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Welcome to 2025 and AgencyONE’s case design ONE Idea kick-off for the new year! Our October 2024 case design ONE Idea featured my interview with OneAmerica’s Regional Account Director for Care Solutions, Brian Shepard, CLTC, in which we discussed the carrier’s Hybrid LTC solutions. In that article, we noted that OneAmerica would be updating their individual and joint Asset Care options to further improve their competitiveness later that year.  

This week’s ONE Idea will focus on those changes and the benefits the solution will offer your clients. The new version of the product will be referred to as Asset Care (2024)* and the previous version as Asset Care (2019)**. (This ONE Idea will not cover the specific California product. If you want to discuss that option, please contact AgencyONE). 

Asset Care (2024) Benefits 

Asset Care (2024) is available for both individual and joint life cases and allows your clients to be slightly rated in the underwriting process. OneAmerica’s hybrid solutions provide a monthly reimbursement benefit. The 2024 version is also better aligned with other carrier benefit periods, allowing AgencyONE to provide you with a more targeted competitive analysis for your clients’ cases. It also offers a 2-year Acceleration of Benefits (AOB) with a 2, 4, 6-year, or lifetime Continuation of Benefits rider (COB). This results in longer coverage – meaning the benefit period will run for 4, 6, 8 years, or lifetime.

OneAmerica’s Asset Care hybrid products remain the only options in the market that allow a lifetime benefit period and can be added to both the individual and joint product offerings. 

Asset Care (2024) Product Specs: 

• Issue Ages are 35-80 years for Single and Recurring Premiums. 
• Joint life has a maximum 25-year age difference between unrated joint insureds. 
• Premium payment options are similar to the 2019 product. 
• On the initial 2-year Acceleration of Benefit (AOB), single pay, 5, 10, 20, and pay to age 95 is available. 

Continuation of Benefits Rider (COB): 

This rider covers the costs of extended qualifying care. The Continuation of Benefit rider (COB) must match the AOB premium mode. 

• Premium cannot increase, and the policy owner can continue this rider as long as premiums are paid on time. 
• Rider benefits start after the base policy long-term care benefits reduce to zero. 
• On a joint policy, the lifetime benefit applies to both insureds for one premium rate. 
• Clients can pay on a single-premium, 5-pay, 10-pay, 20-pay, or lifetime (pay-to-95) basis depending on their funding choice. 
• Continuation of benefits can be added to any Asset Care base policy with an additional premium at application. 

Inflation protection and nonforfeiture benefits may also be available for an extra premium. Note that international facility and care coordination benefits are not available with the continuation of benefits rider.

Inflation Rider – Three Options & Two Durations: 

Options include 2%, 3%, or 5% compound interest for 20 years or lifetime. If selected for both the base coverage and COB Rider, the interest rates and duration must match. If electing base Inflation Protection Rider (IPR) you must also select COB IPR, however you can select COB IPR without including it on the base. The premiums are guaranteed never to increase.

Single Premium Drop-In Rider:  

The Single Premium Drop-In Rider allows clients to make up to two additional premium drop-ins (minimum: $10,000; maximum: $100,000) within six months of policy issue, however the face amount available with this rider may not exceed $250,000. Clients are underwritten for the assumed total face amount including initial premium and all drop-ins. Note: The Single Premium Drop-In Rider is available only with the recurring premium whole life funding option. 

Benchmarking Hybrid LTC products can be difficult as case designs are all over the place with different age limits, pay periods, benefit periods, and inflation options. For comparison purposes, AgencyONE runs all 4 of our carrier partner options (Lincoln, Nationwide, OneAmerica and Securian) for our cases. It is, however, easier to benchmark the new OneAmerica product with the same benefit periods and, as a bonus, OneAmerica offers a lifetime benefit period while the other carriers do not.

Contact the AgencyONE case design department at 301.803.7500 for more information or to discuss a case.  

 OneAmerica UW and Sales Process Guide is attached HERE for your reference. (link to be added).  

*Asset Care 2024 – Updated Product Offering: Alabama, Alaska, Arkansas, Colorado, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Wyoming. 

**Asset Care 2019: Arizona, Connecticut, District of Columbia, Delaware, Florida, Indiana, Montana, New Jersey, North Dakota, South Carolina and South Dakota.

As another year comes to a close, we pause to reflect on 2024 and find that reviewing our ONE ideas helps us to evaluate the last 365 days. Our ONE Ideas convey what is happening in the industry and what is on the mind of our AgencyONE 100 advisors and their clients and are an important part of our communication to our advisors.

2024’s ONE Ideas presented interesting advanced market concepts, case design scenarios, and underwriting information and case studies. We are pleased to provide this annual review and hope that it offers you some insight, answers, and/or ideas for your existing or future cases.

Remember: any of the following ONE Ideas may be customized to be business and/or client-facing for our AgencyONE 100 advisors.

Business Planning / Sales Ideas

A 2023 Review & My 2024 Predictions – Jan. 23
At the beginning of the year, Gonzalo Garcia, CLU highlighted some key items that emerged from previous years that might continue to create both opportunities and challenges in 2024: higher interest rates on products, annuities, the Great Wealth Transfer, and more. He also included his personal 2024 predictions for each category. We encourage you to review this ONE Idea to see how his predictions for the year measured up!

Our Financial Planner Said We Didn’t Need Our Life Insurance When We Retired…Then My Husband Died – Feb. 16
In this ONE Idea, Gonzalo analyzed an article in Kiplinger Personal Finance by Evan T. Beach, CFP, AWMA about the author’s perspective and answer to the question “If You’re Retired, Do You Still Need Life Insurance”? Gonzalo poses some questions to consider when contemplating the use of permanent life insurance during retirement and his opinion on the original article.

A Financial Wellness Primer – June 7
The models of wellness have 6 dimensions, but The National Institutes of Health adds another: The Financial Dimension. In this article, Gonzalo focuses on financial wellness, how to maintain it, and highlights the types of insurance that contribute to one’s overall financial wellness: Health Insurance, Long-Term Care Insurance, Life Insurance, and Disability Insurance. You must read this article!

The Best Laid Plans of Mice & Men: Generational Wealth Planning – Dec. 13
As generational wealth professionals, in collaboration with attorneys, accountants, and other financial advisors, best intentions for clients can sometimes go awry. This piece discusses: the causes based on study conclusions, dynastic and purposeful planning, the option of having a family treasury, and more.

Estate & Tax Planning

Retirement Planning: It’s All About Taxes – May 9
In this ONE Idea, Gonzalo Garcia, CLU discusses the role that taxes play in determining how much money there will be in retirement and the planning that is required to help maximize what is kept and minimize what is paid in taxes. Learn about the various “buckets” and the retirement mistakes to be avoided.

