Application Kit and Transition Rules Updates

Application kits have been updated and they will be available for ordering on January 28th. Changes made are listed under each kit below.

LSW Life Insurance 8121 Application Kits. Each app kit will have the revision date of (0119).

• 8121(0918) – Individual Life Insurance Application. The California application will be updated at a later date.
• 4506T (September 2018) – Request for Transcript of Tax Return
• California only: 9402(0119) – NOTICE REGARDING STANDARDS FOR MEDI-CAL ELIGIBILITY AND RECOVERY

NL Life Insurance 9212 Application Kits. Each app kit will have the revision date of (0119).

• 9212(0616) – Individual Life Insurance Application. Instruction changes ONLY. The New York application will be updated at a later date.
• 4506T (September 2018) – Request for Transcript of Tax Return
• California only: 9402(0119) – NOTICE REGARDING STANDARDS FOR MEDI-CAL ELIGIBILITY AND RECOVERY

Term Conversion Application kit for California – 20007CA(0119)K, Cat. No. 52228

• 9402(0119) – NOTICE REGARDING STANDARDS FOR MEDI-CAL ELIGIBILITY AND RECOVERY

Policy Change Application kit for California – 1441CA(0119)K, Cat. No. 43043

• 9402(0119) – NOTICE REGARDING STANDARDS FOR MEDI-CAL ELIGIBILITY AND RECOVERY

Transition Rules – 8121(0918) New LSW Life Application

New Life Application
• There is a new LSW life application, 8121(0918), for use in all states except California, beginning January 26, 2019.
• California will continue to use 8121CA(0616).

Forms Transition
• The old application and kit will be removed from Merrill on January 28, and the new application and kits will be available.
• Application submissions on the old version will be accepted through Monday, February 25, for all products. After that date, any new submissions received in the home office must be on the new application.

eApp
• The new application will be available in eApp on January 26, 2019.
• Cases that are not locked on January 25 will get the new application automatically, and additional questions may be required.
• Cases that are locked on or before January 25 will maintain the old application version.

TC105991(0119)1