Life Insurance Timesaver

Last step!

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1. QUALIFY

Must answer YES to Questions 1-5
A) Age 30 – 65
B) Diagnosed with HIV more than five years ago
C) Treatment with antiretroviral therapy (ART) for at least 2-5 years without any lapses or delays in treatment Continuous monitoring by a qualified physician
D) Undetectable HIV viral load for at least two years
E) CD4 count of 350 cells/mm3 or higher for at least two years including a current CD4 count

Must Answer “NO” to Questions F-I
F) Hepatitis B and/or hepatitis C infection, with proof of negative test results
G) Resistance to antiretroviral medication
H) Alcohol and/or drug (illicit or prescription) abuse
I)  Coronary artery disease, diabetes, cancer, or significant psychiatric conditions

2. Download

If you passed Step 1’s Qualifying Questions, simply download our TimeSaver by clicking on the button above.
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3. Complete

Print or fill out with PDF software.

Compete all sections of the TimeSaver except for PRODUCER INFORMATION & GOALS OF THE CASE.

4. Submit

Send us the completed TimeSaver via email or FAX.

Fax: 407-249-2720

Email: [email protected]

What’s next?

After you send us your completed TimeSaver we’ll begin the informal shopping process with all the companies that can offer coverage. We then wait to see who provides the best informal offer. We’ll simply put the formal application with the best offer.

It’s that simple!