Is Your Client’s IRA an IOU to the IRS? – Sept. 5
Gonzalo discusses the taxable income that is created by clients with IRAs and 401K distributions and the alternatives that can be considered by financial planners and their clients who are willing to embrace them. He goes on to say that any advisor who wants to do “right” by his/her clients has complete transparency into their taxes, considers account tax cost ratios when making recommendations and reviewing portfolios, and recommends solutions that address present & future taxes.

Accessing Home Equity for Financial Alternatives – Nov. 11
This article focuses on a new program – CHEIFS – available to advisors with clients who want to consider accessing their home equity for financial planning alternatives such as life insurance. Converting Home Equity Into Financial Success (CHEIFS) is offered by Cornerstone Financing, an insurance and investment funding company, and presents a huge opportunity for financial advisors to have a new and different conversation with clients. This is NOT a reverse mortgage conversation; this is a totally new offering and a MUST-READ ONE Idea!

Case Design & Product Intelligence

LTC/Chronic Benefits Using 1035 Funds – Feb. 23
This ONE Idea by Ed Stark, CLU, ChFC highlights the undeniable value and huge potential in doing regular policy reviews with your clients. This article drives that very important message home and discusses a case that resulted in success for both the client and the AgencyONE 100 Advisor. Make sure to check this out!

Hybrid/LTC Products & LTC Rider Options: The First in a Series of ONE Ideas – Apr. 22
In this ONE Idea, Ed discusses Hybrid/LTC products, their rider options, and what’s available in the marketplace. He focuses on Lincoln, Nationwide, OneAmerica, & Securian and their basic product specs and features. Make sure to read this informative article to help you determine which carrier & solution is best for your clients’ needs.

Hybrid/LTC Products & LTC Rider Options: Part 2 – Lincoln Financial – May 22
In the second in a series of articles about the subject, Ed takes a deeper dive into Lincoln Financial’s Hybrid LTC solutions through an interview with Lincoln MoneyGuard’s VP, Timothy Lockwood, RICP, CLTC. Have a look to find out what sets MoneyGuard apart from other solutions, its target markets, the most popular designs, product niches, and more.

A Pacific Life Solution You Need to Know About – Horizon IUL 2 – Sept. 27
In this product-specific article, Ed highlights an exciting IUL solution from Pacific Life. The Horizon IUL 2 replaces two of their previous products making it much easier for advisors to choose the correct option for their cases.

Hybrid/LTC Options Now Available & Overview of New Upcoming Changes at OneAmerica – Oct. 15
The popularity of Hybrid/LTC options continue to grow. Carriers are increasing product flexibility and improving options as consumers prioritize this kind of coverage. In this article – part of the series on Hybrid/LTC solutions – Ed focuses on OneAmerica’s options in the category – what sets OneAmerica apart from other carrier solutions, what is the target market, what is the most popular design, and details on annuity care.

Selling Term: Lowest Cost, Comparable Cost or Higher Cost with More Benefits? – Nov. 22
Term insurance continues to be a popular choice for many clients, however, it is important to review term comparison sheets to really understand the difference between product solutions and the pricing variations. Ed explores sample cases and breaks down the details from comparison sheets in this very informative piece of product intelligence.

Underwriting

Prostate Cancer: Forget the Defense…Let’s Go on Offense – Jan. 12
Dennis Bartos, PA began 2024 with a ONE Idea that discussed Prostate Cancer – what it is, its diagnosis, treatment, and how it is underwritten at AgencyONE and the carriers. It also includes two very real case studies that show how AgencyONE evaluates these cases.

Coronary Artery Disease (Part 1) – Mar. 6
In this first of a two-part series of ONE Ideas, Dennis focuses on Coronary Artery Disease (CAD) and discusses: what it is, the methods for diagnosing CAD, the inherent risk factors underwriters assess, a case study, and how an informed AgencyONE 100 Advisor and their clients can help to positively affect the outcome of their cases.

Coronary Artery Disease – Diagnosing & Underwriting the Risk (Part 2) – May 17
In this second part of the CAD ONE Idea series, Dennis provides a recap on the disease and poses specific questions and answers about CAD that are designed to improve your field underwriting knowledge. Be sure to review this ONE Idea to brush up on Coronary Artery Disease.

Is Life Insurance Possible After Skin Cancer – June 17
Dennis discusses the most common cancer in the US in this ONE Idea – skin cancer – the chances of getting it, the types of skin cancer including the most dangerous kind, what AgencyONE is seeing during underwriting, 2 real case studies, and how they were underwritten. You will want to read this article for all the details!

Memory Loss – Do I Have Alzheimer’s? – Sept. 19
In this article, Dennis talks about the difference between normal age-related memory loss and more severe conditions such as mild cognitive impairment (MCI) or the even more concerning disease of Alzheimer’s. He goes on to discuss diagnosis, how the conditions are treated and underwritten, and real case studies. There is a lot of excellent information in this article for your older age clients!

I’ve Read About Them, But Should I Get a Total Body Scan? – Oct. 25
In this article, Dennis explores total body scans, their growing popularity with the general public, when and if they are a good preventative health screening, how their existence can affect underwriting, and a case study for a client who had one. This is a must-read.

3 Important Underwriting Reminders for Year-End & Beyond – Nov. 14
With the rush to year-end, Dennis thought it important to reiterate some important underwriting reminders about routine physician appointments when your client is in underwriting, the importance of using Accelerated Underwriting Programs (AUP) where applicable, and the important client-facing materials that are available to your clients to help them sail through the underwriting process. This is a must-read article for any time of year!

Annuities

AgencyONE’s 2024 Annuity Outlook – Feb. 9
In this ONE Idea, Craig Baumgartner, RICP discusses the increased activity among our AgencyONE 100 advisors and their clients in the annuity space in 2023 and how the interest rate environment continued to propel annuity sales. He discussed what experts thought 2024 would bring for annuities and reminded readers that if you are still not talking to your clients about annuities, someone else will. It is important to continue to educate yourself about annuities so that you do not leave opportunities on the table!

Hidden 1035 Opportunities: Don’t Miss Out on Creating Joint Benefits – Mar. 15
In this ONE Idea, Craig explores some lesser-known opportunities and the rules and workarounds available for your clients who want to create joint benefits by exchanging an existing individual policy via a 1035.

In July we announced our new annuity offerings and newest resource to AgencyONE’s annuity team, Sal Sigleski, due to our partnership with Brokers Service Marketing Group (BSMG), which resulted from our acquisition by the Specialty Program Group (SPG). This partnership has enabled us to dramatically improve the Annuity Services we offer our AgencyONE 100 advisors. For more information, please view the original announcement HERE and be on the lookout for an upcoming webinar with Sal on how he and his team will help you STREAMLINE & GROW your annuity business.

Marketing

Does Your Business Have a Social Media Presence? A Platform that Makes it Easy – Mar. 25
In this ONE Idea, Lisa Mitchell discusses the popularity of Social Media marketing for businesses and how the practice can reach a wider audience and build relationships while deepening existing ones. Social Media marketing has become the most popular way to market, but a business needs to consider a number of things before taking the leap. Read this ONE Idea to find out what those things are and about a platform that helps.

