American Family Life Assurance Co. (Payroll Code: AI03 -- Billing Unit: American Family Life Assurance Co.)
Insurance Company Policy Type
|
Forms
|
| Accident Advantage |
A-9520; A-12000 |
| Short-Term Disability |
A57600OK
|
| Riders: |
|
| -Value Rider |
A57650OK |
| -Additional Units of Disability Benefit Rider |
A57653 |
|
Cancer Indemnity – Option 1
|
B70100OK
|
|
Cancer Indemnity – Option 2
|
B70200OK
|
|
Cancer Indemnity – Option 3
|
B70300OK |
|
Riders:
|
|
| -Initial Diagnosis Building Benefit Rider |
B70050OK
|
| -Specified-Disease Benefit Rider |
B70051OK |
| -Dependent Child Rider |
B70052OK |
| Hospital Confinement Indemnity – Option 1 |
B40100OK
|
| Riders: |
|
| -Extended Benefits Rider |
B40050 |
| -Hospital Stay and Surgical Care Rider |
B40051 |
| Specified Health Event – Option 1 |
A74100OK |
| Specified Health Event – Option 2 |
A74200OK |
| Specified Health Event – Option 3 |
A74300OK |
| Term Life Insurance – 10 Year |
ICC1368200 |
| Term Life Insurance – 20 Year |
ICC1368300 |
| Term Life Insurance – 30 Year |
ICC1368400 |
American Fidelity Assurance Co. (Payroll Code: AI09)
Insurance Company Policy Type
|
Forms
|
| Renewable & Convertible Term Life Insurance Policy |
ICC14 RCTL14 |
| Whole Life To Age 121 Insurance Policy |
ICC14 WL14 |
| Accelerated Benefit for Critical Illness Rider |
ICC14 LR203 |
| Accelerated Benefit for Long Term Illness Rider |
ICC16 LR204.R416 |
| Waiver of Premium Rider |
ICC14 LR205 |
| Level Term Insurance for Children Rider |
ICC14 LR206 |
| Renewable & Convertible Term Rider with Accelerated Benefit for Terminal Condition Provision |
ICC14 LR207 |
| Accidental Death & Dismemberment Rider |
ICC14 LR208 |
| Limited Benefit Specified Disease Cancer Policy |
C1106(0K) |
| Critical Illness Rider |
AMDl-239(0K) |
| Hospital Intensive Care Unit Rider |
AMDl-240(0K) |
| Accident Only Policy |
A0-03(0K) |
| Accident Only Benefit Enhancement Rider |
AMD1258 |
| Accident Disability Income Rider - 24-Hour Covewrage |
AMDl-224(0K) |
| Group Critical Illness Limited Benefit |
G9250K, G925 |
| Spouse Limited Benefit Rider |
AMD2117 |
| Group Supplemental Limited Benefit Medical Expense |
G9230K, G923 |
| Group Hospital Indemnity |
G14020K, G1402 |
American Heritage Life Insurance Co.
| Accident Insurance |
GVAP1: Approved 8/5/2002 |
| Accident Insurance |
GVAPBER: ALST-126452675 No.0552 |
| Cancer Insurance |
GVCP3:ALST-126107102 |
| Critical Illness Insurance |
GVCIP2: ALST-126536981 |
| Critical Illness Insurance |
GPCIER: ALST-128148220 |
| Term to Age 100 Life Insurance |
GPTLP: MCHU-128934098 |
American Public Life Insurance Co. (Payroll Code: AI05 -- Billing Unit: American Public Life Insurance Co.)
| Accident Expense, Death and Dismemberment |
A-2 (3/80) |
| Cancer and Specified Disease |
S-CSD-1 (6/83) |
| Cancer and Specified Disease |
BDCPA (7/83) |
| Cancer and Specified Disease |
APL-1 (6/86) |
| Cancer and Specified Disease |
GCPW (6/86) |
| Cancer and Specified Disease |
APLIC-1 (10/90) |
| Cancer and Specified Disease |
APLIC-2 (10/90) |
| Cancer and Specified Disease |
APLIC-3 (10/90) |
| Convertible Term Life/Decr. Term |
S-900 (1/89) |
| Hospital Intensive Care/Coronary Care |
IC-CC-1 (Rev. 8/82) |
| Hospital Intensive Care/Coronary Care |
IC-CC-2 (6/86) |
| Heart Attack/Stroke |
HA/S-1 (6/86) |
| Intensive Care/Coronary Care |
IC/CC-3 (2/90) |
| Whole Life |
WL-1 (11/86) |
Assurity Life Insurance Co. (Payroll Code: AI 49 -- Billing Unit: Assurity Life Insurance Co.)
