Underwriting Sweet Spots for Individual LTCi

Knowing which carrier to approach for a health-impaired client can be the difference between a placed case and a lost one. Learn how to match the right LTCi carrier to the right health profile, every time.

In long-term care insurance, underwriting is where cases are won or lost. Knowing the general guidelines is not enough. The advisors and specialists who consistently place difficult cases are the ones who have built a mental library of carrier-specific underwriting sweet spots: the conditions, medications, and health profiles where one carrier will consider what others will not.

In this episode of the Buddy Study Podcast, we dig into underwriting sweet spots for individual LTCi, covering the health conditions and medication scenarios that most commonly challenge advisors, and which carriers tend to offer the most flexibility in each category.

We explore:

• What an underwriting sweet spot is and why building a personal library of them matters
• Why mastering sweet spots saves cases, improves placement ratios, and makes advisors more referable
• Height and weight considerations, including carriers with no build chart or gender-separated charts
• Diabetes underwriting across type 1, type 2, insulin dependency, and A1C thresholds
• Recent surgeries, physical therapy, cortisone injections, and reduced waiting period options
• Joint replacements and how carrier flexibility scales with the number of joints replaced
• Off-label prescription medications and which carriers take a more liberal approach
• Pacemakers, cancer history, mental health conditions, and recreational marijuana use
• Table rating, guaranteed issue, and non-insurance alternatives for hard-to-place cases

This episode is designed to help advisors:

• Identify the right carrier earlier in the sales process to avoid surprises and preserve client momentum
• Pre-qualify more confidently when health history adds complexity to a case
• Build a personal underwriting sweet spot reference they can draw on for years
• Become the go-to resource for referral partners who need a knowledgeable LTC planning specialist

CHAPTER MARKERS

0:00 Welcome and Episode Overview
 1:20 What Is an Underwriting Sweet Spot
 2:07 Why Sweet Spots Matter: Saving Cases and Placement Ratios
 6:55 Finding Opportunities Others Miss: The Referral Advantage
 9:08 Height and Weight: Carriers With Lenient Build Charts
 13:36 Diabetes: Type 1, Insulin Dependency, and A1C Thresholds
 21:45 Recent Surgeries, PT, and Cortisone Injection Timelines
 24:11 Joint Replacements: How Carrier Flexibility Scales
 25:57 Medications and Off-Label Prescriptions: The Aetna Advantage
 33:47 Pacemakers, Narcotic Use, and Cardiac Conditions
 37:04 Mental Health, Marijuana, and Cancer History Considerations
 38:42 Table Rating, Guaranteed Issue, and Non-Insurance Alternatives
 45:29 Final Thoughts and Closing Takeaways

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🔎 About Buddy Study Podcast

The Buddy Study Podcast helps insurance professionals and financial planners master Long-Term Care Insurance through case studies, expert interviews, and carrier product updates. Our goal is to help advisors become more confident, efficient, and knowledgeable when helping clients plan for long-term care.

Transcript

Welcome and Episode Overview

SPEAKER_00 0:00

Hey everyone, welcome to another edition of the Buddy Study Group, and it's time for one of my favorite topics, which is underwriting sweet spots. Now, if you've been following us, or if you were on Thursday's study group, for example, when we did sweet spots for group long-term care, you know that since the beginning of Buddy INS, we've been a company that has been pretty addicted to sweet spots and finding them. So what I want to do is just quickly define uh what a sweet spot is and how it applies to underwriting and why I think finding the underwriting sweet spots are most important. Then we'll move into a little bit of a group discussion. I'll share what I know about underwriting sweet spots at a high level. But I think the number one way for us to really learn and get good with the underwriting sweet spots is to exchange anecdotes and compare notes so that we can take those anecdotes with us and file it away if we have a case that is affected by an underwriting sweet spot that you might have found. So what I define a sweet spot as is

