Supplies

For Agent Use Only - Not for Solicitation Purposes 

Nebraska Individual App and Worksheet
            LS-0202A NE 07/07  (359 kb)
LTC Brochure
      Consumer Brochure
            LS-0301 EXCL 08/07  (213 kb)
2009 Field Underwriting Guide
            LS-0600 ST 02/09  (260 kb)
Agent Quick Reference Guide
      An agent's brief overview of the LifeSecure long term care insurance product, discounts, issue ages, underwriting classes and other helpful information.
            LS-0308 ST 04/07  (113 kb)
Plan-At-A-Glance Form
      A quick reference overview of LifeSecure's long term care insurance product.
            LS-0307 ST 07/07  (65 kb)
Rate Cards
            Rate Cards  (4042 kb)
Mythbusters
      A document that examines common myths about long term care insurance.
            LS-0322 ST 02/07  (83 kb)
HIPAA Form
      Applicant Authorization to Obtain and Disclose Information. This form authorizes release of applicant APS information.
            LS-0107A ST 03/07  (175 kb)
Replacement Form
      Notice for those who intend to lapse or otherwise terminate existing accident and sickness or long term care insurance and replace it with the individual long term care policy issued by LifeSecure Insurance Company.
            LS-0102A ST 02/07  (21 kb)
Change Request Form
      This form allows your client to make updates to their policy and demographic information.
            LS-0123 ST 03/09  (74 kb)
Premium Payment Authorization Change Form
      This form allows your client to change and authorize their preferred premium payment method and/or frequency.
            LS-0123P ST 11/07  (62 kb)
Multi-Life Brochure
            LS-17013 ST 02-10  (2120 kb)
Multi-Life LTC Agent Handbook
            LS-0385 ST 12/09  (3887 kb)

Preferred Marketing Associates, Ltd.
3530 North 163rd Plaza (163rd & Maple)
Omaha, NE 68116
(402)397-9787
Toll Free 1-800-777-0723