WHOLE LIFE - Globe Life Insurance Company of New York

WHOLE LIFE

Simplified Issue Agent Guide

? 2020 Globe Life Insurance Company of New York. All rights reserved.

GNY2990 0620

HOW TO CONTACT GLOBE LIFE INSURANCE COMPANY OF NEW YORK

? By mail: Globe Life Insurance Company of New York, P.O. Box 3125, Syracuse, NY 13220-3125 ? Contact Home Office at 315-451-7975, or email at GLNYAgency@Globe.Life. For supply requests, access the Automated Supply

Order Form from UAOnline at logon. ? New Business fax: 972-767-4462 or 972-569-3678

BEFORE YOU BEGIN

Make sure you have:

1. Agent licensing and Globe Life Insurance Company of New York Appointment procedures complete. A Writing Agent Number will be required on all forms.

2. Current Compliance Sheet listing the materials and required forms for the product portfolio approved for Globe Life Insurance Company of New York.

3. Agents selling life insurance are required to complete Suitability and Best Interests Regulation 187 training and submit a Training Attestation Form to the Home Office.

Please refer to the State of New York Department of Financial Services at dfs. for more information on Suitability and Best Interests Regulation 187 training. The Training Attestation form is available from the Home Office.

Benefits Issue Ages Issue Amounts Renewability Simplified Underwriting

Premium Classes Modal Factors

Policy Fee Cash Values

BASE PLANS

Final Expense Whole Life

Permanent lifetime coverage

50-80*

$1,000 - $25,000**

Guaranteed for life as long as premiums are paid on time

- MIB - Prescription drug database - Telephone interview if needed - Height and weight chart

- Male/Female

Juvenile Whole Life

Permanent lifetime coverage

0-18

$1,000 - $25,000 Guaranteed for life as long as premiums are paid on time

- MIB - Prescription drug database - Telephone interview if needed - Height and weight chart

Male/Female

Automatic Payment Plan

Direct Bill

Automatic Payment Plan

Direct Bill

Annual

1.000

1.000

Semi-annual

0.500

0.520

Quarterly

0.250

0.265

Monthly EFT

1/12

$20 Annual Fee

0.090

Accumulates cash and loan value

Annual

1.000

1.000

Semi-annual

0.500

0.520

Quarterly

0.250

0.265

Monthly EFT

1/12

$20 Annual Fee

0.090

Accumulates cash and loan value

* Maximum issue age is limited on graded products (73 for males; 75 for females) ** Maximum face amount is limited to $150 monthly premium per insured, $300 monthly premium per household, and limited for males to comply with New York Regulation 4228.

1

INSTRUCTIONS FOR COMPLETING THE GNYJUV14 APPLICATION

REQUESTED EFFECTIVE DATE

The Effective Date of the policy is the Underwriting Date or the specific policy date requested on the application.

The Underwriting Date is the later of: (1) the date of the application; or (2) the date all underwriting requirements, as required by the Company's underwriting rules, are completed. A specific effective date can be requested within the following parameters:

? Backdating up to 6 months to save age is allowed.

PAYMENT MODE

Check the payment mode selected. Monthly payments are available only with Electronic Funds Transfer (bank draft). Initial premium will be paid by Bank Draft at the time the policy is issued.

No money can be taken at the time of sale.

PLAN OF LIFE INSURANCE

Whole Life

BENEFIT AMOUNTS

$1,000 - $25,000

OWNER

Fill this out completely, being sure to include the Social Security number and phone number of the Primary Applicant (Policy Owner).

The Policy Owner must have an insurable interest in the life of each Insured. The insurable interest requirement is satisfied if the individual is an immediate family member or would suffer an economic loss by the death of the Proposed Insured. The relationship must be stated on the application.

BENEFICIARY

The beneficiary for children will be the Policy Owner. If the Owner is other than the Proposed Insured, the beneficiary must have an insurable interest. The relationship must be stated on the application.

CHILDREN COVERED IN THE POLICY

Children must be age 0-18. When calculating the Proposed Insured's age, if a specific effective date is requested or if the first premium is to be paid by bank draft, calculate the age as of the effective date or draft date, not the application date.

The Life Face Amount can be different for each child.

UNDERWRITING

The agent must see the proposed insured in person during solicitation of this insurance.

ELIGIBILITY

Refer to the Juvenile Build Chart in this manual.

Weight exceeding the maximum will be declined.

Answer the questions for each Child to be covered under the policy. Applicants with `YES' answers to questions 5-7 on the GNYJUV14 application are not eligible for coverage.

Applicants with health conditions listed as unacceptable risks are not eligible for coverage.

Any Applicant or Owner who has had a Globe Life Insurance Company of New York Life policy lapse in the last 12 months is not eligible for coverage.

REPLACEMENT

Replacements are not allowed.

Agents must provide each applicant with a state-required `Definition of Replacement' form (GNY-DEF). Even though the sale doesn't involve a replacement, this form must be signed by the Applicant and agent and returned with the application to the Home Office.

If the Applicant answers `yes' to any question on GNY-DEF, do not complete the application.

NOTE: Although Globe Life Insurance Company of New York does not allow Replacements, New York Insurance Law requires that GNY-REP be made available for use. A link to this form can be found on the Compliance Sheet.

SIGNATURES

The Policy Owner must sign the application. Signatures are to be witnessed by the agent.

Applicants age 14 ? and older must sign the application.

Note: The application must be received by the Company within 30 days of signature.

BANK DRAFT AUTHORIZATION

Complete the Bank Draft section if the initial premium and/or subsequent premiums are to be paid by EFT. Select a draft day if subsequent premiums are to be paid by monthly EFT on a specified date.

Please note: the initial premium will be drafted on the day the policy is issued.

Helpful information for Social Security recipients:

Social Security Benefits Paid On

Birth Date Draft

On

Date

Second Wednesday 1st ? 10th 14th

Third Wednesday 11th ? 20th 21st

Fourth Wednesday 21st ? 31st 28th

Drafts cannot be the 29th, 30th, or 31st.

SEND POLICY TO:

Check the appropriate box at the bottom of the application to indicate whether the policy will be mailed to the agent or to the Policy Owner. If neither box is checked, the policy will be mailed to the Policy Owner.

2

APPLICATION FOR LIFE INSURANCE * GLOBE LIFE INSURANCE COMPANY OF NEW YORK A NEW YORK STOCK CO. * HOME OFFICE: SYRACUSE, NEW YORK

Requested Effective Date (mm-dd-yyyy)

0 7 2 2 1 9

Payment Mode Payment Type

Monthly Quarterly

Bank Draft

Semi-Annual Annually

Direct

Draft Day (01 to 28 only)

1 5

Child 1

Whole Life

LIFE PLAN

Life Face Amount

Premium

1 0 00 0

4 3 7

Life Face Amount

Premium

SAMPLE Child 2

Child 3 Child 4 Child 5

Whole Life Whole Life Whole Life Whole Life

1 0 0 0 0 4 7 7

Life Face Amount

Premium

Life Face Amount

Premium

Life Face Amount

Premium

Total Premium

Total Collected with Application

9 1 4 0 0 0

Applicant if other than Owner

Name: ______________________________________________________________ Relationship to Owner: ___________________________ Address: _____________________________________________________________ City: _________________ State: ____ ZIP: _________

Best time to call: Home Phone No. 5 5 5 4 4 4 3 3 3 3 8 AM - Noon

Noon - 6 PM 6 PM - 9 PM

2 2 2 1 Work Phone No. 1 1 0 0 0 0

GNYJUV14

Pg 1

(Application Continued)

GNYI2940 0117 3

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