| Return of Premium Rider |
CIR018 |
| Disability Waiver |
CIR016 |
| Automatic Benefit Increase |
A-DR205 |
| Return of Premium Rider |
A-DR208 |
| Residual Benefit Rider |
R-D220 |
| Guaranteed Insurability Rider |
RD221 |
| Hospital Benefit Rider |
A-DR202 |
| Home Modification Rider |
A-DR210 |
| Retroactive Injury Benefit |
RD222 |
| Critical Illness |
CI005 (OK) |
| Accidental Death Benefit |
A-R126 (OK) |
| Spouse Rider |
CIR-010 (OK) |
| Dependent Child Rider |
CIR014 (OK) |
| Critical Illness |
CI007 (OK) |
| Spouse Rider |
CIR012 (OK) |
| Children's Rider |
CIR020 (OK) |
| Personal Disability |
A-D100 (OK) |
| Supplemental DI Rider |
A-DR200 (9/95) |
| Simplified Life |
A-LN00 (OK) |
| Accident Expense Policy |
AAW-A117OK |
| Family Rider |
AAW-AR260OK |
| Outpatient Sickness |
AAW-DR225OK |
| Intensive Care Benefit |
AAW-DR226OK |
| Private Duty Nurse |
AAW-DR227OK |
| Surgical and Anesthesia and Additional Benefits |
AAW-DR228OK |
| Surgical Anesthesia and Additional Benefits |
AAW-DR230OK |
| Disability Income Policy |
AAW-D113OK |
| Sickness Benefits |
AAW-DR220N0 |
| Emergency Accident |
AAW-DR221 |
| Accidental Death and Dismemberment |
AAW-DR222 |
| Cancer Expense |
AAW-C120 OK |
| Cancer Expense Rider |
AAW-CR261 OK |
| Cancer Expense Rider |
AAW-CR262 OK |
| Cancer Expense Rider |
AAW-CR263 OK |
| Cancer Expense Rider |
AAW-CR264 OK |
| Accident Expense |
W A200 OK |
| Accident Expense (Off the Job) |
W A205 OK |
| Short Term Disability Income Rider |
R WA201 OK |
| Short Term Disability Income Rider (Off the Job) |
R WA251 OK |
| Universal Life |
9900 |
| Accidental Death Rider |
0027 |
| Level Term Insurance Rider (20-Year) |
0150 |
| Additional Insured Rider Level Term (20-Year) |
0151 |
| Rider to Apply Monthly Payments and Waive Monthly Deductions in Case of Total Disability |
0153 |
Bankers Fidelity Life Insurance Co. (Payroll Code: AI64 -- Billing Unit: American Trustee, Inc.)
| Group Accident Medical Insurance |
Group Master Policy B 21301- MP-E |
| Group Accident Medical Expense |
B 21301 CRT-E Certificate of Insurance |
| Accident Indemnity Policy |
B 21302 OK- Policy |
| Accident Indemnity Policy |
B 21302 R1 Rider |
| Accident Indemnity Policy |
B 21302 R2 Rider |
| Accident Indemnity Policy |
B 21302 R3 Rider |
| Accident Indemnity Policy |
B 21302 R4 Rider |
| Critical Illness |
B 21303 OK – Policy |
| Group Hospital Indemnity |
B 21304 MP-E Master Policy |
| Group Hospital Indemnity |
B 21304 CRT-E Certification of Insurance |
| Cancer Expense Policy |
B 9401 OK (01-01)- Policy |
| Cancer Expense Policy |
B 9401 R1-1 OK (01-01) Rider |
| Cancer Expense Policy |
B 9401 R1-2 OK (01-01) Rider |
| Cancer Expense Policy |
B 9401 R1-3 OK (01-01) Rider |
| Short Term Care Policy |
B 9305 OK – Policy |
| Disability Income Policy |
B 8722 OK – Policy |
| Disability Income Policy |
B 8722 R1- Rider |
| Disability Income Policy |
B 20702 OK – Policy |
| Term Life Insurance Policy |
B 20601 OK – Policy |
| Term Life Insurance Policy |
B 0211-2 CIBR – Rider |
| Whole Term Insurance Policy |
B 20803 OK – Policy |
Central States of Omaha (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)
| Policy |
C01OK (Actuary No. 1632-92-0014 only) |
| ICU Rider |
8121OK |
| Policy |
C02OK |
| ICU Rider |
8122OK |
| Return of Premium |
8018 |
| First Occurrence Rider |
8119 |
Central United Life Insurance Co. (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)
| Cancer Insurance Outline of Coverage |
FOB98OK-OC |
| Cancer Insurance Application |
AP-FOB99 |
| Cancer Insurance Application |
AP-CEP99 |
| Outline of Coverage -- Cancer |
OC-CP 4000 OK |
| Intensive Care -- Rider |
ICUR 4000 |
| Critical Care -- Rider |
CCBR 4000 |
| Application -- Critical Care Rider |
AP-CEP04-OC-OK |
| Outline of Coverage |
HDHASTOK-OC |
| Heart and Stroke Confinement -- Rider |
HRST98OK |
| Application -- Heart and Stroke Rider |
AP-HST99 |
| Schedule -- Accident |
EAP-SCH |
| Outline of Coverage -- Accident |
EAP-OC-OK |
| Disability Income -- Rider |
EAP-DR-OK |
| Application -- Accident Rider |
CUL-ESAE-OK |
| Combined Application |
AP-COMBO-03 |
Citizens Insurance Co. (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)
| Accidental Death |
ADP-781 |
| Cancer and Dread Disease |
ACC-182; ACC-487-OK |
| Cancer and Dread Disease |
ACC 585-OK |
| Cancer 1st Occurrence Benefit Rider |
FOB-487 |
| Heart Attack and Stroke |
HASP-487-OK |
| Intensive Care Unit Rider |
AIC-487-OK |
| Life |
GDBWL 3/83; 35PL 1/83 |
| Return of Premium Refund Benefit Rider |
RPI-487 |
Colonial Life & Accident Insurance Company (Payroll Code: AI02 -- Billing Unit: Colonial Life Insurance and Accident Insurance Co.)
