Underwriting

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Why is underwriting necessary?
What to expect
Medical underwriting
Financial underwriting
Underwriting decisions
Application tips
Will I qualify as "Preferred"?

Underwriting is a fact of life when you apply for insurance. All insurance companies routinely gather information about applicants (also known as "medical underwriting") in order to evaluate each individual who applies for coverage. Insurability is determined through underwriting — a careful review of the medical and/or financial particulars that pertain uniquely to each applicant.

Effective underwriting allows all applicants to be evaluated consistently in relation to generally accepted industry standards.

Why is underwriting necessary?

In group insurance, underwriting standards — as well as rates — are the same for every member of the group. In other words, no one pays a higher premium to offset what might be a higher risk. Instead, specific conditions may be excluded from coverage to mitigate risk and keep rates consistent for all participants. If underwriting were not required, a group plan would attract a disproportionate number of medically impaired individuals. This would result in high ratios of benefit payments compared to premiums, thus causing rates to rise for all insured participants.

Because underwriting manages risk, it preserves the financial strength of each Plan for the benefit of all participants. For the ADA Insurance Plans, successful underwriting helps safeguard low rates for members, plus increases the likelihood of each Plan's future stability.

What to expect when you apply for insurance

Depending on the type and amount of coverage you apply for, medical and/or financial medical underwriting may be required. Great-West Life underwrites each individual applicant as shown in the table below.

Plan	Type of Underwriting Required
Plan	Medical	Financial
Term Life
Term Plus Universal Life
Income Protection
Office Overhead Expense
MedCASH¹
Student Term Life²
Student Disability³

¹Basic levels of coverage are available without proof of good health. Optional Critical Condition Coverage is subject to approval based on your answers to a brief medical questionnaire.

²$50,000 of Term Life coverage is available to dental students under age 40 without proof of good health if they enroll by October 31 of the year prior to their graduation. Any additional coverage requested, or enrollment after the eligibility deadline or by a student age 40 or older, will be subject to medical underwriting.

³Up to $2,000 in monthly Student Disability coverage is available to dental students under age 40 without proof of good health. After the student's 40th birthday, medical underwriting may be required.

How long does underwriting take?

Normally, a decision can be made 2-3 weeks after all necessary information and medical exam results have been received. However, before evaluation can begin, all supporting materials (required medical and financial records, plus any other requested information) must be received to complete your application file. Delays most often occur when required information isn't submitted in a timely manner.

When applying for coverage, please make sure you answer all questions thoroughly, checking all necessary boxes and providing signatures wherever requested. If your application is incomplete or incorrect for any reason, it will be returned to you for follow-up. Your cooperation, especially in requesting documentation from your physician, will help underwriting proceed as quickly as possible.

Will I qualify as "Preferred?"

When you apply for ADA Term Life coverage, you are automatically considered for Preferred status (the classification given to the healthiest applicants who are determined to have the lowest risk of premature death).

To qualify for Preferred rates, you must be a non-smoker and have low blood pressure (without medication) and low cholesterol, plus meet all other health-related underwriting criteria. In addition, you must have low-risk lifestyle characteristics that include non-hazardous avocations and travel, and a good driving record. Your height, weight, and personal/family health history will also be taken into account.

Not every applicant will qualify for Preferred status, but the healthier you are, the better your chances. (Although the percentage will vary by age, about 45% of Term Life applicants are expected to qualify.) Your eligibility will be determined through medical underwriting, based on questions from your Term Life application and through a routine review of your physician's records, medical history, paramedical exam, and laboratory tests.

If you qualify, Preferred rates will apply for 10 years, after which time you may requalify medically for another 10 years (without applying for additional coverage) or otherwise renew your coverage at Standard rates. Best of all, you will be eligible to pay Preferred rates on all of your ADA Term Life insurance — the amount applied for, plus any coverage that already exists. Click here for more information about the Term Life Plan.

