Underwriting
Applicant has psoriasis treated with Humira injections.
What is Decline?
This neurodegenerative disease, also known as Lou Gehrig’s Disease, results in an automatic decline.
What is ALS (Amyotrophic Lateral Sclerosis)?
Mild asthma with no ER visits and controlled by medication qualifies for this underwriting class.
What is Standard?
All these meds (Lisinopril, Losartan, & Amlodipine) treat the same condition.
What is HBP?
An artist who marks up skin with ink.
What is a tattoo artist?
Applicant has mild sleep apnea controlled by CPAP and also takes BP medication.
What is Decline?
Malignant tumors within this time frame result in a decline.
What is cancer diagnosed within the last 10 years?
In-network Out of Pocket Maximum
What is $2k, $6k, $10k?
This stimulant medication is commonly prescribed for mild ADD and may be acceptable when controlled by a PCP with no hospitalizations.
What is Vyvanse (or Adderall)?
Builds houses for a living.
What is Construction?
Applicant takes metformin but she does not have diabetes.
What is PCOS?
This autoimmune digestive disease is listed as a decline condition.
What is Crohn’s disease?
Doctor Office Benefit on SA.
Pain injection
What is Gabapentin?
This profession involves working at high elevations installing or repairing roofs and is commonly declined due to fall risk.
What is a Roofer?
If an applicant does not have a Social Security Number, what alternative identification may still allow them to enroll in health coverage?
What is a HAGI?
What important limitation applies to benefits under these plans that agents must disclose during enrollment?
What is the Pre-existing Condition?
Life time benefit amount per insured
What is $2 million?
This inhaler medication usually indicates mild asthma and is acceptable when there are no ER visits or hospitalizations.
What is Albuterol?
This activity may be done indoors or outdoors but is still considered a declinable avocation due to fall and injury risk.
Why would an applicant be unable to enroll their pregnant spouse and dependent on a plan that excludes maternity coverage?
What is: Pregnancy is a non-covered condition, making the spouse (and dependent enrollment tied to the spouse) ineligible for this plan?
Which rider or feature allows members to upgrade to comprehensive medical coverage later without additional underwriting?
What is Well-GST Rider (guaranteed upgrade to PremierMed)?
Rate Gaurantee on SA
What is 12mon?
Stacy takes metformin, non diabetic.
What is PCOS?
This individual may be declined even without a hazardous job due to current income or employment status.