What Is an Underwriting Sweet Spot

SPEAKER_00 1:20

uh essentially a differentiator, something that is going to drive you to a specific product or carrier for a specific reason. This is something that sets the carrier apart from others, and it's not as if multiple carriers can't share the same sweet spot, but the point is to be able to have these highlights and take note of them and to be able to use them in our cases for a number of different reasons. So anything that stands out where a carrier is more lenient than the rest of the field on

Why Sweet Spots Matter: Saving Cases and Placement Ratios

SPEAKER_00 2:02

a specific condition, that's an underwriting sweet spot. So I guess to start, let's talk about why are underwriting sweet spots so important? Why is mastering them so important? Why is continuing to collect them so important? And I think there's a couple of really obvious reasons for that. Number one is saving cases, right? We have all had a case that has blown up because of underwriting in some way, shape, or form. If we know an underwriting sweet spot and we're a good field underwriter and we're able to kind of collect our general range of carriers that we can look at, or a short list of carriers that we can look at, we won't have to um have this sort of case develop where we're constantly accelerating, hitting a wall, pivoting to the side of the wall, accelerating again into another wall, and pivoting again, right? If we can have that short list of carriers, if we can filter through our good field underwriting and our knowledge of underwriting sweet spots, that's going to save us cases. And the reason that's going to save us a lot of cases is because the case is smooth, number one. Uh headache free, number two. Number three, it's going to give clients less of an opening to just kind of run away into the ether and ghost us, right? Whenever we have uh something that causes us to take a bit of a pivot, that is really an out for a client to say, eh, you know, uh I'm on second thought, I'm not interested, or not say anything at all and just kind of head for the hills and leave no trace, right? That's the last thing we want. Um, beyond saving cases, we want to um, you know, keep cases before they have an opportunity to need to be saved, right? We want to provide a smooth, easy experience. So underwriting sweet spots have a lot to do with that. Bad surprises also give a for a client to have an out, even though it's not the most logical conclusion. Um at the end of the day, it gives them a reason to feel justified in not going any further into the process. And beyond bad surprises, I think uh I could also lump in broken dreams, right? Shattered dreams. Uh, Linda Thalheimer always says this best. Um, and it's like say yes to the dress, right? Where uh somebody falls in love with that perfect wedding dress, and they find out that it's out of their price range and their dreams are shattered. They feel exhausted instantly and they don't feel like proceeding through the process anymore, or at least their willingness to is greatly diminished, right? So we don't want to introduce a product that a client really likes and find out that from a health perspective, it is outside of their budget, right? So if we're representing products that are in their wheelhouse to be able to qualify for up front, uh at the end of the day, we're going to limit that from happening. But um decline ratios, placement ratios, helping those goes a long way for carriers, it goes a long way for your BGA, and it goes a long way for you as an agent to have a high percentage uh of placed cases, and at the end of the day, a low percentage of declined cases. Um, carriers do look at that. It is uh going to be a factor of judgment if you have a really high um you know ratio of declines in your cases. Um, there's no, I guess, sort of concrete consequences, but it's definitely something you want to watch out for. You don't necessarily um want to be noteworthy for a bad reason whenever an application comes in from you to a carrier. So that's something to keep in mind as well. But I also think the most important

Finding Opportunities Others Miss: The Referral Advantage

SPEAKER_00 6:55

and probably least maybe least obvious, most underrated, in my opinion, is when you know the underwriting sweet spots, you are able to find opportunities that others will not find if you are really studied on this piece. At the end of the day, there are cases where folks will either because they are limited in product offering, they're not as good with their field underwriting, they're not a habitual pre-qualifier, or they're just not able to identify kind of off the rip what the product fit might be, and don't find one, that's a potential case that you could win that others can't. I think it's also something that makes you very, very referable. At the end of the day, a lot of really top-tier referral partners do not even have interest in going through the underwriting process. So being known as somebody who is um really good at that part of the business and really helps clients with a fit that they're happy with and an experience that's smooth, even though their health history is not, makes you infinitely referable, in my opinion, and referable to the best types of referral partners, mainly being financial advisors who really um do everything from a financial perspective for their clients, except get into the nitty-gritty of finding out about their clients' intimate health information. Uh, it's a fact of life in this industry, it's something we have to do, and we generally have to do a bit more of it than uh some of our peers in the industry. So that's kind of framing why I think it is so important um to really have that expert knowledge on underwriting sweet spots. So, what I would like to cover are some of the most popular um underwriting sweet spot categories,

