Banner: Underwriting Changes in Response to COVID-19

10-02-2020

** Updated 10/02/2020 **

Legal & General America’s underwriting team has been closely monitoring the COVID-19 impact on the general population. While the situation remains fluid, they are taking positive actions to help more of your clients get the coverage they need. As COVID-19 case numbers and data continue to evolve, LGA has revised their temporary guidelines to provide more opportunities for cases to be underwritten, approved and issued.

Age and Risk Profile Postponement Parameters

LGA reserves the option to apply Individual Consideration. Applicants in the age ranges below whose assessed risk class exceeds rated table parameters AND the risk profile includes the referenced underlying chronic conditions listed below will generally be postponed for a minimum of 6 months or denied.

  • Ages 55-64 and risk profile exceeds Table 6
  • Ages 65 -70 and risk profile exceeds Table 4
  • Ages 71+ and risk profile exceeds Standard
  • Underlying Medical Conditions (include but are not limited to):
    • Cardiovascular disease
      • Arrhythmia including Atrial fibrillation, Anticoagulant use
      • Coronary artery disease (CAD)
      • Stroke, TIA
      • Other rateable cardiovascular disease
    • Diabetes
    • Lung disease
      • Asthma
      • Chronic Obstructive Pulmonary Disease (COPD)
      • Bronchitis/pneumonia
      • Other rateable lung disease

Good Health Statement

A Good Health Statement will continue to be required with all new or pending applications unless there is a valid TIAA in place.

Foreign Travel

  • Travel plans to a country with advisory Level 1 or 2 is acceptable.
  • Travel plans to a country with advisory Level 3 or 4 due to COVID-19: if travel will be canceled or delayed until the country is determined to be safe by the CDC and US State department guidelines, LGA will amend the application and proceed with completing the underwriting process.
  • Travel plans to a country with advisory Level 3 or 4 due to civil unrest or terrorism; LGA will postpone the application until after travel takes place.
  • Applicants recently returning from international travel will no longer be postponed. LGA will assess their risk based on answers to the COVID-19 questions during the underwriting process.

COVID-19 Disease Cases Remains Unchanged

Postponed for at least 30 days after full recovery. Reconsideration parameters will depend on the severity of the disease and current health status.

 

** 04/09/2020 **

Legal & General America’s mission of protecting families and businesses remains our focus, even more so during these times of uncertainty. As they continue to work closely with exam vendors, Legal & General America understand that the completion of underwriting requirements, specifically insurance exams and in some cases obtaining medical records, is proving more difficult at this time. They have taken the following measures to mitigate this issue and to help your clients get the coverage they need.

Exam and APS Substitutions 

An applicant’s recent routine physical will be accepted in lieu of a paramed exam if it has sufficient data and if the trending rate class based on other evidence does not exceed table 3, does not require a medical flat extra and there is no evidence of material non-disclosure.  When Banner is unable to obtain APSs through traditional ordering, the underwriter may initiate a request for digital health data through Human API or other sources, which may require physician portal information from your client.  Please refer to the bulletin below for more information.

Age and Risk Profile Postponement Parameters

Applicants in the below age ranges whose assessed risk class exceeds rated table parameters AND the risk profile includes any of the referenced underlying chronic conditions listed below will be postponed for a minimum of 6 months:

  • Ages 50-64 and risk profile exceeds Table 6
  • Ages 65 -70 and risk profile exceeds Table 4
  • Ages 71-75 and risk profile exceeds Standard

Underlying Medical Conditions (include but are not limited to):

  • Cancer
    • Advanced Stage
    • Incomplete treatment
    • Organ of origin: lung, pancreas, brain, multiple primaries, melanoma, incomplete resection, recurrence, ongoing chemotherapy etc
  • Cardiovascular / Cerebrovascular disease
    • Arrhythmia including Atrial fibrillation, Anticoagulant use
    • Cardiomyopathies
    • Coronary artery disease (CAD)
    • Stroke, TIA or documented cognitive impairment
    • Valvular disease
    • Other rateable cardiovascular disease
  • Dementia Diabetes (type 2; T2DM)
    • With end organ damage (excluding retinopathy), history hypoglycemia, compliance/control issues, insulin therapy, young age diagnosis (< age 30)/long duration
  • Frailty -Includes mobility issues: current, functionally impairing, recovery not expected
  • Immunosuppression 
    • Current chemotherapy
    • History of recurrent infections
    • Immunosuppression for complex systemic disease (e.g. rheumatoid arthritis) Kidney Disease • Chronic Kidney Disease
    • Cystic kidney disease  
    • Marked proteinuria
  • Lung disease
    • Asthma (moderate or severe)
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Recurrent bronchitis/pneumonia
    • Other rateable lung disease

Temporary Guideline Updates Foreign Travel

  • At this time, due to potential exposure to COVID-19, any planned foreign travel will be postponed for a period of 30 days following the applicant’s return from their trip.
  • If travel plans are confirmed to have been cancelled, or indicated to only take place once the travel advisories are lifted, underwriting will approve the application and include an amendment to reflect the cancellation of travel plans or the parameters under which travel will occur.

Reconsideration of Previous Postponements for Travel

We will be reviewing cases that were postponed in March 2020 due to potential exposure to COVID-19 to see if reconsideration can occur.

COVID-19 Disease Cases

Postponed for at least 30 days after full recovery. Reconsideration parameters will depend on the severity of the disease and current health status.

 

Please also refer to the Underwriting Changes file below for more infromation about underwriting requirements.

Please give us a call at 1-800-792-6795 if you have any questions about these updates.