Agent Guide | Home Health Care Select
Application Instructions Continued
APPLICATION INFORMATION (B) • Application can be used for 1 or 2 applicants. • Fill out all information fully and correctly. ADDRESS • Applicant’s resident state must match the materials being used. • “Mailing Address” is
optional. It should only be used if the applicant wants to receive info somewhere other than their resident address.
• E-mail address is preferred but optional.
PLAN SELECTION • Select policy choice of “Classic”, “Premier” or “Deluxe”. • Use Rate Chart and
conversion factors to calculate initial premium based on mode selected.
OPTIONAL RIDERS • Use Rate Chart and
conversion factors to calculate initial premium based on mode selected.
Please note: Many states have their own unique application for Home Health Care Select Insurance. Please make sure you are completing the correct state application based on the resident state of your client.
12
AGT-HHCS 0224
Made with FlippingBook flipbook maker