We wish you and yours a happy, healthy, and safe holiday season and a New Year full of blessings, possibility, and prosperity!

AgencyONE looks forward to providing more terrific content in 2025. Please contact our Marketing Department at 301.803.7500 for more information or to discuss a case.

“This fabled golden era, this special world of luxury and privilege that the Vanderbilts created, lasted but a brief moment. Within thirty years after the death of the Commodore Vanderbilt in 1877, no member of his family was among the richest people in the United States…. When 120 of the Commodore’s descendants gathered at Vanderbilt University in 1973 for the first family reunion, there was not a millionaire among them.” – Arthur T. Vanderbilt II.

Fortune’s Children: The Fall of the House of Vanderbilt

When Cornelius Vanderbilt died at age 82, he left the bulk of his fortune, estimated at more than $100 million in 1877, to his son William. Generational wealth, often viewed as a family legacy, is surprisingly fragile. Without intentional planning, even substantial fortunes, like that of the Vanderbilts, can vanish in a few generations. How can this happen?

The Problem

The best-laid schemes o’ mice an’ men,

                        Gang aft a-gley,

An’ lea’e us nought but grief an’ pain,

                        For promis’d joy.

Modern English translation – “The best laid plans of mice and men often go awry, and leave us nothing but grief and pain, for promised joy”.

As Scottish poet Robert Burns aptly notes in his 1786 poem To a Mouse, ‘The best-laid plans of mice and men, often go awry’. For many families, well-constructed wealth transfer strategies fail to deliver the intended legacy, leaving grief and disappointment instead.

As generational wealth professionals, in collaboration with attorneys, accountants, and other financial advisors, our best intentions for clients “gang aft a-gley”. In fact, they go awry so often that one must question if there is a better way to accomplish generational wealth planning. According to a 20-year study of 2,500 families by The Williams Group and another extensive study of 750 families by the Miami of Ohio School of Business, fully one-third of generational wealth transfers fail beyond the first generation. Research from a variety of sources indicates that the failure rate can be over 90% by generation three.

When looking for causes of this, the Williams study concluded that only 5% of the failures were the result of poor governance, legal, tax, or investment advice. The other 95% was caused by:

• Breakdown of family communication and trust – 60%
• Inadequately prepared heirs – 25%, and
• Failure to establish a family mission – 10%.

The Importance of Purposeful Planning

Suppose only a 5% failure rate lies in governance, legal, tax, and investment advisory services. In that case, we must become more purposeful in our planning by addressing the reasons noted above for 95% of planning that fails. Isabel Miranda, JD, Managing Partner at Pearlman & Miranda, LLC with offices in Newark, New Jersey, and New York, New York defines purposeful planning as “expressing your wishes in a way that is driven – not by tax laws and financial wealth – but by enduring wealth. Purposeful planning is about your family and the values and philosophy that you engender and embody.” I interpret this as a focus on a family’s core values, shared experiences, sound financial stewardship, and charity to others. Mrs. Miranda continues by stating “to accomplish this, we need to work with our clients to capture their essence in a meaningful way and reflect that in their estate plans.”

Bob Larkins, CLU, ChFC and Accredited Estate Planner (AEP) in Dayton, Ohio comments that “generational wealth planning is not a legal exercise, it’s not a financial exercise; it’s an emotional exercise with legal and financial consequences”. I would emphasize that these legal and financial consequences, if gone awry, can be devastating to individual family members and entire families.

Generational Execution – A Long Game

When planning for many generations, possibly hundreds of years, with tools such as multi-generational or dynastic trusts, due diligence is required to ensure that the wishes of the founding family members are honored well past their lifetime and that the connection to their value system and desires be maintained. It is critical that long-term governance be considered.

“An independent corporate trustee can play many extremely important roles for perpetual family enduring wealth” states Al W. King, III, the Co-Founder, Co-Chairman, and Co-CEO of South Dakota Trust Company. He goes on to say that “the independent corporate trustee not only assists the family with many of the administrative tasks associated with a perpetual trust but also acts as a great mentor, sounding board, and arbitrator for the family. Additionally, an independent corporate trustee located in one of the modern trust states (i.e., DE, NV, SD, or WY) can provide a family and its perpetual trusts with tax benefits, asset protection, control, and flexibility regarding trust investments and distributions, assist with the promotion of family values intergenerationally, privacy and much more.”

Independent corporate trustees for a perpetual trust generally operate within a “directed trust” fiduciary structure which provides a collaborative relationship among the family, family advisors, beneficiaries, and the independent trustee. Multiple trustees/fiduciaries and managers assume duties generally assigned to a single trustee. This structure leverages specialization of function regarding trust investments, distributions, custody, and administration combined with active family and family advisor involvement. Consequently, an independent corporate trustee can protect a family’s goals and purpose in perpetuity.

Dynastic Planning

Athos, Porthos, Aramis, and d’Artagnan’s motto “all for one and one for all” in the famous Alexandre Dumas novel, The Three Musketeers, simply means that every individual acts for the benefit of the group, and the group should act for the benefit of every individual.

Most planning involves each family in a generation creating a trust or series of trusts for the benefit of their direct descendants, as each family unit will have unique needs, goals, and circumstances, leading to a distinct but often shared family mission.

Multigenerational or Dynasty trusts will ultimately hold a multitude of family assets such as business interests, managed investment portfolios, family homes, commercial real estate, life insurance, and other assets, for the benefit of the intended beneficiaries of said trust. These assets, which are protected from creditors and shielded from wealth transfer taxes, will serve as the income-generating tool for distributions to trust beneficiaries.

There is another factor to consider, however, which is just math.

As the chart above indicates, after several generations, the beneficiaries will no longer be closely related to the grantor. A child of the grantor will be related 50%, a grandchild, 25%, a great-grandchild, 12.5%, so that by the 6th generation, the beneficiary only has a 1.6% relationship with the grantor, and that relationship continues to halve with each successive generation. Intentionality as to governance, the communication of family values and mission, and the preparation of heirs are critical to long-term success.

By the same reasoning, the trust income or property must be divided among more and more beneficiaries. If the grantor and each beneficiary have 2 children, then there will be 64 beneficiaries in the 6th generation. Unless there is adequate governance and stewardship and a constant replenishment tool, the wealth, as with the Vanderbilts, will dissipate.

The Family Treasury – Constant Replenishment

The Family Treasury, which is an Insurance Limited Liability Company, takes the Three Musketeers motto into the multigenerational family setting. It is established for the sole purpose of executing the “all for one and one for all” mindset. 

Trusts can invest a portion of their assets, via capital contributions, into a “Family Treasury” which does nothing more than own life insurance on all living members of the family, by birth or by marriage, in equal amounts. Over the generations, each family trust benefits equally from the life insurance proceeds. The life insurance serves as the great equalizer for the benefit of the “all” by replenishing wealth for subsequent generations. 

Why life insurance?

