Quotes

Life

Life
Disability
Long Term Care
Annuity

We want to convert your opportunities to sales as quickly as possible! We will work with you from quote through policy issue, as well as provide policy service support if needed. Our carrier relationships, direct access to their underwriters, and industry expertise enable us to view cases from multiple perspectives and design the best solution for your clients.

Quoting a Case Through GPAgency
Most agents contact us directly for assistance, especially if your client has any potential underwriting concerns (health, avocation, age, etc.). Call us (919) 834-7937 | (800) 283-8376, or email melinda@gpagency.com (she will direct your inquiry to one of our brokerage managers). You can provide basic information in an email or attach this form: Prescreening Guide for Life Insurance (fillable) (Note: You need to download the form for the fillable fields to activate.)

Quoting Tools
As a registered user of our website, you can use these tools 24/7 to assess a case, generate an NAIC compliant quote, and submit an application electronically.

LifePipe Quick Quote	FAST quotes through iPipeline for Term & UL. Email quote, submit iGO eApp or request Drop Ticket.
VitalQuote Comparisons	Term & UL comparison & quoting system (including carriers not listed on iPipeline); underwriting guidelines & quick facts on carriers.
WinFlex Illustrations	Run permanent quotes complete with NAIC compliant illustrations.
Informal Quote Request	Let us identify competitive, potential solutions for your high-value cases – email this form to melinda@gpagency.com.

PLEASE NOTE: Not all our carriers subscribe to these quoting tools. Contact us if you need assistance obtaining a quote with a carrier not featured: (919) 834-7937 or contact melinda@gpagency.com (she will connect you to one of our internal brokerage managers).

Helpful Data Collection Tools

Pre-App Form (fillable)

Pre-App Form with HIPAA Form (fillable)

Prescreening Guide for Life Insurance (fillable)

Note: You need to download the form for the fillable fields to activate.

DI Quote

For a quote, complete the fillable quote request form, save the PDF file, and email it to lyman@gpagency.com. We will provide you with the best option available among our disability insurance carriers. OR, complete the form below, which you can easily submit online to GPAgency.

Three Essential Pieces of Information When Quoting DI

1. Occupation: assess the level of risk associated with the job
2. Medical History: determine ability to obtain coverage
3. Income: key to determining right maximum benefit amount

Request a Disability Quote

Broker Information
Agent Name
First Last
Email
Phone
Prospect Information
Name
First Last
Birthdate
Gender
- Male
- Female
State of Residence
State Written In
Occupation
Employment Status
- Salary Employee
- Sole Proprietor
- LLC/Partnership
- S-Corp Owner
- C-Corp Owner
Length of Time in Role
Specific Duties and % of Time Per Week Performing
Prospect's Annual Net Income - Current Year & Previous 2 Calendar Years
Any Other DI Coverage in Force?
- Yes
- No
Amount of Group DI in Place?
Amount of Individual DI in Place?
Medical History
Height
Weight
Tobacco Use In Past 12 Months:
- None
- Cigarettes
- Cigar
- Pipe
- Smokeless
- Nicotine Patch, Gum or Inhaler
Current or Date of Last Use:
Currently Taking Medications?
- Yes
- No
List Medications/Dosage
Check If History of:
- Neck or Back Disorders
- Mental/Nervous Conditions
- Diabetes
- High Cholesterol
- Hypertension
- Not Applicable
Provide Details on Items Checked
In Last 5 Years, Seen:
- Physician
- Chiropractor
- Counselor/Psychiatrist
- Not Applicable
Provide Details on Items Checked
Are You pregnant?
- Yes
- No
Additional comments, health concerns or benefits?

StrateCision is for agents who regularly sell long-term care insurance. It will provide an immediate quote that you can save as PDF. You must be a registered with GPAgency’s website to access. If you don’t regularly sell LTC insurance, please complete the online form below for a competitive quote.

Use the StrateCision tool to:

Get quotes for a single client or a couple for all current stand-alone (traditional) LTC insurance policies.
Choose levels for all benefits, including special riders unique to the policy
Create single or comparative proposals
Show additional illustrations such as cost of waiting, how inflation protection increases benefits, and alternative premium tables
Quotes are state-specific and designed to mirror those of the carriers’ software.

For an LTC quote, please complete and submit the form below. Our LTC Sales Director, Marshall Clement, will prepare a quote for you. Any questions, please contact Marshall at marshall@gpagency.com or 336-339-0593.