Height and Weight: Carriers With Lenient Build Charts

SPEAKER_00 9:08

and what carriers or product types I think do a really, really good job uh with certain health conditions. I think a really popular one that you have to have in your back pocket is um height weight. Height weight is a super important underwriting sweet spot to know. There are some uh options that have very lenient build charts, and there are some options that have no build chart at all. Okay. Uh, if you are going to work with a lot of clients, you are going to run into some people who are a little bit short for their weight or uh a little bit light for their height, right? You're going to run into over and underweight folks, and knowing how to, you know, handle those situations is going to be important. So, number one, I always think about Aetna short-term care when I think about height weight, because there is no build chart in order to qualify for Aetna short-term care. Um, also kind of dually important is that um short-term care is a relatively affordable pay as you go option. So I think working with that gives you an opportunity to help more people that are in that scenario. But I will also um give a shout out on the hybrid long-term care side to One America. Um, their build chart has no minimum weight. Um, so I think that is pretty interesting because especially for women, uh, we run into an issue of underweight uh a lot uh more often than we do uh with men. So no minimum weight on their build chart is really, really good. Um, but they are generally going to, because they do a lot of homework as a carrier, ask about things like bone density tests and scores, right? Just because they have no minimum weight doesn't mean they won't do homework, but they are also a fantastic underwriting team, do a really good job with pre-qualifications, and will generally guide you to that need if it's needed. I believe um NGL as well, you know, they are not going to show up too often for me in underwriting sweet spots, but I will say they separate out uh male and female build charts, which can be pretty darn helpful. Uh, again, especially um for when you compare it to carriers who have a unisex build chart and pretty strict minimum weights. I think that can definitely be helpful. Um, so I think from a height weight standpoint, those are the best, but I would also give a shout out to um neutral abomaha, tends to be a little bit more lenient on the heavier side. Anyone else have any other carriers that they turn to uh when it comes to specifically height weight challenges? Obviously, I could say Equitrust Bridge for every category as well, um, just because they are guaranteed issue, but there is um consideration around um how underwriting will pan out as far as your leverage ratio. Had no we covered. Um, yeah, no height weight chart is always gonna win. Um, but if there are none others, I'll move on to some other categories. And as I go, guys, feel free to just shout out or throw in the chat um if you had any specific cases where an underwriting sweet spot was found that saved you, or um any challenging underwriting cases that you're going through now that we can try to identify a sweet spot for, um, anything of that nature, I'm happy to cover it. But um another big one has to um

Diabetes: Type 1, Insulin Dependency, and A1C Thresholds

SPEAKER_00 13:36

let's see. Oh, Chris says, wear shoes when getting measured for height, shoes off for weight. Yeah, that's a good one. That's a good one. I have I've never seen anybody um successfully finesse that, but I've always thought about it, you know, especially um when it comes to getting your height taken, just a little extra platform on, but make sure that they're not there when you step on the scale. I like that. Um diabetes. Diabetes tends to be a huge one. Um and diabetes has a lot of different ranges of outcomes, right? Diabetes is one of those comorbids that really can give you trouble when combined with other conditions, um, not even just necessarily comorbid in nature, right? When we talk about um cardiac conditions, diabetes gets very challenging, even combined with something that would normally be minor as hypertension. Those cases can get difficult. But we also have uh the variations between type 1 and type 2 diabetes, of course, or insulin-dependent versus non-insulin-dependent diabetes, um, how long the diabetes has actually been present and diagnosed for, uh, the level of control, we have A1C levels, we have um how it's controlled, right? With is it just diet and exercise? Is it just with oral meds? Um, whatever it may be. There's a ton of different ranges um of diabetes manifestation for carriers to be able to take different stances. So I find that knowing those sweet spots um can generally be helpful. Um Jackie says both One America and Care Matters take type one. One America is rated. Oh, that's interesting on care matters. Um, Jackie, do you know of any sort of specific um things that they absolutely need to see to be able to consider a type one diabetic?