• Life insurance is a non-correlated asset relative to the other investments in the family portfolio.
• It is always worth 100% of face value at the death of the insured regardless of market cycles (equities, debt, real estate, commodities, etc.).
• It is converted to cash at death providing immediate liquidity.
• Cash value grows on a tax-deferred basis and can be invested in a variety of asset classes (equities, bonds, cash equivalents, etc.) if desired.
• Cash value can be used as collateral for borrowing purposes.
• Death benefits are income tax-free and, if properly owned, estate tax-free.

In this setting, the descendants who are investment bankers and neurosurgeons are as “valuable to all” as the descendants who are elementary school teachers and Peace Corps volunteers. Family members can be empowered to pursue their life’s goals and passions without fearing great wealth disparities over the generations and can contribute in their own unique way to the family mission, value system, and stewardship.

With Purposeful Planning, Generational Execution, and a Family Treasury, the chances of generational wealth, both enduring wealth and financial wealth, increase dramatically.

For more information on The Family Treasury or to discuss a case, contact Gonzalo Garcia at 301.910.1234 or gonzalo@agencyone.net. Our goal is to work in a collaborative way with other legal, tax, trust, financial, and insurance advisors.

How many advisors are actively selling term insurance? I would venture to say that nearly every insurance advisor has sold a term policy at some point in the past year. While you may not believe term is the ideal solution for your client, the competitive cost can provide essential protection as they build their estate. Therefore, it is important not to overlook term insurance as a vital component of a client’s financial strategy. Additionally, securing a client’s insurability has always been a key benefit of term insurance.

AgencyONE’s case design team has been receiving an increasing number of inquiries about term products. Some questions pertain to additional riders and features, while the majority focus on conversion options and age limits. Currently, there are carrier products with limited or no conversion options that come at a lower price. However, be sure to review term comparison sheets to understand the differences between products. A minimal cost increase may add benefits and therefore enhance value to your client. Let’s explore some sample cases and break down the details from the comparison sheets.

Below are the findings from a $1M 20-year term sheet for a 45-year-old male client, assuming Preferred non-tobacco (NT) status.

• Carriers A, B, C, D, and E all offer a premium of approximately $1,192 per year (with very minor price differences).
• Carrier F shows a premium of $1,199 per year.

All carriers listed have A to A+ AM Best ratings and provide E-App options, with some offering Accelerated Underwriting Programs – AUPs (more details on that later). While you might be tempted to choose the lowest cost option and start the application process immediately, we recommend you and your client explore the solution fully to understand what you are getting for the premium:

• Carrier A allows conversion throughout the term or up to age 70, whichever comes first. They offer a Conversion Specific Guaranteed UL with limited flexibility, priced higher than fully underwritten GUL products.
• Carrier B provides conversion for 18 years, allowing ANY product for the first 5 years, then switching to a product specifically designed for conversions in years 6 and beyond. For a higher cost (increase from about $1,192 per year to $1,492 per year) you can add a conversion extension rider that includes an option for a chronic rider when converted to the permanent product. This option requires advanced underwriting.
• Carrier C offers a conversion option for 10 years to a specific product available in the state of sale.
• Carrier D allows conversion to ANY product for the first 10 years, followed by a conversion-specific option for years 11-20.
• Carrier E does not provide a conversion option at this price on the base term product unless your client purchases an extended conversion rider, raising the price to $1,337 – still competitive among top options.
• Carrier F allows conversion to a conversion-specific GUL for the full 20 years.

These six carriers present varying conversion options, with premium costs closely aligned. If underwriting is similar for all six, which option would be the best choice?

When selecting a product based on price, benefits, and conversion options, prioritize carriers with the best AUPs. Accelerated underwriting offers clients and advisors the opportunity to have a policy issued very quickly – sometimes within minutes from application to issue – assuming they meet the program requirements.

Qualification for carrier accelerated programs depends on the client’s age, current health, and the death benefit requested. If a client meets all requirements and the application proceeds smoothly through the accelerated program, they may bypass the need for an exam or wait for APS records. Even if a client gets “bumped” from the accelerated program to standard underwriting, their policy could still be issued more quickly simply because they began in the accelerated process.

Several carriers are now considering fluidless programs for older applicants (over 50), provided they have undergone a comprehensive exam and lab tests with their physician in the past year. The maximum face amount for many of these programs has increased and may continue to rise. Some processes can now be fully digital from beginning to end, enhancing the overall customer experience, and expediting the underwriting process further.

For any questions regarding conversion options, please reach out to the AgencyONE case design team. We are here to help you select the best solution and work with new business and underwriting to identify the ideal fit for your clients.

Contact the AgencyONE Case Design Department at 301.803.7500 for more information or to discuss a case.

The rush to year-end is on. While there is still plenty of time to place your business, AgencyONE thought a reminder of sorts would be helpful in getting your cases successfully placed before the carrier deadlines.

Reminder #1 – Routine Physician Appointments

Consistent medical care is of utmost importance, but your clients must be especially mindful when scheduling those routine appointments during the underwriting process.

Advisors should recommend that their clients only see their doctors for cause (to treat an ailment, illness, or accident) and hold off on any routine checkups or testing until AFTER underwriting is complete and the policy is placed.

ANY visit to the doctor or test is considered a change in health for underwriting purposes. The underwriter is required to obtain any information about an updated office visit or a test before your client can be cleared and the case placed. A routine doctor visit can negatively affect the outcome of the case by possibly:

• Downgrading the underwriting rating;
• Causing a postpone; or
• Resulting in a decline in your client’s case.

AgencyONE recently had a case with a policy in the field, but not yet placed, when the client visited the doctor for a routine checkup. This required that we retrieve the results which showed an elevated A1C of 6.2. This client is now considered Prediabetic and is in danger of losing the PREFERRED BEST policy protection that was issued before the routine physician visit and testing occurred.

Reminder #2 – Accelerated Underwriting Programs

Accelerated underwriting is NOT just for your term or small cases anymore. Accelerated underwriting requirements continue to change. Carriers are raising face amounts, digitizing the entire process, delivering policies electronically and drastically lowering the time from app to issue. If you have not taken advantage of these programs, NOW is the perfect time to try! Stay up-to-date by referring to the AgencyONE Carrier Accelerated Underwriting Sheet under the New Business & Underwriting tab on your personal Advisor Dashboard. 

Reminder #3 – Client Facing Materials

We cannot emphasize enough the importance of educating your clients on the underwriting process and the necessary steps to ensure their policy is placed as planned. Communication is key throughout underwriting.

AgencyONE has created a variety of client-facing materials for our AgencyONE 100 advisors to share directly with their clients. We have videos and easy-to-understand written one-pagers to help you and your clients better understand the detailed insurance and underwriting process.

These helpful materials are on the AgencyONE website under your “Advisor Dashboard” and the” For Client Use” dropdown. They include Exam Prep, Interview Prep, Senior Supplement, and Inspection Report Prep. We encourage you to use these materials with all your clients, where applicable.