Long Term Care Quote Request

Agent Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Fax
Client Information
Client Name
First Last
Date of Birth
MM slash DD slash YYYY
State of Residence
Risk Class
- Best
- 2nd Best
- Rated
Height
Weight
Has applicant ever used tobacco in the last 5 years?
- Yes
- No
Specify type & date of last use
Medications taken in last 12 months
Name of Prescription & Reason for Taking:
Medical History
Include All Specialists Seen in the Last 5 Years:
Spouse/Partner Name
First Last
Spouse/Partner Date of Birth
MM slash DD slash YYYY
State of Residence
Spouse/Partner risk class
- Best
- 2nd Best
- Rated
Height
Weight
Has applicant ever used tobacco in the last 12 months?
- Yes
- No
Specify type & date of last use
Spouse/Partner medications taken in last 12 months
Name of Prescription & Reason for Taking
Spouse/Partner Medical History
Include All Specialists Seen in Last 5 Years
Benefit Amount
Is this benefit amount:
- Daily
- Monthly
Marital Status
- Married
- Single/Divorced/Widowed
- Same Generation Living Together at Least 2 Years
Elimination Period (days)
- 0
- 90
- 180
- 365
Benefit Period (years)
Inflation
Home Care
- 50%
- 75%
- 100%
Non-Forfeiture Benefit Rider
- Yes
- No
Waiver of Home Care EP Rider? (Day 1 HHC)
- Yes
- No
Joint Waiver of Premium, if available?
- Yes
- No
Shared Care
- Yes
- No
Payment Mode Options
Accelerated Payment Options
- 10-Pay
- Single-Pay
- Life Pay
Are you in competition for this case?
- Yes
- No
Approximate Net Worth?
Approximate Annual Income?
Carrier Preferences
- Mutual of Omaha
- National Guardian Life (NGL)
- Thrivent
If Applicant Owns a Business, Indicate Type:
- C-Corp
- Pass-Thru Entity (S-Corp, LLC, Partnership, Sole Proprietor, Self-Employed)
Comments

If you register with our website site, you can review Fixed and Multi-Year Guaranteed annuity options online. (To register, click on Producer Login.) You can also submit the form below for an annuity quote.

Request an Annuity Quote

Broker Information
Agent Name*
First Last
Phone*
Email*
Client
Annuitant
Name*
First Last
Birthdate*
MM slash DD slash YYYY
Gender*
- Male
- Female
Joint Annuitant
Name
First Last
Birthdate
MM slash DD slash YYYY
Gender
- Male
- Female
Annuity
Insurance Company Preference, if any
State of Issue*
Tax Qualified*
- Yes
- No
Premium Amount*
Primary Objective*
If Income is the primary objective, in how many years will distributions begin?
Income Preference*
If Select Period is chosen, how many years?
Additional Information
Please list any additional comments, health concerns or competition information that will assist us in properly preparing your quote.

GPEZ Concierge Service (click to learn more)

Tight on time? For a $50 fee per case, we will complete your client’s application on your behalf.

IMPORTANT: For quotes, please have your client’s DATE OF BIRTH, not just his/her age. Most insurers calculate rates based on age to nearest birthday, i.e. if their next birthday is closer than their last, their rate may be based on the higher age.

What to Expect with eSignature?

Click HERE.

Life

Life
Disability
Long Term Care
Annuity

Quoting Tools
As a registered user of our website, you can use these tools 24/7 to assess a case, generate an NAIC compliant quote, and submit an application electronically.

LifePipe Quick Quote	FAST quotes through iPipeline for Term & UL. Email quote, submit iGO eApp or request Drop Ticket.
VitalQuote Comparisons	Term & UL comparison & quoting system (including carriers not listed on iPipeline); underwriting guidelines & quick facts on carriers.
WinFlex Illustrations	Run permanent quotes complete with NAIC compliant illustrations.
Informal Quote Request	Let us identify competitive, potential solutions for your high-value cases – email this form to melinda@gpagency.com.

Helpful Data Collection Tools

Pre-App Form (fillable)

Pre-App Form with HIPAA Form (fillable)

Prescreening Guide for Life Insurance (fillable)

Note: You need to download the form for the fillable fields to activate.

DI Quote

Three Essential Pieces of Information When Quoting DI

1. Occupation: assess the level of risk associated with the job
2. Medical History: determine ability to obtain coverage
3. Income: key to determining right maximum benefit amount

Request a Disability Quote

Broker Information
Agent Name
First Last
Email
Phone
Prospect Information
Name
First Last
Birthdate
Gender
- Male
- Female
State of Residence
State Written In
Occupation
Employment Status
- Salary Employee
- Sole Proprietor
- LLC/Partnership
- S-Corp Owner
- C-Corp Owner
Length of Time in Role
Specific Duties and % of Time Per Week Performing
Prospect's Annual Net Income - Current Year & Previous 2 Calendar Years
Any Other DI Coverage in Force?
- Yes
- No
Amount of Group DI in Place?
Amount of Individual DI in Place?
Medical History
Height
Weight
Tobacco Use In Past 12 Months:
- None
- Cigarettes
- Cigar
- Pipe
- Smokeless
- Nicotine Patch, Gum or Inhaler
Current or Date of Last Use:
Currently Taking Medications?
- Yes
- No
List Medications/Dosage
Check If History of:
- Neck or Back Disorders
- Mental/Nervous Conditions
- Diabetes
- High Cholesterol
- Hypertension
- Not Applicable
Provide Details on Items Checked
In Last 5 Years, Seen:
- Physician
- Chiropractor
- Counselor/Psychiatrist
- Not Applicable
Provide Details on Items Checked
Are You pregnant?
- Yes
- No
Additional comments, health concerns or benefits?

