Guaranteed Issue Contracting Request

Have you presented this guaranteed issue whole life product/illustration to your client?*

Yes
No

(Please present options to the client before proceeding with contracting. PLEASE only proceed with contracting if your client is ready to purchase.)

Can you confirm if your client is over the age of 40?*

Yes
No

You are unable to submit an e-application with the carrier due to the client being under the age of 40. Therefore, we cannot complete the contracting request for this carrier.

Did your client agree to purchase the product and are they ready to submit an application to the carrier?*

Yes
No

In order to proceed with contracting, your client has to agree to purchase the policy. If we get you contracted with the carrier and you do not submit an application in the first 30 days, the carrier will cancel your contract and we will have to go back through contracting again later. PLEASE only proceed with contracting if your client is ready to purchase.

Have you been contracted with this carrier under OCI?*

Yes
No

If you’re already contracted with the carrier please follow the steps in the below user guide which provides step by step instructions on how to register for an account and submit an e-application.

User Guide

Are you the agency owner?*

Yes
No

Please have the lead agent complete the OCI appointment as per the agreement between American Family and OCI, as only the lead agent can be set up with OCI.

Agent Name:*

First Last

Agent Company:*

Agent Email:*

Agent Phone:*

Client's Name:*

First Last

Client's Date of Birth:*

State:*

State

PLEASE CONFIRM: Due to the internal cost and time needed for contracting, do you pinky promise that your client will move forward with purchasing the policy?*

Yes
No

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Guaranteed Issue Contracting Request

Wellabe (A Great Western Company) Guaranteed Issue Contracting Request