Minimum Medical Requirements: Term Life Plan and Term Plus Universal Life Plan
Age	Coverage Amount
Age	$50,000 - $100,000	$125,000 - $250,000	$275,000 - $975,000	$1,000,000 - $2,000,000
20-40
41-49
50-59
60-64

Minimum Medical Requirements: Income Protection & Office Overhead Expense Plans
Age	Monthly Coverage Amount
Age	Up to $1,900	$2,000 - $2,500	$2,600 - $3,500	$3,600 - $4,000	$4,100 - $4,900	$5,000 or more
20-25
26-35
36-44
45-49
50-59

	Blood draw and urinalysis
	Blood draw, urinalysis and paramedical exam
	Blood draw, urinalysis, paramedical exam and physicians report
	Blood draw, urinalysis, paramedical exam, physicians report and EKG

Minimum Financial Requirements: Income Protection Plan
Monthly Coverage Amount	Your Employment Status
Monthly Coverage Amount	Employee	Sole Proprietor	Partnership	S Corporation or P Corporation
$3,000 or more (with all carriers) OR any amount with Future Increase Option or COLA Option	W-2 form & current year-to-date salary statement OR paycheck stub	IRS form 1040 and Schedule C	IRS form 1040, Schedule E, IRS form 1065 (all pages) and Schedule K1	IRS form 1040, IRS form 1120 or 1120S (all pages) and W-2 form

Minimum Financial Requirements: Office Overhead Expense Plan
Monthly Coverage Amount	Your Business Status
Monthly Coverage Amount	Sole Proprietor	Partnership	S Corporation or P Corporation
$10,000 or more (from all carriers)	Schedule C and Supplemental Expense Schedule	IRS form 1065 and Schedule K1	IRS form 1120 or 1120S (all pages) and Supplemental Expense Schedule

Medical underwriting

Medical underwriting requirements are different for each Plan, as shown in the tables below. Minimum requirements are determined by your age and the amount of coverage you request. Additional information may be required on a case-by-case basis as determined by your personal medical history.

Required medical examinations, blood draws, and urinalysis must be performed by a paramedical service or individual authorized by Great-West Life, who will contact you for an appointment. To make the paramedical exam as convenient as possible, you can choose to schedule an appointment at your office or home. Blood draws will be sent to an independent laboratory for analysis. Fees for required examinations will be paid by the ADA Insurance Plans. Please note: Underwriting requirements are subject to change without notice.

Medical underwriting is not required when you apply for core MedCASH coverage, because that coverage is guaranteed without any proof of insurability. When you apply for Optional Critical Condition Coverage under the MedCASH Plan, however, your approval will be based on your answers to a brief medical questionnaire.

Financial underwriting

Financial underwriting requirements apply only for applicants in the Income Protection and Office Overhead Expense Plans, as shown in the tables below. Minimum requirements are determined by your employment and/or business status and the amount of coverage you request. Additional information may be required on a case-by-case basis. Please note: Underwriting requirements are subject to change without notice.

Underwriting decisions

Your application for insurance will be evaluated by a Great-West Life underwriter who applies extensive professional experience to a generally accepted set of industry standards. A select group of underwriters reviews every application received from ADA members, and this group is devoted exclusively to the ADA Insurance Plans.

From start to finish, you will be treated fairly and professionally by our underwriting team. After underwriting, your application will be approved, modified, or declined. Here's how Great-West Life defines these possible decisions.

Approved: Your application was accepted as submitted. Your coverage will take effect on the date it was approved by Great-West Life, subject to the payment of your first premium.

Modified: Your application will be accepted once you agree to any modification(s) offered by the underwriter. A modification may change the amount of coverage or eliminate benefits for specific medical conditions. Note: You are not obligated to accept our offer for modified coverage.

Declined: Your medical condition (as demonstrated by your medical history) falls outside the established range of insurability for the ADA Insurance Plan you applied for. You will receive a letter explaining the reasons your request was declined.

At any time, feel free to contact us at 800-568-2001 or ada@gwl.com for information about underwriting or to check the status of your application.

Application Tips

You can help speed the underwriting process by following these pointers:

Provide complete information, including as much detail as possible. Researching your medical records can cause significant delays, so please provide the full name, address, and phone number of all your physicians. Even seemingly insignificant details (minor illnesses, benign tumors, or surgery over five years ago) may be surprisingly relevant.
Schedule your medical tests right away. When the paramedical service contacts you, make an appointment immediately. Your application can't move forward until you're examined.
Notify your physician. Alert your doctor of the need to provide a detailed account of your medical history. A "heads up" can even help the office prepare copies of your medical records in advance.
Submit copies of your tax forms. If you're applying for Income Protection or Office Overhead Expense coverage, certain tax documents will be required. Avoid delays by sending them along with your application.

Your cooperation and patience are appreciated while your application is reviewed. Contact us at 800-568-2001 or ada@gwl.com to check the status of your application.