Only 44 days to year-end! (At the time this ONE Idea was published)

Please contact AgencyONE’s Underwriting Department at 301.803.7500

for more information or to discuss a case.

My wife and I own a lake-front house, and we love spending time there. However, our two adult children rarely enjoy it for a variety of reasons. I am sure they will sell it when they inherit the house. The house has no mortgage and during the pandemic, like so many vacation homes, the value of the home grew significantly. Will that growth trajectory continue? The house is currently worth approximately $1.5MM and we would pay hefty capital gains taxes if we sold it for cash to reinvest in other investments or financial products.

CONSIDER A NUMBER OF WHAT IF’S:

WHAT IF we could, instead, take $500,000 of value in that home and invest it in a managed account that will outperform the historical growth of the property? A comparison from 1945 to the present day shows that the normalized historical returns of the Case Schiller Home Price Index was 4.87% versus 11.07% for the S&P 500. Sounds like good arbitrage to me!

WHAT IF we could arrange for our children to receive a $2.9MM income and estate tax-free payment PLUS their share of the home’s remaining equity value at our death by taking the $500,000 of equity out of the house today? I am referencing a single premium Survivorship Life (Second-to-Die) Insurance policy. At life expectancy (ages 89/84) the insurance alone is a 7% tax-free return.

WHAT IF we could turn that $500,000 into a guaranteed income stream by purchasing an immediate income annuity to supplement retirement income?

WHAT IF we could create a longevity hedge via the purchase of a deferred income annuity with payments starting at a future date?

WHAT IF we could purchase guaranteed long-term care benefits, or a combination of life insurance with long-term care benefits, or an annuity with long-term care benefits?

The planning options to use dormant equity in a primary or secondary home are endless.

This is NOT a Reverse Mortgage conversation; this is a totally new offering that many of our readers have never heard of. More later.

According to a 2024 Board of Governors of the Federal Reserve report, there is $31 trillion sitting in home equity in the United States which represents a significant percentage of overall household net worth across all ages.  

This brings us to a new financial product that focuses on this unused home equity asset.

Introducing Converting Home Equity Into Financial Success or CHEIFS offered by Cornerstone Financing, an insurance and investment funding company. CHEIFS presents a huge opportunity for financial advisors to have a NEW AND DIFFERENT conversation with clients about using their dormant home equity to achieve meaningful financial planning results. It also provides financial advisors with a unique product that enhances their toolkit!

As I said before, this is NOT a reverse mortgage. CHEIFS is structured as a minority fractional investment in residential real estate requiring NO interest or principal payments. There is no personal liability for payment of the homeowner’s obligations under the agreement (non-recourse). This allows the homeowner to continue to live in and\or enjoy their home without the burden of monthly payments, using the equity taken to purchase financial products resulting in a more holistic financial plan. It provides access to tax-free cash with no debt service requirement, resulting in a highly efficient cost of capital. The homeowner continues to enjoy all utility benefits of homeownership, remaining completely in control while sharing some of the economic benefits with Cornerstone.

In a Point Research survey in April 2023, when asked the primary reason homeowners won’t use a loan (like a reverse mortgage, cash-out refinance, or a home equity line of credit) to pay for home updates, the primary reason, 38.9% of respondents, was “I want to be debt free”.

A CHEIFS transaction is an equity participation in the property based on a predetermined formula, with a cap on the equity percentage.

Conversely, a reverse mortgage is a loan in which borrowed money PLUS interest PLUS fees each month create a rising loan balance. The homeowner or their heirs will eventually have to pay back the loan, usually by selling the home, and often, little to no equity remains to share with the heirs. 

The market for Home Equity Investments has exploded, as noted by head of securitized products at Barclays Bank, Mark Ginsberg.

An October 30th WSJ article stated that “private equity giant, Blackstone, began spending hundreds of millions of dollars on family homes that went into foreclosure after the 2008-2009 financial crisis, creating a completely new asset class for institutional investors”.

Cornerstone Financing, the developer of CHEIFS, recently announced that they had secured $285 million in aggregate financing through global finance firms Aquiline Capital Partners LP and Nomura.

The press release goes on to state that “a new funding solution for insurance and financial advisors revolutionizes the home equity landscape by augmenting the evolving financial toolkit for advisors and homeowners”.

CHEIFS is currently approved to do business in Pennsylvania, California, Arizona, Florida and Virginia with more states to follow. 

Imagine a planning process that releases dormant home equity for use in investment and protection solutions without monthly payment or debt. Imagine a planning process where required cash is readily available, leaving fee-generating AUM intact, existing cash on hand and liquidity remains in place. Imagine a planning process where the funding conflict or challenge often presented when trying to purchase insurance and annuity products is eliminated.  This is CHEIFS! Imagine what it can do for your customers and your advisory practice.

AgencyONE held a webinar with the creators of CHEIFS, during which they explored this unique program in further detail. Watch the replay of the webinar HERE!

Please contact AgencyONE at 301.803.7500 for more information about CHEIFS or to discuss a case. 

Should you get a total body scan, either CT (Computed Tomography) or MRI (Magnetic Resonance Imaging) as a preventative health screen? While prevention is a good thing, these sophisticated tests are very sensitive to any abnormality. In this ONE Idea, we will discuss the difference between a CT and an MRI, what you should expect from the results, and explore a Case Study. If you have health concerns, then yes, you should have one completed but consider the timing. Is NOW the right time?

As the costs of these detailed imaging tools have dropped, there are more centers popping up to offer health screening and total body imaging scans that can be performed without medical necessity or a doctor’s order. All you need is money! These screening results can be a valuable tool in early detection of health issues before symptoms arise. Each of these studies has their own merit and each is extremely sensitive. In fact, they have coined the phrase “incidentalomas,” since they so often pick up incidental findings in the lungs, liver, and kidneys. If an abnormality is found, follow-up imaging or further testing needs to occur to confirm that the finding is in fact “incidental” and not a small pathologic growth. These findings can put the underwriting process for life insurance on hold until the follow-up testing or a further work-up rules out any mortality concern.

Timing is very important! It is better to get your life insurance policy in place prior to scheduling any total body screening MRI or CT scan. That just makes good practical sense!

Can These Scans Find Cancer?

The answer is yes, but they can also miss a small cancer so just getting a total body scan that is reported as negative should not relieve you of other routine cancer screening tests like a colonoscopy, pap, or mammogram. 

What is the Difference Between a CT Scan and an MRI?

While both procedures are painless, the CT scan is faster and can be completed in less than 20 minutes. A CT scan involves radiation (like an X-ray), while an MRI involves radiofrequency waves and magnets so there is no radiation risk. The MRI is highly sensitive in imaging soft tissues, swelling, and tumors but takes nearly an hour and requires the patient to remain perfectly still. While that sounds tough, the facility will give you headphones that play music and sometimes a TV to distract you as the shifting magnets can be very loud and disconcerting. 

