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What is the purpose of this insurance?
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Group Benefits
Individual Income Protection
Key Person or other business use
Other
How do you want to provide financial, occupational, lifestyle and medical information?
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🛈
Not here. Let's schedule a time to talk.
On this form. (Estimated time: 20 minutes)
Are you the person to be insured?
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Yes
No. I represent someone else
What is your relationship?
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Financial Advisor
Insurance Agent or Benefits Consultant
Co-Worker, Business Partner, or Assistant
Other
Other
An established client?
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Yes
No
From here on out, "you" refers to your client.
Where are you in the process?
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Looking into my options
Ready to apply
Where in the process is the group?
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🛈
Requesting Proposals
Ready to implement
Business name
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Please use the legal name of the group, as this will be on the policy.