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Coverage Amount
How much coverage do I need?
We recommend that each household breadwinner carry ten times their annual income in total life insurance. Caregiving adults who are responsible for others should consider $300,000. If you need personalized advice, call our life insurance counselors at 1-800-410-0733 or click here to view our online life insurance needs calculator.
State of Residence  Check box if living abroad 
Birth Date
(Ages 14 Days - 85 Years)
Sex Male Female 
Tobacco, nicotine or
marijuana use?
Why do life insurers ask about this?
Nicotine use of any kind, including marijuana use, is looked at very closely by all life insurers. Smoking, chewing, inhaling in a vaporized form, consuming in edible products, and wearing a patch on the skin, all constitute use of these products. Non-admittance of marijuana use can result in a decline. Sources of information the insurer may use include: statements made on your application, telephone interviews, your paramed exam results (if one is required), your outside medical records and your Medical Information Bureau (MIB) profile. If you currently use marijuana AND any product containing tobacco or nicotine, please select the response that most closely describes your tobacco or nicotine use. Always be 100% honest when you answer tobacco use questions to ensure accurate quotes. Remember, a false statement on an application for insurance could void your coverage. If you need personalized advice, call our life insurance counselors at 1-800-410-0733.
Weight (with clothes on)
Why does the life insurance company need to know your actual weight?
Weight (with clothes on) is a key rating factor with all life insurance companies. Please give an honest answer here so that you can receive accurate rate quotes. And keep in mind that the paramed examiner who visits you will be carrying a portable scale, so be honest here. If you need personalized advice, call our life insurance counselors at 1-800-410-0733.
Height 
I am in excellent health, take no prescription drugs and
have no pre-existing medical conditions.
No Yes
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