SPEAKER_02 15:53

They have to see the A1C, of course they're build, and they have kept their A1C and their diabetes in control throughout those years. Because I had one.

SPEAKER_00 16:04

Okay, interesting. And you know, and I apologize, there's a ton of noise. Um, outside my bundle all day, somebody's been trimming a tree, and now there's like, I don't know, construction in my kitchen. I can't even tell that it's going crazy finding.

SPEAKER_02 16:19

I hear it, so you're good.

SPEAKER_00 16:21

Okay, and and you know, it doesn't surprise me now that I hear you say it because Alan Gragoire worked at Mutual of Omaha uh before Care Matters, and he was also um there, uh able to take type one diabetes and is always wanting to be flexible because he kind of identifies the variants that can take place with diabetics. Um do you know if there was a specific um amount of insulin? Is there are they not going to consider insulin whatsoever?

SPEAKER_02 16:58

I think their insulin is still based at 50 units. Okay. Now, one America went up to 100 units on one case I had, but it was an annuity care.

SPEAKER_01 17:07

Okay.

SPEAKER_02 17:07

So I can tell you for the nationwide in the beginning didn't have it till they redid their underwriting. I called him after one America told me yes. So what about you? How come yours is not going through? That's when you told me they were relooking at theirs, and when you see the new guide, it shows it there.

SPEAKER_00 17:23

Well, that's helpful. Thank you. And I'll make sure to um add that to my compilation of underwriting sweet spots. 50 units seems to be a relative industry standard. So where it's actually accepted under 50 units daily, where I see that is again with Aetna. You're gonna hear Aetna come up a decent amount uh with mutual Omaha, and now adding to this with Care Matters. Um, 100 is, you know, a pretty large amount of insulin use as far as I'm concerned daily. But again, annuity care is designed, and annuity long-term care in general, designed to be products that can be more lenient on underwriting and target a higher acceptance rate just because of the nature of the product design. Um, but those are good to know. I love walking away from a study group saying I learned something today, even if I was presenting, so that's helpful. And Jackie also brings up a good point in what she was saying in regard to talking to different carriers. That's another benefit to knowing your underwriting sweet spots. Um you know, if you have a case that you know is all of it is going to work, except for one thing. You know, if you have a good relationship with your underwriters, which um Alan Gregoire, when he was on our study group, made sure to have as his big takeaway, develop relationships with your underwriting teams. Um if you have a good relationship, you will get the ear of underwriters. And the more cases that you put through, the more business that you put through with carriers, you are going to notice that you'll start to get a little bit more back and forth from underwriters. And all of a sudden, um, underwriting guidelines go from completely black and white, yes, no, or just this mysterious individual consideration. You will start to potentially see more flexibility. Now, know that that does not apply in all cases. It it doesn't apply in many cases. But if you have a very good relationship, you have a good case, and you have done your homework as the field underwriter, you can um sort of negotiate back and forth with underwriters. This carrier is willing to take them. I know the issue is the insulin-dependent diabetes. Is there anything we can do here or any extra information that you would need to see to make you feel more comfortable about taking this client, knowing that we've got some competition involved? Um, yeah, Romeo puts it exactly right to trust. They trust that you are looking out for them as well as for yourself and your client. And that's the most important thing to convey as an agent looking to have relationships with carriers, um, you know, in in all facets. So we talked about insulin-dependent diabetes. Um I don't see a whole heck of a lot of difference between carriers for say type 2 diabetes. I see a lot of carriers just sticking to um as long as you have good control, as long as you have A1C um under seven and stable, um, and as long as you are compliant with medication, as long as there are not significant comorbids and um combination. In general, I see the responses from carrier, the stances from carriers being relatively level. But if you have another anecdote like Jackie shared, um feel free to let me know. I would love to add it to the list. Um let's see. Another one that tends to stop a lot of people is uh recent procedures, recent surgeries,

