Quick Reference:
INDIVIDUAL DISABILITY INCOME INSURANCE
Quick Reference:
Group LTD Conversion Program
The Group LTD Conversion Program provides the opportunity for individuals covered under a Guardian Group LTD Program as students, residents or fellows to convert their coverage to ProVider Plus individual disability income insurance at the end of their program. Who is eligible Application Submission
BASIC CONVERSION Coverage Amounts
Policy Form
Medical, dental or veterinary students, residents and fellows who have Guardian Group LTD with a conversion option. • Fax new applications to 860-683-1195. • Email new applications to [email protected] and any additional requirements to [email protected]. • Use the New Business Conversion Transmittal, AA1632. • Prepayments cannot be submitted with the application. Used when no additional insurance is requested • • • •
Medical residents (standard conversion amount) – $4,000 Medical residents (with prior Guardian Group approval) – $5,000 Dental Students – $2,000 Veterinary Students – $2,000
Provider Choice policy form 18ID (If 18ID not approved in state, then ProVider Plus policy form 1400.)
Application Process
• Complete the DI conversion application. On GuardianOnline.com, go to: Products>Disability Insurance>New Business>State Application and Form Search, find the form for the correct state. • Complete Question 8A on DI-CONV-2007 on the Berkshire application with the terminating group insurance information. • A financial supplement is not required. • Submit a cover letter detailing any special considerations or discussions held with Berkshire management related to your DI conversion applications. • Applications may be submitted up to 60 days prior to or up to 31 days after the date the LTD coverage ends. Policy date will be one day after Group coverage ends.
Post-Policy Issue
• The policy placement period is 70 days. • Policies not paid within the 70-day placement period will become “not taken.” If a new policy is requested subsequent to the 70-day period, then the Berkshire Application for Disability Insurance (Group Conversion 2007) is required. The application will be subject to routine processing and underwriting requirements because the conversion privileges have expired. • If a policy is re-dated due to a graduation date change, then the 70-day placement period is calculated using the original policy date.
Coverage Amount
• Other individual disability coverage in effect or applied for that will remain in force after graduation will be taken into consideration at the time of conversion and may affect the amount of coverage available under this program. The Special Limits for New Professionals (See Field Underwriting Guide Pub7492BL for Provider Choice or Pub4373BL for ProVider Plus and ProVider Plus Limited) will be used to determine the amount of coverage available. Continued…
The Guardian Life Insurance Company of America New York, NY 10004-4025 For Producer use only. Not for use with the general public.
UNDERWRITTEN CONVERSION Coverage Amounts
Additional coverage is being applied for • Additional coverage (amount is higher than the guaranteed amounts of a basic conversion) may be applied for.
Policy Forms
Provider Choice policy form 18ID (If 18ID not approved in state, then ProVider Plus policy form 1400.)
Paper Application Process
• Complete the Berkshire Application for Disability Insurance. On GuardianOnline.com, go to: Products>Disability Insurance>New Business>State Application and Form Search, find the form for the correct state. • Submit a cover letter detailing any special considerations or discussions held with Berkshire management related to your DI conversion applications. • The additional amount applied for is subject to full underwriting. If the additional coverage is ridered, rated, or declined, and the applicant decides to proceed on a straight conversion basis only, then a DI Conversion Application is required. • Applications may be submitted up to 60 days prior to or up to 31 days after graduation.
eApp Application Process
• Begin the eApp process and choose the state. • Complete the Application for Disability Insurance (choosing DI-2016 for Provider Choice and DI-2011 for ProVider Plus or ProVider Plus Limited.) • On the upper right of your eApp screen, find the AGENT/AGENCY NOTES Section. In Notes for New Business Administration, indicate that this is a conversion from Guardian Group LTD.
Post-Policy Issue
• The policy placement period is 70 days. • Policies not paid within the 70-day placement period will become “not taken.”
Questions? Contact your local Guardian-affiliated agency or New Business and Underwriting at: Northeast
866-672-1964
Southeast
866-672-2018
Midwest
866-904-6518
West
866-672-2019
Individual disability income products underwritten and issued by Berkshire Life Insurance Company of America, Pittsfield, MA, a wholly owned stock subsidiary of and administrator for The Guardian Life Insurance Company of America (Guardian), New York, NY. Product provisions and availability may vary by state.
Pub 5867BL (06/16) 2015—15174 (Exp. 06/18)
The Guardian Life Insurance Company of America New York, NY 10004-4025 For Producer use only. Not for use with the general public.
