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Ask an Underwriter: Can my client with HIV get life insurance?


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The short answer? Yes, it’s possible. It helps to understand the disease before making an assessment. 

 

HIV, or the Human Immunodeficiency Virus, affects the immune system by destroying important cells that help fight disease and infection. The virus can only be transmitted through specific activities and through direct contact bodily fluids – the highest risks of contracting the virus are through unprotected sexual intercourse or direct exposure blood, such as sharing needles or syringes. You cannot contract HIV simply through human contact such as shaking hands, hugging, coughing, sneezing, sweating or crying.1

 

Know the Facts

Currently, more than 1 million people in the United States are living with HIV. They are living longer and have a better quality of life thanks to extensive scientific research and more advanced treatments, such as Antiretrovival Therapy or ART. ART slows the progression of HIV and helps protect the patient’s immune system. If taken properly, the medicine can keep them healthy for many years and greatly reduces their chance of transmitting HIV to sexual partners.2

 

Two important elements to keep in mind with HIV are viral loads and CD4 levels. The viral load is the amount of HIV in the blood. The more HIV there is in the blood (and therefore the higher the viral load), then the faster the CD4 cell (or T cell) count will fall, weakening the immune system and creating a greater risk of becoming ill.3 

 

Underwriting

While more people are living longer with HIV today, the number of insurers is limited. Don’t fret over this! At Ash Brokerage, we have partnered with carriers who are willing to consider HIV risk candidates.  The best candidates: 

  • Are between the ages of 35-60 
  • See an infectious disease physician
  • Have a minimum 3-5 year of ART compliance
  • Are negative for Hepatitis B and C 
  • Don’t have any co-morbid factors, such as coronary artery disease, diabetes or depression 
  • Have maintained favorable and consistent CD4 and viral loads

 

Reach Out

At Ash Brokerage, you have a dedicated staff of experienced and well versed underwriters available to answer your questions regarding your clients with HIV. Our HIV Questionnaire can help guide your conversation with clients by obtaining the details essential for an accurate assessment. 

 

About the Author

Kiana has been working in the brokerage industry for 20 years, with the last 15 years in underwriting. As an underwriter at Ash Brokerage, she truly loves serving as a client advocate because she values the responsibility of satisfying each client's planning needs.

 

Learn More

Ash HIV Questionnaire: https://ashcmsstorage.blob.core.windows.net/media//Docs/uw/impairment/HIV.pdf

1Centers for Disease Control, HIV Transmission: https://www.cdc.gov/hiv/basics/transmission.html

2CDC, Living With HIV: https://www.cdc.gov/hiv/basics/livingwithhiv/index.html

3Aidsmap, Viral Load: https://www.aidsmap.com/Viral-load/page/1327496/

Ask an Underwriter: What should I know about breast cancer?


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Do you know somebody with Breast Cancer? It’s highly likely that you or somebody you know has been diagnosed with breast cancer at some point.  

 

The Facts

In 2017 alone, it is estimated that more than 300,000 new cases of invasive/non-invasive breast cancer will be diagnosed in women in the United States; this does not include the more than 3.1 million women who are currently being treated or have completed treatment. And, it’s not just women who are affected. A man has a 1 in 1,000 risk of developing breast cancer; in 2017, nearly 2,500 men will be diagnosed with this disease.1

 

A diagnosis of breast cancer is not a death sentence. There continues to be a decline in deaths from breast cancer every year, thanks to early detection and improvements in treatment. Breast cancer cannot be prevented, but early detection is paramount. Mammography continues to improve and is the gold standard for breast cancer screening because it can detect breast cancer up to two years before a tumor can be felt by you or your doctor.  