Should I get a Total Body Scan?

Well, that decision is up to you. A total body scan, either CT or MRI, can offer you a comprehensive picture of your overall health and can identify early signs of disease before any symptoms present themselves. It can certainly be reassuring to have a “clean” total body scan but the sensitivity of these studies along with the incidental findings, can cause concerns for life insurance underwriters when any abnormalities show up.

Coronary Calcium Scores

A total body CT scan can document a coronary artery calcium score but only a more focused chest CT angiogram can quantify the calcium deposits and pinpoint their location – inside the coronary arteries or within the coronary artery walls.  The calcium score is believed to correlate with coronary artery disease and that a higher calcium score presents as more risk for underwriting. However, we have seen high coronary artery calcium scores that do not represent coronary artery blockages of any blood flow because the calcium deposits occur inside the artery walls, and not inside the artery lumen. 

While the coronary calcium score is a flag, it is not a diagnostic test. Further studies are often needed to determine this. It is certainly good preventative care to aggressively monitor anyone who has an elevated coronary calcium score with cardiac stress testing, echocardiograms, or other diagnostic tests. Elevated coronary calcium scores present underwriting issues for sure.

For more information on coronary calcium scores and coronary artery disease, please have a look at two of our articles from earlier this year: Coronary Artery Disease – Life Insurance Protection and Coronary Artery Disease – Diagnosing & Underwriting the Risk.

Bottom Line

Total body imaging studies, either CT or MRI, will give you a significant amount of information about your body. These tests can help your physicians detect serious diseases like cancer at early stages when they are more easily treated and potentially cured. However, these studies present underwriting concerns because of their sensitivity and often require 6-month or 1-year follow-up studies to see if any “changes” in the images have occurred. The best advice is to get your life insurance protection in place before having these screening studies performed! Once the life insurance protection is in effect, the testing can be done and, if normal, AgencyONE can go back into underwriting on the policy anniversary for a potential upgrade in the underwriting class with this new and comprehensive information.

Case Study 

Mr. Jones applied for a large policy. He receives top-shelf concierge medical care that includes multiple screening tests for preventative care and longevity enhancements. One of these studies was a thyroid ultrasound that found a small growth (incidental), that was too small for biopsy criteria. His medical record shows a chart note for a follow-up repeat study in 1 year. That was 5 years ago, and Mr. Jones has had no specific thyroid follow-up. Since then, the client has had a total body MRI and a Galleri early detection cancer test* (a revolutionary and simple blood test that screens for over 50 cancers) that revealed no cancers, but the Galleri test does not include thyroid-specific testing yet. However, the Prenuvo Whole Body MRI scan from 8 months ago became a valuable tool in this underwriting process. The medical director at the carrier downgraded this risk to a STANDARD rate class (from Preferred BEST initial consideration) since no follow-up thyroid ultrasound was performed, and would not budge without a repeat test. AgencyONE pointed out that a total body MRI was performed within the past 12 months with no abnormal findings in the thyroid portion of the MRI report. We emphasized that an MRI is much more sensitive than an ultrasound. The file was reviewed again and finding no abnormality in the thyroid as we noted, the Medical Director allowed the case to be issued for $25 million at a PREFERRED BEST rate class!

AgencyONE is well-versed in the newest diagnostic technologies. We are available to help you and your clients navigate these new direct-to-consumer tests and to understand the consequences of having them.

Please contact the AgencyONE Underwriting Department at 301.803.7500 for more information or to discuss a case.

*The Galleri early detection cancer test is a blood test that can detect more than 50 types of cancers – many of which have no other available diagnostic screenings yet. With a negative Galleri screening result, an insured can get life insurance underwriting credits for good health! This innovative test is available to our AgencyONE 100 advisors at a deeply discounted rate. Please contact the Marketing Department at 301.803.7500 for more information.

The popularity of Hybrid or Linked LTC/Chronic Care solutions continue to grow as carriers increase product flexibility and improve options and as consumers prioritize the need for this kind of coverage.  

Earlier this year, AgencyONE launched a series of ONE Ideas featuring our carrier partners who offer Hybrid LTC products. Our first Hybrid Product ONE Idea dated April 22 briefly discussed the specific carriers in our portfolio – Lincoln, OneAmerica, Nationwide, and Securian. Our second ONE Idea from May 22 was a deep dive into the features that Lincoln Moneyguard offers. Feel free to review the previous ONE Ideas linked above for a recap on the carriers and products.

This week’s ONE Idea will focus on OneAmerica’s current Hybrid/LTC options available to our AgencyONE 100 advisors. They include individual and joint life products that offer excellent premium design flexibility. The products have a unique option for a lifetime benefit period and are the only product that allows for ratings on the client. For clients who are 65-85, OneAmerica also has an annuity-based option called Annuity Care which is appealing to older age clients. (Find the Asset Care Product Overview HERE)

We just learned this past week that OneAmerica is coming out with pricing and benefit changes on their Asset Care (Life/LTC product line). The change will take effect on October 21, 2024. AgencyONE will send a product idea update as soon as these changes are in effect and able to be presented. 

Thank you to our OneAmerica Representative Brian Shepard, CLTC and Regional Account Director Care Solutions for agreeing to be interviewed for this ONE Idea. Please note that in the time since this interview, OneAmerica has appointed a new Regional Vice President, Brad Shepard (this is not a typo, Brad and Brian are brothers), who will assist us with ongoing business.

OneAmerica – 2024 Progress

Sales remain strong year-over-year with the Care Solutions products. OneAmerica has been an industry leader in Asset-Based LTC solutions for over 35 years. Asset Care, the flagship product, is a single premium whole life insurance chassis with LTCI benefits released to market in 1989. Since then, OneAmerica has created additional versions of Asset Care that can be funded with qualified money and ongoing premiums, and an entirely different product called Annuity Care. Collectively, the product suite has become known as OneAmerica Care Solutions.

What sets OneAmerica’s Individual and Joint products apart from other Hybrid LTC options? (Learn more about Asset Care differentiators HERE) 

There are four things that make Care Solutions products unique:  

1) The joint life option allows for two people to be covered under one policy and to share the LTC benefit pool. Of course, OneAmerica insures single clients as well. 

2) These products can be funded with virtually any type of premium – from single premiums of cash or qualified money to recurring and limited pay options, and even 1035 exchanges from existing life insurance policies or annuities.  

3) The products offer an optional “Continuation of Benefits rider” (COB) that guarantees LTCI benefits will be payable to the insured(s) for as long as they need care, with an unlimited benefit pool. Limited durations are also available. 

4) OneAmerica offers some of the most reasonable underwriting guidelines in the industry and is often able to make offers to people who would not be insurable with other companies.

Who is OneAmerica’s target market for each product option? 

The target market for Asset Care is 50-70 years old. The reason is the life insurance component as the base policy. The younger and healthier the client, the better leverage and the less invasive the underwriting. This product allows underwriting through table 8 which can be appealing to clients with health concerns. More traditional underwriting is expected when health is a concern and over age 60.