Recent Surgeries, PT, and Cortisone Injection Timelines

SPEAKER_00 21:45

recent physical therapy, occupational therapy, um anything of that nature. So injections, surgeries, intensive treatments, or rehabilitation. Uh, or any sort of therapy of sorts, generally you are going to get stonewalled with a waiting period by many carriers. Again, this is something where a good relationship, good trust with carriers could get you some flexibility potentially. Um, but one carrier that I know who does really well with these items is um Bright House's smart care product. Um, they are pretty unique, in my opinion, because they can generally consider a client immediately upon completion of PT as long as they are released from their doctor's care. Again, you're gonna see three to six months of waiting period on that for the most part, but also recent cortisone injections um can also be considered immediately if there is no um ADL impact as a result of those injections and they are released from their doctor's care. So I hear all the time from people that those two things can generally stop them in their tracks. Brighthouse does uh a pretty nice job of being liberal there in just allowing that instant uh consideration. So if anybody has any other carriers that they know do really, really well on reduced wait periods um for that, let me know. I'm always happy to take that information in. Let's see what else we have. I've got a number of conditions that I can walk through. Um let me see. I'm trying to find ones that I hear about a lot. Um knee replacements, joint replacements, I I kind of lump in together. Um on the traditional side, I see that

Joint Replacements: How Carrier Flexibility Scales

SPEAKER_00 24:11

NGL and Mutual of Omaha do a pretty decent job there. NGL, if one or both knees after three months with um, you know, full ambulation, no arthritis and other joints, generally they can consider uh preferred. Uh, and when I see recovered after three months with severe arthritis but no physical limitations standard, now this is California, they are going um with that sort of pass-fail underwriting um in all other states, so much of that will kind of run in individual consideration. Mutual of Omaha is gonna say if all joint replacements, all joint replacements are really the same. One joint after three months, fully recovered, no assistive devices, no PT. Select if it's two joints without a rateable build, fully recovered, no limitations, can be anywhere from select to individual consideration. Three joints without a rateable build can be class one. Any more than three joints is a decline. So I really like the differentiation there. Um, based on the number of joint replacements, of course, your build has to be solid. Um, but those are two pretty good considerations there that I like. Um, one of the items I want to make sure to talk about, um, and I told you you'd hear Aetna's name a lot. Medications are a huge one for underwriting sweet spots