 

Family History

Genetic testing has played a huge role with early detection in those individuals with a family history of breast cancer. Abnormal BRCA1/2 genes accounted for 1 out of every 10 cases of breast cancer. If you have been found to have BRCA1/2 mutation, you have an 80 percent risk of developing breast cancer during your lifetime. These mutations are rare in the general public, but testing should be considered when there is a strong family history of breast cancer.2

 

Underwriting

What does this all mean for your clients’ chances of securing life insurance? The continued increase in survival with breast cancer has resulted in lower mortality rates. Carriers are continually re-evaluating their manuals when it comes to breast cancer, giving more survivors the opportunity to secure affordable life insurance.  

 

Still, many factors need to be taken into consideration for underwriting. Ash Brokerage is here to help.  To help assist you in gathering the needed information, Ash has developed a Breast Cancer Client Questionnaire. Give our experienced underwriting staff a call to discuss your case.  

 

Learn More

1BreastCancer.org, U.S. Breast Cancer Statistics: http://www.breastcancer.org/symptoms/understand_bc/statistics

 

2American Cancer Society, “Breast Cancer Risk Factors You Cannot Change”: https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-change.html

 

Breast Caner Underwriting Questionnaire: https://ashcmsstorage.blob.core.windows.net/media//Docs/uw/impairment/Cancer-Breast.pdf

 

About the Author

With the majority of her 20-year brokerage insurance career spent as an underwriting advocate to a diverse customer base, Kim Schrass has built long-lasting partnerships throughout the industry. The depth of her knowledge coupled with her competitive spirit of winning have earned her significant credibility among her customers and peers alike. 

Underwriting Breast Cancer

Ask an Underwriter: Is coverage available for clients with prostate cancer?


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Do you know the top two leading causes of death among men in the United States? If you answered heart disease and cancer, you are correct!1 What you may not know is that prostate cancer is the most prevalent type of cancer among men. Currently, nearly 2.9 million American men are living with the disease, and the American Cancer Society estimates that in 2017, 161,360 men will be told they have prostate cancer.2 With these statistics, there is a high probability you will encounter the opportunity to protect a prostate cancer survivor, if you haven’t already.  

 

As a result of increased preventative screening to include Prostate Specific Antigen (PSA) – normal values between zero and four – digital rectal exam (DRE), and advancement in treatments, early detection is naturally higher. 

 

Diagnosis

When Prostate Cancer is diagnosed, usually through a biopsy procedure, a specific stage will be assigned. The staging refers to the extent of the cancer (how much cancer is present and how far it has spread), stage I-IV. Staging is a big piece of the puzzle in underwriting, along with a Gleason Score, which is based on the tumor pattern the pathologist sees.     

 

Key Information 

All of these factors have improved many life insurance carriers’ underwriting guidelines, leading to decreased postponement periods and more favorable ratings. The key to successfully insuring your prostate cancer survivor is understanding what information is important to find the very best solution. 

  • Stage of cancer
  • Gleason Score
  • Date of diagnosis
  • Type of treatment(s)
  • Date of last treatment  

 

Additional Questions That Could Be Helpful 

  • Any lymph node involvement?
  • Any metastasis (spreading of the cancer to other areas in the body)?   
  • Any relapses?
  • Date and result of most recent PSA?
  • Any current medications being taken? 
  • Family history of prostate cancer?  

 

Two important pieces of information will be whether or not they are in full remission/cancer free and for how long (month/year the remission was established). The longer your client has been cancer free, with regular follow-up and testing, the more favorable their offer may be.   

 

For most life insurance carriers to give consideration of someone who has a history of prostate cancer, the client must fully complete treatment (surgery, radiation, chemo) and often the carrier will require a waiting period, referred to as a postponement period. The extent of the rating and duration of postponement varies depending heavily on the stage of the prostate cancer, type of treatment, and date of last treatment. Risk philosophy also varies from carrier to carrier based on the reinsurance manual used or the carrier’s own proprietary guidelines. 

 

Active Surveillance/Biochemical Recurrence

With increased early detection, we are seeing more and more cases with these considerations. Active surveillance or watchful waiting means the client’s physician is treating them by regularly monitoring the client’s lab markers (PSA, CEA, etc.) on an interval basis and closely monitoring PSA velocity. 