Annuity Care offerings are a hit with clients 65-85 years old (age 87 with home office approval)

This clientele tends to be older and wealthier with possible health complexities. Most clients are in the distribution phase of their life with the ability to reposition assets. The underwriting is non-invasive (no paramed or medical records). It is a pass/fail interview if the LTCI rider (COB) is elected. 

What is OneAmerica’s most popular design when illustrating individual and joint products? (Learn more about qualified funds for LTC HERE) 

The Asset Care concept using qualified money is a packaged product with a 25% bonus applied to the premium which takes every dollar transferred and spends like $1.25 to fund the base and rider. The client appreciates this as there is no additional premium owed and OneAmerica does the clerical work. The client just receives a 1099 each year for 10 years on the distribution of pre-tax money. This is a hot topic as it opens the conversation about using qualified money to fund LTC coverage even if the advisor wants to manage the asset moving forward and accounts for the distributions to fund an ongoing premium.

What about Annuity Care?  

OneAmerica recently announced instant approval with Annuity Care when putting premium into the deferred annuity only (base only coverage). Why do this? The client already has a non-qualified annuity with gain. With Annuity Care being a Pension Protection Act compliant annuity, any funds used for LTCI claim are distributed tax free. We say, “Tax Deferred to Tax Free for LTC”!

Stay tuned for the updates coming out on October 21. OneAmerica will launch enhanced long-term care protection options for Asset Care which will include:

• Added and enhanced benefits to support informal caregiving, independent caregiving and care received at home; 

• Simplified benefit period options to make tailoring a plan and designing coverage easier;  

• Expanded inflation protection options to help safeguard against rising costs of long-term care over time; 

• An enhanced benefit that provides direct physical, financial and emotional support for informal caregivers; and  

• Improved value through enhanced pricing for many clients.

With its simple and flexible solutions, OneAmerica’s Asset Care helps your clients cover long-term care expenses if they need it — or leave a financial legacy to their loved ones if they do not. 

OneAmerica has a robust marketing site that will help you communicate the product offerings to your clients. Additionally, their regional directors are available to discuss options in more detail if you have specific questions or want more information on their solutions. Again, thank you to OneAmerica for their contribution to this ONE Idea.

The variety of Hybrid and Linked LTC/Chronic Care solutions available today make customizing a policy to your client’s needs easier than ever before. With the continued aging of the population, we will see more clients and their advisors requesting long-term care coverage.  

Please contact the AgencyONE Case Design department at 301.803.7500 for more information or to discuss a case!

This week’s ONE Idea is product-specific and highlights an exciting IUL solution that Pacific Life launched earlier this year – Horizon IUL 2 – a product built on the most successful features of Pacific Life’s previous IUL products. AgencyONE is also hosting a webinar with Pacific Life on October 1 @ Noon to take a deeper dive into this solution and we encourage you to register HERE!

The new Horizon IUL 2 makes it much easier to choose the correct option for your cases with its choices and versatility. It replaces the original Horizon and Pacific Discovery Xelerator 2 IULs, 2 of the various products Pacific Life has offered over the years – many available at the same time – which made the case illustrator’s job more challenging.

Pacific Life has always offered blendable term product solutions that allow for lower client costs in exchange for reduced targets. I cannot remember the last time I ran a non-blended option since it is harder to benchmark with other carriers. Most of my personal solves start with a 60% base/40% term design or a 75% base/ 25% term on increasing death benefit solves which puts the product into a competitive premium range. Underwriting has been competitive in the cases we have seen, which has resulted in successful sales on larger cases.

Let’s explore features of Pacific Life’s new Horizon IUL 2 solution:

1. Greater Design Versatility
2. Age 90 No-Lapse Guarantee Rider
3. Flexible Duration No Lapse Guarantee Rider
4. A Fixed Charge Index Loan
5. A New Enhanced Performance Factor Rider (EPFR)
6. A Choice of 3 Living Benefit Riders

Greater Design Versatility: There are three options to choose from depending on the solve requested. Is your client’s planning goal cash accumulation or death benefit-oriented? The table below shows the premium duration that makes the most sense for each option. All of them have a 10-year surrender charge.

The Long-Term Performance (LTP) design works best for single pay scenarios and for most other solves except early cash values, although individual designs including dump-ins may change that.

Age 90 No-Lapse Guarantee Rider: Horizon 2 offers a guarantee based on cumulative premiums paid. It is automatically added to the policy up to a maximum issue age of 79 and provides a guarantee up to the insured’s age of 90. This makes it a strong product to provide a possible LE-based guarantee.

Flexible Duration No-Lapse Guarantee Rider: This rider guarantees that the policy will not lapse up to the insured’s lifetime. The available issue ages are 18-90 with no indexed account restrictions.

A Fixed Charge Index Loan: Horizon 2 offers three (3) different loan types:

1. Standard loans – 2.25% Current rate with a 2% crediting rate for years 1-5 and then 2.25% for years 6+.
2. Indexed loans – 4.9% Current (8% Guaranteed max). Loaned values can be in the 1-year indexed account only.
3. (NEW) Fixed Charge Indexed Loan – 4.5% Current/ Guaranteed. The loaned values remain in the Loaned 1-Year Volatility Control index account.

Enhanced Performance Factor Rider (EPFR): This is an optional rider which may enhance performance by increasing overall indexed credits. There are four (4) EPFR rider designs: Classic, Plus, Performance, and Performance Plus. See attached collateral entitled Get More Upside Potential for more detailed information.

Choice of 3 Living Benefit Riders: Horizon 2 offers three (3) strong Living Benefit Rider options.

1.     Premier LTC Rider – Provides up to $3 million of accelerated benefit limited by policy face amount.

a.     Monthly Indemnity with no permanent requirement

b.     2% or 4% option 

c.     Provides lapse protection while on claim

d.     Benefit reduces the death benefit dollar for dollar

e.     See Using the Premier LTC Rider collateral for more information

2.     Premier Chronic Illness Rider – Provides up to $3 million of accelerated benefit limited by policy face amount. 

a.     Monthly Indemnity with no permanent requirement

b.     2% and 4% option 

c.     Provides lapse protection while on claim

d.     Benefit reduces the death benefit dollar for dollar

3.     Premier Living Benefits Rider 2 – Provides up to $1.5 million of accelerated benefit limited by policy face amount.

a.     Monthly or Annual Indemnity benefit

b.     Requires a permanent condition

c.     Death benefit is reduced by an amount greater than the rider benefit payment 

Don’t forget to REGISTER for our October 1 webinar with Pacific Life at 12:00pm ET. Please make sure to register AND attend to find out:

• HOW Pacific Life’s new Horizon IUL 2 stacks up competitively against other carrier products;
• WHAT is happening in the marketplace that makes this solution an attractive option for diverse types of cases; and
• MORE details about this solution to help you determine how its features will benefit your clients’ financial and risk management planning.