Use the StrateCision tool to:

Get quotes for a single client or a couple for all current stand-alone (traditional) LTC insurance policies.
Choose levels for all benefits, including special riders unique to the policy
Create single or comparative proposals
Show additional illustrations such as cost of waiting, how inflation protection increases benefits, and alternative premium tables
Quotes are state-specific and designed to mirror those of the carriers’ software.

Long Term Care Quote Request

Agent Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Fax
Client Information
Client Name
First Last
Date of Birth
MM slash DD slash YYYY
State of Residence
Risk Class
- Best
- 2nd Best
- Rated
Height
Weight
Has applicant ever used tobacco in the last 5 years?
- Yes
- No
Specify type & date of last use
Medications taken in last 12 months
Name of Prescription & Reason for Taking:
Medical History
Include All Specialists Seen in the Last 5 Years:
Spouse/Partner Name
First Last
Spouse/Partner Date of Birth
MM slash DD slash YYYY
State of Residence
Spouse/Partner risk class
- Best
- 2nd Best
- Rated
Height
Weight
Has applicant ever used tobacco in the last 12 months?
- Yes
- No
Specify type & date of last use
Spouse/Partner medications taken in last 12 months
Name of Prescription & Reason for Taking
Spouse/Partner Medical History
Include All Specialists Seen in Last 5 Years
Benefit Amount
Is this benefit amount:
- Daily
- Monthly
Marital Status
- Married
- Single/Divorced/Widowed
- Same Generation Living Together at Least 2 Years
Elimination Period (days)
- 0
- 90
- 180
- 365
Benefit Period (years)
Inflation
Home Care
- 50%
- 75%
- 100%
Non-Forfeiture Benefit Rider
- Yes
- No
Waiver of Home Care EP Rider? (Day 1 HHC)
- Yes
- No
Joint Waiver of Premium, if available?
- Yes
- No
Shared Care
- Yes
- No
Payment Mode Options
Accelerated Payment Options
- 10-Pay
- Single-Pay
- Life Pay
Are you in competition for this case?
- Yes
- No
Approximate Net Worth?
Approximate Annual Income?
Carrier Preferences
- Mutual of Omaha
- National Guardian Life (NGL)
- Thrivent
If Applicant Owns a Business, Indicate Type:
- C-Corp
- Pass-Thru Entity (S-Corp, LLC, Partnership, Sole Proprietor, Self-Employed)
Comments

Request an Annuity Quote

Broker Information
Agent Name*
First Last
Phone*
Email*
Client
Annuitant
Name*
First Last
Birthdate*
MM slash DD slash YYYY
Gender*
- Male
- Female
Joint Annuitant
Name
First Last
Birthdate
MM slash DD slash YYYY
Gender
- Male
- Female
Annuity
Insurance Company Preference, if any
State of Issue*
Tax Qualified*
- Yes
- No
Premium Amount*
Primary Objective*
If Income is the primary objective, in how many years will distributions begin?
Income Preference*
If Select Period is chosen, how many years?
Additional Information
Please list any additional comments, health concerns or competition information that will assist us in properly preparing your quote.

GPEZ Concierge Service (click to learn more)

Tight on time? For a $50 fee per case, we will complete your client’s application on your behalf.

iGO iPipeline Drop Tickets Update: Text Reminders Now Available

iPipeline now includes TCPA language which allows the agent to select ‘cell’ when imputing the applicant’s telephone number. Choosing ‘yes’ will allow text (SMS) notifications to be sent to your client reminding them to complete the online application.

Boston Mutual Quote Tool
(Not on iGo)
Click on logo to quote

Boston Mutual: NC Legacy Life Express Application (simplified issue)

Boston Mutual: NC Infinite Life Application (fully underwritten)

You must be logged in to use this feature!

Submit Your Applications Electronically!

– Fill out your client applications faster! Get paid Faster!
– Simplify and accelerate the application process.
– Experience easy-to-use, intelligent wizard screens!
– Utilize e-Signature and e-Submit features.

Never used iGO?
Click HERE for access to a short video.

Legal & General’s e-App
(NOT ON IGO)
CLICK ON LOGO for APP

Boston Mutual Quote Tool
(Not on iGo)
Click on logo to quote

Boston Mutual: NC Legacy Life Express Application (simplified issue)

Boston Mutual: NC Infinite Life Application (fully underwritten)

You must be logged in to use this feature!

Submit Your Applications Electronically!

Never used iGO?
Click HERE for access to a short video.

Legal & General’s e-App
(NOT ON IGO)
CLICK ON LOGO for APP

You must be logged in to use this feature!

You must be logged in to use this feature!

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