Guaranteed Issue Contracting Request (AmFam)

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.)

Hidden

Did you ask your client the health questions?*

Yes
No

(Please refer to the health questionnaire to see what product your client qualifies for.)

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 Corebridge under OCI?*

Yes
No

If you’re already contracted with the carrier you can register if you haven’t already, review the product guide, and log in to submit an application at this link: https://giwl.life2.corebridgefinancial.com/

Are you the agency owner of your American Family Agency?*

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 Email:*

Agent Phone:*

Client's Name:*

First Last

Client's Date of Birth:*

State:*