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Gender |
Age |
Health Class |
| Primary |
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| Spouse |
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| Child 1 |
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| Child 2 |
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| Child 3 |
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| Child 4 |
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| Child 5 |
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| Child 6 |
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*Select all family members that will be covered by this policy
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Select the preferred health rating class if you have no pre-existing medical conditions, take no maintenance medications, and have a good height to weight ratio.
Select the standard health rating class if you take any maintenance medications, you are somewhat overweight, or have any pre-existing medical conditions.
Select the tobacco rating class if you have used any form of tobacco in the last 12 months.
Children are always assigned the standard health rating class.
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Health