Medications and Off-Label Prescriptions: The Aetna Advantage

SPEAKER_00 25:57

because I don't know about you guys, but I think medications in cases that I have had derailed or have had to pivot from one carrier to another on, uh, I would say 25% or more have been due to um some medication that a client, oh, uh, I forgot to tell you, I'm taking this. Uh, and at the end of the day, um, we can find homes for many different types of medication, but many carriers will lump the reason for use of that medication in with all of the other uses, uh, which can lead to some problems. I had a couple of cases where I had clients who were taking a prescription drug called CeroQil. Now, cerequil is a medication that is prescribed for a number of things. Um, but for some reason, back when I was actually producing, there were a number of doctors that were prescribing it as a sleep aid. And the problem with that when it comes to long-term care underwriting is that seroquil is most commonly known as an antipsychotic drug. And with many carriers, that is going to be uh right, bipolar, right. Um, or I think a couple of other mental health conditions as well. Um, most carriers are gonna look at that and say, it may be in the record that they're, you know, having it prescribed as a sleep aid, but I'm certainly not gonna take it. Um where Aetna can really come in clutch for you is that they will take a number of prescriptions um if taken for off-label reasons. So that tends to be um a big one. And let me pull up that list because I do have a list somewhere of uh prescriptions that Aetna will consider for off-label reasons. One moment, please, while I pull that up. And let's see here. Okay. So Ceracil was one, if uh acceptable for their home care plus product unconditionally, acceptable for recovery care when not used for schizophrenia or bipolar. So that's a big one. Um, abilify is another big one, acceptable for home care plus unconditionally, and available for recovery care if not used for schizophrenia or bipolar. Again, uh another one that's um in that same realm as Cerequil. Uh, let's see. Enbril tends to be uh uh a knockout for many carriers. That is an injection that is most commonly used to treat arthritis. Um, Aetna will actually look at that for home care plus unconditionally. Um let me just go through a few more. Oxygen. Uh again, that's not an off-label prescription, but I see oxygen is acceptable for home care plus unconditionally, not acceptable for recovery care. Prednisone is a big one, acceptable for home care plus unconditionally, acceptable for recovery care, if not used for lupus, kidney disease, cancers, or brain tumor. Sometimes you hear about people taking prednisone, so that tends to um be a big help there. Prozac is another one that I hear a lot, um, acceptable for recovery care if not being used to treat bipolar. Risperdol is another one that I used to get a lot acceptable for home care plus unconditionally, not acceptable for recovery care. Ceraclose is another big one. Zell Jans is another one that I hear every so often is acceptable for home care plus unconditionally. So I see like Aetna with home care plus specifically, um, you know, tends to be a great home for people who are taking any of these medications that you know of. Um, lamotrogen is a common anti-seizure medication or anti-convulsant. It's acceptable for recovery care, not being used for bipolar schizophrenia. So a lot of those drugs that kind of have dual purpose and a lot of them having to do with, you know, severe mental health conditions that I see quite a bit. Um if they're being used for some off-label reason in this case, Aetna will consider that. So I think that's uh a big one to know. If you know of any other prescription uh sweet spots, feel free to let me know. But I've always seen Aetna as kind of a good place to go for that or at least take a look. Mark says, for underwriting, isn't there some kind of AI service that we can input details and it kicks out ideas on short-term or long-term care options? I don't know if Pathwork AI has this as a feature yet, but they're kind of like the premier um product that I see out there on the market right now for AI tool-assisted underwriting. Um, and what I have known them as, I haven't done a demo in in quite a while with the Pathword team. Um, but what I have known them as is major assistance with the pre-qualification piece. Okay, Mark's got an update here that they just started pulling in prescription data a few weeks ago. So that's another great um tool to use just to kind of help nail down underwriting sweet spots because it's going to comb underwriting guides. Um again, working directly with the carriers is gonna help you really understand the full nature of flexibility. Just because somebody gets one case through with a certain condition with a certain carrier doesn't mean that everybody will uh at the end of the day. Everybody has extremely unique um health pictures. Um Mutual has it as underwriter discretion for Seroquel. Care Matters doesn't list Serequil as a decline for medications. I know I've had some moo declines for Serequil, um, but if it's underwriter discretion, uh at the end of the day, I think um, you know, just always beware pre-qualify and and know that if a medication like that shows up on an application, they're probably going to um do some sort of full core press on the interview to uh to check to see if there's anything um underlying that they can detect there. Um let's see. I'm not going to use this as an advertisement to say send all of your narcotic users to One America, but One America will consider narcotic use if used as prescribed. Uh again, your mileage may vary here. It's really going to be dependent on each client's individual surrounding health scenario, but I