| Cancer Assist |
CanAssist-OK |
| Critical Illness 1.0 |
CI-1.0-OK |
| Individual Medical Bridge |
IMB7000-OK |
| Individual Accident 4000 |
IAC4000-OK |
| Term Life 5000 |
ICC18-ITL5000 |
| Whole Life 5000 |
ICC19-IWL5000 |
| Individual Short Term Disability 3000 |
ISTD3000-OK |
| Individual Dental PPO |
IDN8000-OK |
EMC National Life (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty, Inc.)
| Cancer & Specified Disease Policy |
HP 9370 OK 8-99 |
| First Occurrence Rider |
AMH 9372 8-99 |
| The EMCNL Protector for Cancer |
HP3000 |
Equipoint Partners/DBA Pre Med Defender (Payroll Code: AI68)
| Group Supplemental Benefit Certificate |
NGSBCRT-OK 3/17 |
Family Heritage Life Insurance Co. (Payroll Code: AI66 -- Billing Unit: Family Heritage Life Insurance Co.)
| Cancer Care Plus Series 5 |
C8APP-OK/C8BR02-OK |
| Intensive Care Unit Rider |
186V2-OK |
| Cardia Care Plus Series 5 |
H4APP-OK/H4BRO-OK |
| Injure Care Plus |
ASAPP-OK/ASBR02-OK |
| Heritage Life Extra |
L4APP-OK2/L4BRO-ST |
| Indemnicare |
KIAPP-OK/L6BRO-ST |
| Child Whole Life Insurance Protection |
L6APP-OK/L6BRO-ST |
Humana (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty, Inc.)
| Cancer Insurance (Application) |
HIC-CAN-APP-OK 05/09 |
| Cancer Insurance Policy Brochure (Outline of Coverage) |
HIC-OOC-OK 5/09 |
| Intensive Care Rider |
HIC-ICR-OK 5/09 |
| Payment Benefit Rider |
HIC-POBR-OK 5/09 |
Kemper Benefits (Payroll Code: AI64 - -- Billing Unit: American Trustee, Inc.)
| Accident Medical Expense - Certificate |
KB-MAE-CER-1301-0K |
| Accident Medical Expense - Spouse Rider |
KB-MA-SR-1301 |
| Accident Medical Expense -Child(ren) Rider |
KB-MA-CR-1301-0K |
| Accident Medical Expense - Accidental Death Benefit Rider |
KB-MAE-AR-1301 |
| Accident Medical Expense - Group Policy |
KB-MAE-POL-1301-0K |
| Critical Illness - Certificate |
KB-MCI-CER-1301-0K |
| Critical Illness - Spouse Rider |
KB-MCI-SR-1301 |
| Critical Illness - Child(ren) Rider |
KB-MCI-CR-1301-0K |
| Critical Illness - Group Policy |
KB-MCI-POL-1301-0K |
| Whole Life - Certificate |
KB-MWL-CER-1301-0K |
| Whole Ufe - Accidental Death Benefit Rider |
KB-MWL-ADR-1301-0K |
| Whole Life - Chlld(ren) Term Life Benefit Rider |
KB-MWL-CTR-1301-0K |
| Whole Life - Accelerated Death Benefit Terminal Illness Disclosure |
KB-WL-ABTIR-D-1301 |
| Whole Life - Accelerated Death Benefit Payment Notice |
KB-WL-AB-NOT-1301 |
| Whole Life -Group Policy |
KB-MWL-POL-1301-0K |
Liberty National Life Insurance Co. (Payroll Code: AI56)
| Group Term Paid Up at 65 |
GE65 |
| Group Term |
GE2 |
| Accident Protector Max |
HAJ, HAK, HAL |
| Cancer Endurance |
5KM, KKN, 5KO |
| Cash Center |
LCANLS-2 |
| Career Life Plus |
8039/5148 |
Manhattan Life Assurance Company of America (Payroll Code: )
| Cancer Care Plus |
CP4000OK04104 |
| Intensive Care Rider |
1CUR 4000 |
| Critical Care Rider |
CCBR4000OK |
| Accident Expense |
C-ACEXP-OK |
| Wellness Rider |
C-ACEEXWL19 |
National Teachers Associates Life Insurance Co. (Payroll Code: AI13 -- Billing Unit: National Teachers Associates Life Insurance Co.)
