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Includes underwriting guidance to improve success, required income and tax documentation by applicant type (employees, self-employed/commissioned, and various business owners), and instructions for providing health history, doctor information, and paramedical exam requirements. Specifies non-medical limits and examination/urinalysis/blood requirement thresholds by age and monthly benefit amount, plus procedures for ordering interviews and contacting authorized paramedical firms. Includes producer-only and state availability notes.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/checklist-for-submitting-a-completed-app-long-term-disability-insurance-i-income-protection/301839/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/checklist-for-submitting-a-completed-app-long-term-disability-insurance-i-income-protection/301839.png","ImageObject",442,249,{"name":88,"@type":89},"Cart","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-25","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What income documentation must be included with a client’s Income Protection+ application?","Question",{"text":108,"@type":109},"Include the required income documentation indicated in the checklist based on whether the applicant is an employee or self-employed/commissioned, or whether the applicant is part of different business structures.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"When are paramedical exams and medical requirements required?",{"text":113,"@type":109},"Exams and lab requirements depend on the applicant’s age and monthly benefit amount, with specified “No/Yes” determinations for paramedical exam, urinalysis (UA), and blood requirements (BLD).",{"name":115,"@type":106,"acceptedAnswer":116},"What should producers do for applications with monthly benefits over $10,000?",{"text":117,"@type":109},"Assurity conducts a personal history interview. Inform the client they may receive a phone call, and if applicable, record the client’s time preference on the application.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},301839,1789785770,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":9},18829141979164,"https://eur-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Checklist for Submitting  \na Completed App  \nLong-Term Disability Insurance I Income Protection+  \nHere are some tips from our Underwriting Department to help increase your success!  \nWe’re always available if you have questions at: 800-276-7619 Ext. 4264 or [underwriting@assurity.com](underwriting@assurity.com).  \nIncome Documentation  \nInclude the required income documentation indicated below with your client’s application.  \nEmployees  \nEmployee Only Monthly Benefit Amount Documents Needed  \n| Not Self-Employed | $8,000 or less\u003Cbr>More than $8,000 | None\u003Cbr>ı 2 pay stubs, Federal Tax Form W-2 or\u003Cbr>Federal Tax Return |\n| --- | --- | --- |\n| Self-Employed or Commissioned Salesperson | $6,000 or less\u003Cbr>More than $6,000 and 1 Year,\u003Cbr>2 Year, 5 Year, or 10 Year benefit period\u003Cbr>More than $6,000 | None\u003Cbr>ı Federal Tax Return with all schedules ı Federal Tax Form W-2\u003Cbr>ı 2 years Federal Tax Returns with all schedules ı Federal Tax Form W-2 |\n\nBusinesses  \nBusiness  \nPersonal Documents Needed  \nBusiness Documents Needed  \nSole Proprietor  \nFarmer or Rancher  \nOwner of C Corporation  \nOwner of S Corporation  \nPartner of  \nPartnership  \nı Federal Tax Form 1040, including Schedule C  \nı Federal Tax Form 1040, including Schedule F  \nı Federal Tax Form W-2  \nı Federal Tax Form W-2  \nı Federal Tax Form 1040, including Schedule E, Part II  \nı Federal Tax Form 1040, including Schedule E, Part II  \nNone  \nNone  \nı Federal Corporate Tax Form 1120, including Schedule E  \nı Federal Corporate Tax Form 1120S, including Schedule K-1  \nı Federal Partnership Tax Form 1065, including Schedule K-1  \nHealth History  \nPlease use the Pre-Qualification Checklist if your client has any health history. Also, make sure to provide the doctor’s information with the application.  \nNon-Medical Limits & Exam Requirements  \nAge  \nMonthly Benefit Amount  \nExam  \nParamedical Exam  \nUA  \nUrinalysis  \nBLD  \nBlood Requirements  \n| 18-50 | $500- $10,000 $10,001 and above | No\u003Cbr>Yes | No\u003Cbr>Yes | No\u003Cbr>Yes |\n| --- | --- | --- | --- | --- |\n| 51-64 | $500- $6,000\u003Cbr>$6,001 and above | No\u003Cbr>Yes | No\u003Cbr>Yes | No\u003Cbr>Yes |\n\nNOTE: These limits are subject to change at any time. Assurity reserves the right to require a medical exam and/or other medical requirements on any applicant.  \nAuthorized Paramedical Firms  \nOur authorized paramedical firms have the examination forms, containers and blood draw kits in stock. For significant medical health histories or if the applicant has previously been declined, contact the Customer Connections prior to scheduling an examination.  \nAmerican Paraprofessional Systems, Inc. (APPS) Examination Management Services (EMSI)  \nQuest Diagnostics – ExamOne  \nHooper Holmes Portamedic National Service Center  \n800-967-1499  \n800-872-3674  \n800-873-8845  \n800-765-1010  \nPersonal History Interviews  \nFor applications with monthly benefits over $10,000, our team at Assurity will conduct a personal history interview with your client. An interview may be ordered on any benefit amount if necessary at the underwriter’s discretion.  \nı Inform your client that he/she may receive a phone call regarding a Personal Health Interview.ı If applicable, indicate your client’s time preference for the interview on the application.  \nAssurity Interview Department: 877-611-4701  \nMonday – Thursday: 7 a. m – 8 p. m. CST  \nFriday: 7 a. m.– 6 p. m. CST  \nSaturday: 9 a. m.– 1 p. m. CST  \nFor complete details, please refer to Assurity’s Underwriting Guide on the Agent Center.  \nFOR PRODUCER USE ONLY. NOT FOR USE WITH THE GENERAL PUBLIC. NOT AVAILABLE IN NEW YORK.  \nPolicy Form No. I H2401 underwritten by Assurity Life Insurance Company, Lincoln, Nebraska.  \nAssurity is a marketing name for the mutual holding company Assurity Group, Inc. and its subsidiaries. Those subsidiaries include but are not limited to: Assurity Life Insurance Company and Assurity Life Insurance Company of New York. Insurance products and services are offered by Assurity Life Insurance Company","cbCaiiFcVgzleasf","https://ap.wps.com/l/cbCaiiFcVgzleasf","pdf",162464,"English","# Income Documentation\n## Employees\n## Businesses\n# Health History\n# Non-Medical Limits & Exam Requirements\n## Authorized Paramedical Firms\n# Personal History Interviews","[{\"question\":\"What income documentation must be included with a client’s Income Protection+ application?\",\"answer\":\"Include the required income documentation indicated in the checklist based on whether the applicant is an employee or self-employed/commissioned, or whether the applicant is part of different business structures.\"},{\"question\":\"When are paramedical exams and medical requirements required?\",\"answer\":\"Exams and lab requirements depend on the applicant’s age and monthly benefit amount, with specified “No/Yes” determinations for paramedical exam, urinalysis (UA), and blood requirements (BLD).\"},{\"question\":\"What should producers do for applications with monthly benefits over $10,000?\",\"answer\":\"Assurity conducts a personal history interview. Inform the client they may receive a phone call, and if applicable, record the client’s time preference on the application.\"}]","Checklist for Submitting a Completed App Long-Term Disability Insurance I Income Protection+ | PDF"]