CICA LIFE OF AMERICA – Underwriting & Health Questions

Underwriting Overview

CICA Life of America uses a disciplined underwriting process to assess applicant risk.

Applicants are eligible for one of two products:
• Standard Issue (SI)
• Guaranteed Issue (GI)

No applicant is denied coverage. If Standard Issue criteria are not met, the applicant qualifies for Guaranteed Issue.

What Underwriting Does NOT Use

CICA Life of America underwriting does not consider:

• Height or weight requirements
• Tobacco usage
• Medical Information Bureau (MIB)

How Product Eligibility Is Determined

Applicants answer eight health questions (questions may vary by state).

• If all answers are “No” → Standard Issue
• If any answer is “Yes” → Guaranteed Issue

Agents must read each question verbatim and record answers accurately.

Health Question A

Is the proposed insured currently hospitalized, confined to a bed or nursing facility, residing in an assisted living facility, receiving hospice care, or unable to perform normal activities of daily living without assistance, or terminally ill?

Health Question B

Has the proposed insured tested positive for HIV or been diagnosed with ARC or AIDS caused by HIV infection?

Health Question C

Has the proposed insured been diagnosed with more than one occurrence of any cancer, a recurrence of cancer, metastasis of cancer, or is currently being treated for cancer (excluding basal cell or squamous cell skin cancer)?

Health Question D

In the past 10 years, has the proposed insured been diagnosed with uncontrolled diabetes, uncontrolled high blood pressure, stroke or TIA, paralysis, congestive heart failure, heart disease, cardiomyopathy, lung disease (including COPD or emphysema), liver cirrhosis or failure, kidney failure or end-stage renal disease?

Standard approval applies if the client IS taking medication or being treated by a licensed medical professional.

Health Question E

Has the proposed insured ever been diagnosed, treated, or taken medication for a mental disorder, disorder of the brain or nervous system, systemic lupus (SLE), Alzheimer’s disease, dementia, ALS, Huntington’s disease, muscular dystrophy, cystic fibrosis, pulmonary fibrosis, or multiple myeloma?

Health Question F

In the past 2 years, has the proposed insured been hospitalized two or more times or been advised to have tests, treatment, surgery, or hospitalization that has not been completed?

Health Question G

Within the past 2 years, has the proposed insured been treated for or advised to seek treatment for alcohol, drug, opioid, or controlled substance abuse, been convicted of a felony or misdemeanor, or attempted suicide?

Health Question H

Within the last 5 years, has the proposed insured been advised by a licensed medical professional to have an organ transplant?

Mental Health Underwriting – Standard Issue Criteria

All of the following must be met for Standard Issue consideration:

• No antipsychotic medications
• Minimal medication use
• Stable condition with no functional limitations
• No hospitalizations, disability, or confinement
• No co-existing mental health or mood disorders
• No drug or substance abuse history
• No alcohol dependence
• No history of self-harm or suicide attempts

Mental Health Underwriting – Guaranteed Issue Triggers

Any of the following result in Guaranteed Issue eligibility:

• Hospitalization for mental health conditions
• Functional limitations or restrictions
• Disability due to mental health
• History of electroconvulsive therapy (ECT)
• Use of multiple mental health medications
• Suicide attempt or self-harm
• Co-existing mental health or mood disorders

Convictions – Eligibility Rule

Applicants who have pleaded guilty or been convicted of a felony or misdemeanor for any reason within the past two years are eligible only for Guaranteed Issue.

Underwriting Discretion

Underwriting reserves the right to determine eligibility based on all risk factors presented. State-specific applications and rules may vary.