Pacemakers, Narcotic Use, and Cardiac Conditions

SPEAKER_00 33:47

have um you know had a little bit better of an experience um in using One America when I have conditions that are being treated with some narcotic use, um, and generally more likely, as we've said, with annuity care than uh with asset care. But again, your mileage may vary. Uh let's see, pacemaker is one I used to get, you know, decently, um with no other heart disorders. And I don't want to be a broken record with this, but again, always pre-qualified. This is not to say that every case you put through in these conditions will end up a good story at the end. But um NGL had uh consideration with no other heart disorder and normal cardiac output from what I saw um in my searches, and One America will actually look at a pacemaker six months post-insertion, stable, no coexisting coronary artery disease, or diabetes. That can actually be considered for all products with expedited underwriting, which I thought was an interesting sweet spot. Um, let's see. Anyone have one for military disability? I'm just going to uh survey the room here. Um, I remember that there was one or two carriers that, um, depending on the percentage and depending on why they qualified for military disability, there could be some considerations open. Um, but it is just a fleeting thought from my past in my head. I don't want to actually put out the specific um carrier I thought it was. Um, but there are some minor things that folks will be on military disability for. Like, for example, I was near some heavy equipment or obviously um gunfire, things of that nature, and I've got hearing loss to a point where I qualified for military disability. If anybody knows of carriers that are willing to have some wiggle room on that, I would love to hear about it from you. Um let's see, what other conditions do I have that are generally very controversial, I would say. I think Bright House tends to do pretty decently with common mental health conditions like anxiety, depression, and the like. Um, I want to give them a shout out there. They tend to be a little bit more liberal. Um recreational marijuana use. I do see Brighthouse um doing a good job with as well. I think a lot of this has to do with kind of changing medical trends. Um, for example, I think we'll start to see more carriers do a better job with um

Mental Health, Marijuana, and Cancer History Considerations

SPEAKER_00 37:04

joint replacements because that medical science has advanced so far so quickly, they've got you up and walking within a matter of days after a joint replacement. I think we've started to see a lot of carriers loosen their belt a little bit as far as their considerations there. And obviously, with the legalization of marijuana and um more states, it seems, each and every year. Um, I think that is something we will start to see more solidified guidelines around. Um, Bright House says recreational use is fine unless it causes social or occupational issues, job loss, or any other greater psychiatric issues. So I think that's an interesting one. Um let's see, we already had them for recent physical therapy. I obviously think, guys, that um that Equitrust Bridge being an FIA annuity long-term care product that offers guaranteed issue underwriting, they are kind of a walking underwriting sweet spot, but also keep in mind your carriers that are willing to table rate or offer a rating as a po as opposed to approve or decline, right? One America asset care is the big one that comes to mind for me. Um, we're talking about getting a product where we feel like we might not have many options, we're not talking about um, you know, getting

Table Rating, Guaranteed Issue, and Non-Insurance Alternatives

SPEAKER_00 38:42

an incredibly priced product. Table rating does affect your leverage quite a bit. But if one America is able to take many conditions at a table six, six or even a table eight, eight, which is um, again, really going to strain the leverage, um, that is something to absolutely keep in mind. I think Romeo, you give a really good shout out. True Freedom uh is another product worth considering. It is not an insurance product. Again, it is kind of like the the purchase of home health care hours in bulk. Um, but true freedom is another really good one. Um, you do want to make sure that your client isn't definitively on the fast track in a certain amount of time, one to two years of care. Um, that is an important thing to note. Um, but if it is somebody who is um maybe a bit on the younger side with health issues that are a challenge, but there is no immediate or near immediate need of long-term care. True freedom is a good one to look at. Um, because there are really um no health questions or underwriting otherwise, um, and also no age limit. And all 50 states, underwriting sweet spots don't necessarily I guess I would consider it a bit more product sweet spot than underwriting, but each has something to do with this session, right? Um, at the end of the day, I think that definitely deserves a shout out. You're right. Um Hey Jason, yeah, Diane.