 

This treatment option may be elected with a first-time diagnosis or biochemical recurrence. A biochemical recurrence happens when the PSA levels transition from undetectable to detectable, generally increasing, and may occur among men treated with radical prostatectomy or radiation for localized prostate cancer. These clients require careful consideration on an individual basis with the most favorable being age 65 or older, initial diagnosis Gleason Score of six or less, availability of favorable PSA trending documented over several years, and being three or more years out if previously treated. 

 

Get Started

Let Ash Brokerage assist you with your next Prostate Cancer case. To simplify fact-finding, use our Prostate Cancer Questionnaire. We leverage our experience, carrier relationships and resources to identify viable solutions based on your client’s individual circumstances and insurance needs. Reach out to your underwriting team for information or assistance. 

 

Learn More

1Centers for Disease Control: https://www.cdc.gov/healthequity/lcod/men/2014/index.htm

2Zero: https://zerocancer.org/learn/about-prostate-cancer/facts-statistics/

Ash Brokerage Underwriting Questionnaire:http://go.ashbrokerage.com/rs/535-YRX-827/images/Cancer-Prostate.pdf

 

 

About the Author

Julie’s unwavering passion and dedication for risk advocacy promotes lasting partnerships while driving impactful results for all stakeholders, from our agents to our carriers. She leverages her 20 years of industry experience with her relational approach to ensure you experience the Ash difference.

Underwriting Prostate Cancer Life Insurance

Running Toward Tax-Deferred Money: Turning a Challenge into an Opportunity


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What is it that we get spooked so easily by challenges? Something changes, or becomes a little difficult, and we prefer to complain, or just avoid the problem completely. 

 

Well, I believe inside every challenge lies an opportunity. Recently, I talked with Mike McGlothlin (Ash’s EVP of retirement and one of the most respected guys in the annuity business) about why so many advisors are running away from a certain challenge rather than running toward it. 

 

The challenge we discussed? Tax-deferred assets. I’m blow away by the number of advisors who have NO IDEA they can turn tax-deferred gains into tax-free benefits. Yes, you read that correctly. Tax-deferred into TAX-FREE. I’ll give you a couple examples of what I’m talking about. 

 

Linked Benefits

You can take an existing, nonqualified annuity and do what’s called a 1035 exchange, moving those funds into a linked-benefit product for long-term care. Your clients’ asset is leveraged into a larger pool of benefits, which are tax-free. We call this “transferring the risk” because you’re shifting the risk of long-term care expenses to an insurance company, rather than leaving that risk on your clients’ retirement assets (and subsequently taking a hit with taxes on their pent-up gain). 

 

Harvesting the Cost Basis

Non-qualified annuities are great accumulation vehicles for many reasons – multiple investment options, tax deferral and guaranteed income for life. However, a highly appreciated annuity is one of the worst assets to have on your personal balance sheet at death. Controlling the tax – the amount and the timing – is a critical factor to a successful legacy strategy. You need to have the conversation with all your clients about controlling tax at distribution, regardless if that comes during their lifetime or at death. 

 

Don’t Miss the Boat

By using these strategies, you’re accomplishing multiple things at once: 

  • You’re creating tax efficiency as their tax-deferred gain becomes a tax-free benefit
  • You’re creating a more meaningful/impactful result for your clients
  • You’re involving the next generation in the planning process, establishing trust and credibility and increasing your chances of keeping that AUM past the first generation 

 

If you’re avoiding your clients’ tax-deferred assets because you’re afraid of the taxes on their pent-up gains, then you’re missing the boat. Better yet, you should just get your own boat because this might be the next “blue ocean.”

 

Mike and I dove deeper into this topic during a webinar Sept. 21. If you client has ANY tax-deferred asset, you need to watch this replay.

 

GO DEEPER

For more, watch this 20-minute video with Tim and Mike McGlothlin explaining the topic in further detail.

Turning Tax-Deferred Into Tax-Free

Life Insurance Annuities Tax-Deferred Linked Benefit

Foreign Travel: Where in the World is the Risk?


