Application Kit Updates

Maryland Only:

8121MD(0320)K – LSW Life Insurance Application Kit, Cat. No. 46791  

• Removed: 20299MD(1114) – Disclosure Statement for Accelerated Benefits Critical Illness and Injury
• Added: ICC15-20314(0115) – Disclosure Statement for Accelerated Benefits Terminal Illness/Critical Illness/Critical Injury
• Removed: 8533 – Supplemental Application for Qualified Pension or Profit Sharing Trust
• Updated: Kit instructions

8121MD(0320)K – NL Life Insurance Application Kit, Cat. No. 47476

• Removed: 20298MD(1114) – Disclosure Statement for Accelerated Benefits Critical Illness and Injury
• Added: ICC15-20313(0115) – Disclosure Statement for Accelerated Benefits Terminal Illness/Critical Illness/Critical Injury
• Removed: 20240 – Supplemental Application for Qualified Pension or Profit Sharing Trust
• Updated: Kit instructions

20007MD(0320)K – Term Conversion Application Kit, Cat. No. 52243

• Removed: 20298MD(1114) – Disclosure Statement for Accelerated Benefits Critical Illness and Injury
• Removed: 20299MD(1114) – Disclosure Statement for Accelerated Benefits Critical Illness and Injury
• Added: ICC15-20313(0115) – Disclosure Statement for Accelerated Benefits Terminal Illness/Critical Illness/Critical Injury
• Added: ICC15-20314(0115) – Disclosure Statement for Accelerated Benefits Terminal Illness/Critical Illness/Critical Injury

1441MD(0320)K – Policy Change Application Kit, Cat. No. 43050

• Removed: 20298MD(1114) – Disclosure Statement for Accelerated Benefits Critical Illness and Injury
• Removed: 20299MD(1114) – Disclosure Statement for Accelerated Benefits Critical Illness and Injury
• Added: ICC15-20313(0115) – Disclosure Statement for Accelerated Benefits Terminal Illness/Critical Illness/Critical Injury
• Added: ICC15-20314(0115) – Disclosure Statement for Accelerated Benefits Terminal Illness/Critical Illness/Critical Injury

Connecticut Only:

8121CT(0320)K – LSW Life Insurance Application Kit, Cat. No. 46856

• Replaced:  8121CTG – Agent’s Report with 8121G(0119) – Agent’s Report
• Removed: 8533 – Supplemental Application for Qualified Pension or Profit Sharing Trust
• Updated: Kit instructions

8121CT(0320)K – NL Life Insurance Application Kit, Cat. No. 47466

• Replaced:  8121CTG – Agent’s Report with 8121G(0119) – Agent’s Report
• Removed: 8533 – Supplemental Application for Qualified Pension or Profit Sharing Trust
• Updated: Kit instructions

All Other States:

8121 LSW Life Insurance Application Kits. Each app kit will have the revision date of (0320).  

• Removed: 8533 – Supplemental Application for Qualified Pension or Profit Sharing Trust
• Updated: Kit instructions

8121 NL Life Insurance Application Kits. Each app kit will have the revision date of (0320).  

• Removed: 20240 – Supplemental Application for Qualified Pension or Profit Sharing Trust
• Updated: Kit instructions

New:

Pension Kits, Form 20713. Each kit will have the revision date of (0320):

• Form 1620 – Pension/Profit Sharing Plan Insurer Only Agreement.  For use with life insurance and/or NL annuity applications ONLY.  Needs to be included with each qualified plan.
• Form 5887 – Agreement To Fund A Defined Benefit Pension Plan.  For use with Defined Benefit 412(e)(3) plans funded with life insurance and/or NL annuity ONLY.
• Form 0843 – Fiduciary Approval.  For use with life insurance and/or NL annuity applications ONLY. Needs to be included with each qualified plan.
• Form 4258 – Employer Information Form.  For use with LSW annuity applications ONLY or LSW annuity applications combined with life insurance applications. (n/a to NY)
• Form 8533 (LSW) / 20240 (NL) – Supplemental Application for Qualified Pension or Profit Sharing Trust.  Needs to be included with each pension life application.
• NY Only:  Form 7414NY – Sales Illustration Certification.  Pension is exempt from Reg 187, and will follow the rules for Reg 74.