SPEAKER_01 40:27

Diane. Hey, I I just did some pre-qualifying for um recreational marijuana because I had a client declined with NGL. And he told B on the application that he used to, but he hasn't in six months. And then when he filled out the um the medical questionnaire or answered the nurse or whatever, he said no most every day. And I'm like, well, you can't lie on the application, but right, but nationwide was the most lenient. They said less than six to six or less times a week. All the other ones were three or less.

SPEAKER_00 40:59

Okay, that's interesting. Six or less per week recreational. That's uh that's pretty lenient as far as I'm concerned. I would, of course, I would still consider Bright House the most lenient there because it's just kind of like it's fine as long as there are no um underlying or social uh occupational hazards there. Um that yeah, that's stoned damn near every day. I I would agree. Um that's uh pretty lenient. Um let's see, that's a good one. Appreciate that. Um again, this is going to sound uh pretty general, um, but I've noticed that with One America's annuity care, at least stage one to three cancers um that are cured or in remission are considerable. Um so that's something to look out for. I know, especially folks who have um either been cured or are in remission from stage three cancers generally um deal with some underwriting challenges there. Um for care when it comes to cancers. If you are five plus years out, leukemia, Hodgkin's, lymphoma, non-melanoma cancers diagnosed more than five years ago um are considerable past knockout. Um America again, annuity care. Another really interesting one is uh kidney transplant. That's one that I don't run into often, but I also don't see many carriers considering very often. Another one for annuity care is non-ocular myasthenia gravis could potentially be considerable. You see that on most carriers' knockout questions. Um let's see. Any others? Um, just another one on Bright House across the board, and you guys are getting a trend, right? It's all about how carriers design their products. Um, at the end of the day, some will choose to pull that lever to be more lenient in certain scenarios to try to welcome um more business, right? But Bright House doesn't consider family history of comorbidities or cognitive at all for smart cares. So um that's another one that trips a lot of people up. And I know Mutual of Omaha recently um, you know, started to liberalize just a little bit to that end as well, but with a capped benefit. So Brighthouse kind of leads in a lot of underwriting sweet spots, including um what I was talking about with asset care, being able to table rate folks really gives them that sort of advantage. Um I think that is it for the major ones that I really have here. Uh let me do one more quick little comb here, but I think those are the major ones that I wanted to get out to you guys. Um, but before we start to wrap it up a bit, does anybody else have any other specific sweet spots they've run into or are looking for assistance on? All right. Well, um, if that's it, I think this is one that I want to do at least once a year because obviously under underwriting guidelines change, but of course, the underlying assumptions that are built from medical science change every single year. And you just never know uh when we come to this session year after year, what is going to be kind of a major change that used to be a blocker for folks. And again, if you know these underwriting sweet spots and and you you keep them and catalog them in some way, shape, or form using a tool or using a notebook, uh, at the end of the day, you're gonna be able to find opportunities that a lot of people won't. You're gonna be able to save cases that other people won't be able to save. And I think because of that, you as

Final Thoughts and Closing Takeaways

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a skilled underwriter become super referable. And guys, if you found that 70% or more of these sweet spots were new to you because you are new to long-term care, I will say don't fret, number one. Um, because the only real way to collect these underwriting sweet spots is with practice. Practice comes with meeting with people every single day for years and years and years, and getting more of that slice of Americana through your door meeting with you, finding out about unique health situations, and going and doing your homework with the carriers and figuring out what they bring back to you, right? That is really the only way outside of sharing stories like you all did a great job with uh on the call today. That's the only real way to build up that bank uh for yourself. So I encourage you to just keep going out and doing your thing. And if there are any anecdotes that you think that people would find helpful, just continue to share them with us. Uh, as a note, next week we will have nobody study group. Um, I most of us um are traveling just very quickly um Monday and Tuesday um for a little carrier engagement. Um so we will not have a study group next Tuesday, but this Thursdays is still on, and next Thursday's study group is still on as well. So just wanted to give you that update. Otherwise, be well and we will talk to you Thursday. Have a good one.