| Accident Policy |
GRA-3001 (1/95) |
| Cancer Policy |
GRC-2004-OK (1/03) |
| Heart Disease, Heart Attack and Stroke Policy |
GRH-1003-OK (10/96) |
| Disability Income Policy |
GRD-6003-OK (10/99) |
| Spouse Rider - Accident |
GRA-SR-OK (1/95) |
| Child Rider - Accident |
GRA-CR-OK (1/95) |
| ICU Rider - Accident |
GRA-ICU-OK (1/95) |
| All Purpose Impatient Rider |
GR-1026-OK (2/03) |
| ICU - All Purpose Rider |
GR-2015-OK (1/03) |
| Specified Disease Rider |
GR-1045-OK (10/96) |
| Hospital Enhancement Rider |
GR-1013-OK (8/98) |
| Benefit Booster Rider |
GR-1056-OK (10/04) |
| Return of Premium Rider |
GR-1082-OK (10/04) |
| ICU - Heart Only Rider |
GR-1025-OK (10/96) |
| Heart Attack & Stroke First Occurrence Benefit Rider |
GR-1035-OK (10/96) |
| Heart Wellness Rider |
GR-1011-OK (6/98) |
| Cancer Benefit Enhancement Rider |
GR-1014-OK (1/03) |
| Whole Life Insurance Policy |
L-1115 (1/94) |
| Renewable & Convertible Term Life Insurance Policy |
L-2225 (1/94) |
| Convertible Decreasing Term Life Insurance Policy |
L-2224 (1/94) |
| Accidental Death and Dismemberment Rider |
L-ADDR.70 (1/94) |
| Children's Term Insurance Rider |
LCR-111 (1/94) |
| Accident Policy -- Series II |
GRA-3002-OK (5/06) |
| Accident Home Recovery Benefit Rider |
GR-AHRBR-OK (3/07) |
| Heart Disease, Heart Attack & Stroke Policy -- Series III |
GRH-1004-OK (9/06) |
| Heart Benefit Enhancement Rider |
GR-HBER-OK (10/07) |
National Union Fire Insurance Co. of PA (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty, Inc.)
| Cancer & Specified Disease Insurance |
C30551NUflC |
| Hospital Intensive Care Rider |
C30553NUFIC |
Occidental Life Insurance Co. (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)
| Cancer |
HC3B-1 Ed. 7-86 |
| Cancer |
HC2-1 Ed. 7-86 |
| Cancer |
HC4-1 Ed. 7-86 |
| Group/Franchise Disability |
HD1-1 Ed. 3-87 |
| Individual/Limited Benefit-Accident |
HA1-1 OK Ed. 5-88 |
| Individual/Whole Life |
FOH Ed. 8-86 |
Pre-Paid Legal Casualty, Inc (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)
| Family Plan |
PPLSI-233 |
| Law Officers Legal Plan |
PPLSI-234 |
Providential Life Insurance Co. (Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)
| Cancer |
CC-174 |
| Intensive Care |
IC-101 |
Security Financial Life (Payroll Code: AI49 -- Billing Unit: Assurity Life Insurance Company)
Washington National Insurance Co. (formerly Conseco Health Insurance Co.) (Payroll Code: AI06 -- Billing Unit: Washington National Insurance Co.)
| Accident Secure (AD&D and Accident Insurance) |
BM000/PS1OK-A |
| LifeChoices Series |
CH000/PS1OK-A |
| Benefit Rider |
CH0B1/IS1ST-A |
| Benefit Rider |
IS003/EA1OK-AA |
| Benefit Rider |
SD090/EA1ST-A |
| Pulse Protection (Heart & Stroke Insurance) |
KH000/PS1OK-BZ |
| Worksite Universal Life |
CIC-3001-OK |