Quick Reference:
Group LTD Conversion Program
The Group LTD Conversion Program provides the opportunity for individuals covered under a Guardian Group LTD Program as students, residents or fellows to convert their coverage to ProVider Plus individual disability income insurance at the end of their program. Who is eligible Application Submission
BASIC CONVERSION Coverage Amounts
Policy Form
Medical, dental or veterinary students, residents and fellows who have Guardian Group LTD with a conversion option. • Fax new applications to 860-683-1195. • Email new applications to [email protected] and any additional requirements to [email protected]. • Use the New Business Conversion Transmittal, AA1632. • Prepayments cannot be submitted with the application. Used when no additional insurance is requested • • • •
Medical residents (standard conversion amount) – $4,000 Medical residents (with prior Guardian Group approval) – $5,000 Dental Students – $2,000 Veterinary Students – $2,000
Provider Choice policy form 18ID (If 18ID not approved in state, then ProVider Plus policy form 1400.)
Application Process
• Complete the DI conversion application. On GuardianOnline.com, go to: Products>Disability Insurance>New Business>State Application and Form Search, find the form for the correct state. • Complete Question 8A on DI-CONV-2007 on the Berkshire application with the terminating group insurance information. • A financial supplement is not required. • Submit a cover letter detailing any special considerations or discussions held with Berkshire management related to your DI conversion applications. • Applications may be submitted up to 60 days prior to or up to 31 days after the date the LTD coverage ends. Policy date will be one day after Group coverage ends.
Post-Policy Issue
• The policy placement period is 70 days. • Policies not paid within the 70-day placement period will become “not taken.” If a new policy is requested subsequent to the 70-day period, then the Berkshire Application for Disability Insurance (Group Conversion 2007) is required. The application will be subject to routine processing and underwriting requirements because the conversion privileges have expired. • If a policy is re-dated due to a graduation date change, then the 70-day placement period is calculated using the original policy date.
Coverage Amount
• Other individual disability coverage in effect or applied for that will remain in force after graduation will be taken into consideration at the time of conversion and may affect the amount of coverage available under this program. The Special Limits for New Professionals (See Field Underwriting Guide Pub7492BL for Provider Choice or Pub4373BL for ProVider Plus and ProVider Plus Limited) will be used to determine the amount of coverage available. Continued…
The Guardian Life Insurance Company of America New York, NY 10004-4025 For Producer use only. Not for use with the general public.
UNDERWRITTEN CONVERSION Coverage Amounts
Additional coverage is being applied for • Additional coverage (amount is higher than the guaranteed amounts of a basic conversion) may be applied for.
Policy Forms
Provider Choice policy form 18ID (If 18ID not approved in state, then ProVider Plus policy form 1400.)
Paper Application Process
• Complete the Berkshire Application for Disability Insurance. On GuardianOnline.com, go to: Products>Disability Insurance>New Business>State Application and Form Search, find the form for the correct state. • Submit a cover letter detailing any special considerations or discussions held with Berkshire management related to your DI conversion applications. • The additional amount applied for is subject to full underwriting. If the additional coverage is ridered, rated, or declined, and the applicant decides to proceed on a straight conversion basis only, then a DI Conversion Application is required. • Applications may be submitted up to 60 days prior to or up to 31 days after graduation.
eApp Application Process
• Begin the eApp process and choose the state. • Complete the Application for Disability Insurance (choosing DI-2016 for Provider Choice and DI-2011 for ProVider Plus or ProVider Plus Limited.) • On the upper right of your eApp screen, find the AGENT/AGENCY NOTES Section. In Notes for New Business Administration, indicate that this is a conversion from Guardian Group LTD.
Post-Policy Issue
• The policy placement period is 70 days. • Policies not paid within the 70-day placement period will become “not taken.”
Questions? Contact your local Guardian-affiliated agency or New Business and Underwriting at: Northeast
866-672-1964
Southeast
866-672-2018
Midwest
866-904-6518
West
866-672-2019
Individual disability income products underwritten and issued by Berkshire Life Insurance Company of America, Pittsfield, MA, a wholly owned stock subsidiary of and administrator for The Guardian Life Insurance Company of America (Guardian), New York, NY. Product provisions and availability may vary by state.
Pub 5867BL (06/16) 2015—15174 (Exp. 06/18)
The Guardian Life Insurance Company of America New York, NY 10004-4025 For Producer use only. Not for use with the general public.
