order specic
medical requirements or Attending Physician Statements, as needed, from the medical providers indicated on
the form, to assess the risk. For a pre-trust case, the agent may order the appropriate age and amount medical
requirements. The underwriting department will order any TIRs, or MVRs, as needed.
When a decision on the informal inquiry has been made, the General Oce will be notied through the system. The
Service Leader will be instructed to print and deliver the oer or declination letter to the agent.
Table of
contents
For Internal Use Only. Not for Distribution to the General Public.
New York Life Insurance Company
New York Life Insurance and Annuity Corporation
(NYLIAC) (A Delaware Corporation)
51 Madison Avenue
New York, NY 10010
www.newyorklife.com
AR08345.072020 SMRU1891269 (Exp.03.31.2023)
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