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So your client is planning a trip outside of the United States. While their travel list may contain things like flip-flops, sunblock, beach towels, and toothbrushes, a life insurance underwriter’s travel list will often include things like political climate, crime rate, access to health care, participation in risky activities, and length of stay. These are just some of the many angles from which an underwriter is going to evaluate your client’s foreign travel risk.

 

Political Climate

When an underwriter talks about political climate, they are often referring to countries or regions where governments may be unstable or where governments have unfavorable opinions of the United States. Of the many lenses from which an underwriter evaluates a case, this is likely the most obvious, because oftentimes, these areas are the ones commonly seen on the news – the Middle East, Venezuela, the Philippines, and much of Africa.1 While travel to these countries/regions may not eliminate your client from potential coverage, the political climate in these areas raises some obvious red flags in consideration for your client’s safety.

 

Violence

So your client isn’t going to a politically unstable region, they should be good to go, right? Not so fast … The local violent crime rate is a major factor an underwriter takes into consideration when evaluating risk. A prime example of this is Acapulco, Mexico. When most people think Acapulco, they think beautiful beaches, a bustling nightlife, and wonderful golf courses, but when you look under the surface, another amazing characteristic jumps out … Acapulco, in 2016, had the second highest murder rate in the world, checking in at 113.24 murders per 100,000 residents, which is nearly twice as high as the most violent city in the United States.2 This, again, won’t automatically eliminate an individual from coverage, but does have potential to result in an adverse action depending on the client’s plans while there.

 

Health Care

Another consideration while examining travel is access to health care. Should the client be injured or become ill during their trip, what is the quality of health care that they would receive? And, how far do they have to travel to receive care? There is a clear risk if health care is substandard or difficult to obtain.

 

Activities

While traveling, will your client be participating in any potentially hazardous activities, such as mountain climbing, SCUBA diving, sky diving, or any other avocations that could add to their potential risk? While many of these activities carry an innate risk in and of themselves, when compounded with possible language barriers and/or poor access to health care, an adverse underwriting action can occur.

 

Length of Stay

Lastly, the length of your client’s stay abroad may affect their potential rating. If a client is planning a trip that is less than six months, then assuming they otherwise qualify based on the above criteria, there is generally no concern. But, if their expected stay crosses the threshold of six months, they become foreign residents and thus are evaluated differently. In some cases, a country can be OK for travel, but not OK for foreign residence, and an adverse action may be taken.

 

Overall, there are many considerations that go into foreign travel risk. If you have a client who has travel plans in which you suspect may result in an adverse underwriting action, consider that clarity is key and that a detailed cover letter can eliminate many concerns about your client’s upcoming trip. Check out our Foreign Nationals and Travel Questionnaire, a guide that can help you collect all the information you need for underwriting. 

 

Should you have any questions about any of your potential clients, please don’t hesitate to reach out to an Ash Dedicated Underwriter, and we would be more than happy to answer any questions that you have.

 

Learn More

Foreign Nationals and Travel Questionnaire: https://ashcmsstorage.blob.core.windows.net/media//Docs/uw/impairment/Foreign_Nationals_and_Travel.pdf

 

1U.S. Department of State, Travel Alerts and Warnings: https://travel.state.gov/content/passports/en/alertswarnings.html

 

2Business Insider, “The 50 most violent cities in the world,” April 8, 2017: http://www.businessinsider.com/most-violent-cities-in-the-world-2017-4/#50-durban-south-africa-had-3443-homicides-per-100000-residents-1

  

About the Author

Joe Taulbee has been in the life insurance industry for nearly 11 years with more than five years as an underwriter, and he’s helped numerous families and individuals gain much needed financial security and peace of mind through the procuration of life insurance. He has an Associate designation (AALU) through the Academy of Life Underwriting and is currently pursuing an underwriting fellow designation with ongoing LOMA coursework.

Underwriting Foreign Travel Life Insurance