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Guarantee Trust Life Lump Sum Cancer/Heart Attack and Stroke 1. Each person must be a U.S. citizen or hold a “green card” (permanent resident of US).
2. The agent must be health licensed and use the state approved application in the state where the applicant 3. If both spouses’ apply for coverage, each person must answer the questions and sign the application.
4. If power of attorney is used, please submit a signed copy of the form with the application.
5. If the applicant is taking any of the medications listed on the Medication List, the applicant will not qualify 6. If an application is over 31 days old when received by the Company, we will require a new currently dated 7. The effective date cannot be more than 90 days from the application date or earlier than the application 8. Dual applicants must be legally married or their resident state must recognize civil unions. If the state recognizes common law marriage, they must complete the common law form and submit it with the application. If the state does not recognize common law marriage, each person must submit their own application and each must pay the annual policy fee. 9. Family and Couple premium rates will be calculated by the older spouse’s age regardless of how it is listed 10. The maximum benefit amount for the Cancer plan is $75,000. The Heart Attack/Stroke plan/rider also has a If you submit an application for the Cancer plan with Heart Attack/Stroke rider the amount for each benefit must be the same. For example, if the Cancer benefit is $75,000, the Heart Attack/Stroke rider must also be $75,000. If the amounts are different, if approved, separate policies will be issued. For example, if the Cancer benefit is $75,000 but the Heart Attack/Stroke benefit is $50,000, each benefit will be a standalone plan. Please note that each policy will have an annual policy fee. 11. Please remember to add the $20 annual policy fee to the total premium--then calculate the modal premium i.e.; monthly (.09), quarterly (.265), or semi-annual (.52). In this case—monthly was selected, example would be: $291.00 + $20.00 = $311.00 x .09 = $27.99 12. Single Parent plan denotes one parent (regardless of marital status) applying with eligible dependent An application for Cancer Plan should not be taken in the following situations:
• History of internal cancer or malignant melanoma within 5 years of the application date • Medication prescribed for the treatment of internal cancer or malignant melanoma within 5 years • PSA reading of 4.0 or greater without further investigation • Symptoms or signs of cancer that need further investigation The applicant is not eligible for the Heart Attack and Stroke Plan or Rider in the following
situations and with the following medical conditions:

• History of heart attack, stroke, bypass, stent placement, angioplasty, or angina within 5 years of the • Medication prescribed for the treatment of heart attack, stroke, bypass, stent placement, angioplasty, or angina within 5 years of the application date • Coronary Artery Disease with 50% or more blockage in any artery or Left Main Disease • Peripheral Vascular Disease with 75% or more blockage If the applicant is taking any of the following medications for the condition listed, the applicant is not eligible for the plan or a benefit rider. This is not an all inclusive list and maybe subject to change from time to time.
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Source: https://www.garityadvantage.com/Documents/CHS/Lump%20Sum%20Underwriting%20Guide%20(Black%20and%20White)%20May%2017,%202012.pdf

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