Register for the October 1 webinar at 12:00pm NOW!

Contact AgencyONE’s Case Design department at 301.803.7500 for more information or to discuss a case.

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Where are my keys? I forgot my password. I know that guy…but WHAT is his name? As we get older memory loss events occur more often. This is an unpleasant fact, but it does NOT mean that it is an indication of dementia or Alzheimer’s, but……it could be. That possibility is the scary part for your client, and for the underwriter reviewing the medical history for the life insurance protection you want to place. 

This week’s ONE Idea will discuss how to determine the differences between normal age-related memory loss and the more serious mortality accelerating dementia or Alzheimer’s, and case studies that show how these conditions are approached during underwriting.

At AgencyONE, we see medical records every month on patients whose chart notes reveal memory loss. Normal age-related memory loss can be annoying but generally does not impact one’s day-to-day functioning. According to the Alzheimer Society, age-related memory issues do not:

• Noticeably affect your day to day functioning;
• Prevent you from doing tasks that are required of you; or
• Prevent you from taking in and remembering new information.

But what if your client is diagnosed with Mild Cognitive Impairment or MCI? This condition is still considered mild but is more severe than normal age-related memory issues. The condition should be monitored by a physician and may mean that your client is at a higher risk of developing Alzheimer’s or dementia.

How do your clients know if they are experiencing normal age-related memory loss or more severe memory issues? There are quick verbal, short term memory tests that a physician can employ in the office to make this determination. However, the diagnosis of Alzheimer’s or early dementia should be left to a qualified neurologist and involves more serious diagnostic testing like brain MRI’s, PET, and CT scans.

MMSE (Mini-Mental Status Exam) and MoCA (Montreal Cognitive Assessment): For decades, the MMSE has been the physician’s quick memory and cognitive function test. It takes just 5 minutes and requires no special equipment. The MoCA test is also easily performed but more comprehensive. It takes about 15 minutes and also can be done in a physician’s office or care facility.

When underwriting life insurance protection for an individual with a chart note of MEMORY LOSS, having the results from a quick MMSE or MoCA test can often mean the difference between obtaining insurance for this individual or unfortunately postponing the ability to secure coverage until further testing is completed.

TIAs and Mini-Strokes are terms we often see in a medical record that require a thorough investigation. A TIA (Transient Ischemic Attack) is an “event” where a sudden loss of speech, memory, or a wide awake mental blackout occurs. It appears like a stroke and can show all the signs and symptoms of a full-blown stroke like drooping facial features, motor dysfunction, or aphasia (unable to talk coherently). It’s called TRANSIENT because these signs and symptoms will disappear within 24 hours. This is scary, but this is NOT a stroke. A TIA is often referred to as a Mini-Stroke but is considered a warning of a future stroke. 1 in 3 people who experience a TIA will go on to have a full-blown stroke (brain infarct), and of those, about 50% will occur within the first year after the TIA event.

FAMILY HISTORY – ALZHEIMER’s Disease: A very strong risk factor for developing Alzheimer’s is family history/genetics. As the Baby Boomer generation ages, tremendous financial resources are being funneled into treatment and care for Alzheimer’s, dementia, and other age-related illnesses. Research is ongoing into focused ultrasound treatments that help to reduce the effects of Tau-Tangles (a protein that accumulates in the form of tangles) and Amyloid plaques. For now, Vitamin D3 and Omega-3 (fish oil) may help boost the immune system and remove brain plaques.

Underwriting: Ask your clients for a listing of ALL their over-the-counter (OTC) medications and supplements as part of the underwriting process, as the insured may not fully understand the underwriting benefit to taking Vitamin D3, Omega-3, Turmeric, or antioxidant therapies like Alpha-Lipoic acid. We are also seeing the use of METFORMIN as a HEALTH SUPPLEMENT and not just a diabetes medication.

Case Study #1: Mr. Smith is 71 years old and a practicing physician. He has coronary artery disease and is being treated aggressively for high blood pressure. An annual checkup in February 2024 showed a blood pressure reading of 136/86 – perfectly normal. However, Mr. Smith’s blood pressure goal was less than 120 systolic, so medications were “tweaked” to bring his reading down. Additionally, Mr. Smith’s doctor directed him to monitor his blood pressure readings at home. His routine blood pressure readings are less than 110 systolic with diastolic readings under 60 – a bit low.

In May 2024, Mr. Smith returns to his attending physician with mild cognitive disorder and memory loss complaints by his wife. It was thought that stress of a recent move could be a factor. During Mr. Smith’s evaluation his MMSE was poor. He remembered only 1 of 3 given words and failed to draw intersecting pentagons. He also failed his MoCA testing by missing 4 of 5 words in memory recall. Mr. Smith’s blood pressure during the exam was only 91/59 – very low. His doctor believed his cognitive issues could be related to low blood pressure and immediately halved his medication and asked him to closely monitor his blood pressure readings at home. In August 2024, Mr. Smith’s physician reported much better readings. The patient underwent an insurance exam with a PERFECT senior supplement of 10/10 for word recall. His blood pressure readings are still a bit low at 104/72 but Mr. Smith’s cognitive functions have fully recovered.

A medical follow up and physician clarification note is still pending. Is this a mortality risk? AgencyONE underwriting does not think so and will negotiate accordingly. While prescribed medications are crucial in treating diagnosed conditions, they can also cause other issues and need to be carefully monitored.

Case Study #2: Ms. Jones is 83 years old and the Chief Executive Officer and owner of a company with over 100 employees. During her underwriting, her medical records showed a history of anxiety which had been treated with medication. She also recently had complaints of minor memory issues such as remembering phone numbers and people’s names.

Her medical records also showed that a preliminary MMSE screening test had been perfect. Since she was over age 70, Ms. Jones’ insurance application required that she take the Senior Supplement that screens for motor and cognitive functioning. Because she performed so well on a previous test, AgencyONE expected that she would pass this time, as well. Our underwriters were surprised when her word recall was only 6 out of 10. As a result, the insurance company’s offer was a postpone for further consideration.

As active and committed advocates for the clients of our AgencyONE 100 advisors, our underwriting team initiated a call with the client and her advisor to discuss the underwriting concerns. During the conversation, the client revealed that she had been under a high level of corporate stress around the time of the insurance exam and Senior Supplement. That stress had now passed, and the client was willing to participate in another, more thorough, cognitive test with her attending physician. Ms. Jones passed easily. At our request, the physician provided a summary letter with additional observations and insights regarding Ms. Jones’ cognitive condition. As a result, AgencyONE was able to negotiate the case to a STANDARD Non-Smoker.

The AgencyONE underwriting team remains tuned-in to all the encouraging diagnostic and medical research related to memory issues, dementia, and Alzheimer’s. We work very closely with our AgencyONE 100 Advisors and actively advocate for their clients to obtain the insurance coverage they need.

Please call the AgencyONE Underwriting Department at 301.803.7500 for more information or to discuss a case.