• New payroll groups in a Section 125 Cafeteria Plan have a one year premium rate guarantee from the date the group is established with its initial enrollee policies A copy of the face page of the Summary Plan Document (SPD) is required as proof • Additional policies/insureds to an existing payroll group will be at the premium rate in effect when the additional policies are issued • Anyone who has had cancer in the past is not eligible for FOB • Any applicant that had previous Cancer FOB will be excluded from coverage COMPLETING THE APPLICATION • Be sure to ask the proposed insureds ALL health questions and the answers recorded on the application exactly as stated to you • MIAC must have the full name of the person to be excluded and the health condition listed • All applicants age 18 or older must sign the application • When submitting an application on an existing payroll account, be sure to write the group number as well as the group name as it appears on the billing on the new application • ManhattanLife does not accept: – post‐dated checks; – C O D applications; – partial payments; – applications with the date altered; – applications where “white‐out” has been used; – personal checks from an agent or agency – money order, cashiers check and temporary checks REPLACEMENT OF COVERAGE • If an application is written in a state or territory other than that of the principal insured, you must state the city and state where the application was signed on the application You must be licensed and appointed in that state • Home office approval needed if you are replacing coverage, make sure you list any existing policies and complete the replacement information The 30 day waiting period will be waived for Individual and monthly bank draft policies For List bill groups replacing another carriers cancer policies, we will waive the 30 day waiting period • When replacing coverage, MIAC coverage begins when the policy with the former carrier expires for insureds who have never been diagnosed with cancer • The replacement form is mandatory whenever replacement is involved • ManhattanLife accepts business on monthly bank draft, list bill and direct bill methods of payment The annual, semiannual and quarterly modes of payment are acceptable for all forms of payment Payroll rates are only available for list billed payroll groups of 3 or more • All premium checks must be payable to ManhattanLife Insurance and Annuity Company METHODS OF PAYMENT The method of premium payment should be selected on the application with the modal premium written in the designated field The available premium payment modes are as follows: Direct Bill* Bank Draft Annual Annual Semiannual Semiannual Quarterly Quarterly Monthly *Please see below for acceptable forms of payment. BANK DRAFT OPTIONS Pay initial and renewal premiums by bank draft A completed Bank Draft Authorization form must accompany the application If drafting from a checking account, a voided check must be submitted If the applicant wishes to draft from a savings account, the Bank Draft Authorization form must be filled out in its entirety If the information provided is incomplete or unclear the company will require proof of the routing number and account number from the financial institution
4
FOR AGENT USE ONLY
AGT-CP4000 0216
Made with FlippingBook - PDF hosting