Final expense underwriting guide for agents: knockouts, medication flags and graded triggers in public carrier forms

Final expense underwriting sorts each applicant into a level plan with the full benefit from day one, a graded or modified plan that limits the benefit for two or three years, or, when the health questions rule both out, guaranteed issue. Each carrier’s questions, look-back windows and database checks decide which; the carrier makes every underwriting decision.

This final expense underwriting guide reads the rules where carriers print them for the public: three application forms that route each answer to a plan, and documents from seven carriers that show how six of them limit early benefits. Most agent guides we found are marked for agent use only, and no marked document is used here. Every rule below is taken from a document read on October 14, 2026, with its form number and edition.

How final expense underwriting works on a phone application

A final expense application is decided on two things: what the applicant answers, and what the applicant lets the carrier check. The public documents describe five checks, and none of them leaves the decision with the agent. Transamerica’s application has the applicant agree “that the agent does not have the authority to waive any question on this application, to decide if insurance will be issued”; Columbian’s says no agent may “pass on insurability”.

1. The health questions, asked as written. Each form groups its questions into sections, and each section carries a rule: a “yes” in the first section ends the application, and a “yes” in a later section routes it to a lower class or a graded or modified plan. The matrix below sets those rules side by side.
2. The authorizations. The applicant signs releases for MIB and for prescription records: Security National’s authorization names pharmacies, prescription vendors and pharmacy benefit managers, and Columbian’s covers “prescription drug records”.
3. The database checks. Security National’s 2023 product overview says “Prescription histories are ordered, regardless of which plan you are writing.” Columbian’s 2020 overview lists an MIB check, a prescription drug database check and, for issue ages 18 to 35, a motor vehicle report. Fidelity Life says its RAPIDecision Final Expense decision depends on “the answers to a few health questions on the application and results from certain database records, like motor vehicle reports.”
4. The build chart. Height and weight can end an application on their own. Columbian’s 2020 table declined an applicant 5 feet 6 inches tall who weighed under 103 or over 290 pounds.
5. The phone interview, when the carrier wants one. Columbian’s forms warn that “a telephone interview may be necessary to verify or supplement information given to the Company on this application,” though its 2020 overview listed “No telephone interview!” ELCO Mutual’s Silver Eagle brochure offers “a short telephone interview or our e-application, if available.”

MIB is a cross-check, not a verdict. MIB says a member carrier “will cross check the information you provide on your application against any information in your MIB Consumer File”, and a consumer has that file only after applying to a member carrier for life insurance in the last seven years when something of “underwriting significance” was found. Columbian adds that it “does not rely, in whole or in part, on an MIB report in making a final underwriting decision.”

Telesales readiness: signatures, e-apps and disclosures by carrier

A phone sale ends with a signature and the disclosures the applicant receives. The table shows what the carriers’ public documents, read on October 14, 2026, say about each step; “Not described” means a document is silent on it.

Foresters’ PlanRight brochure and Fidelity Life’s RAPIDecision pages describe none of the three steps. Of these seven carriers, only Columbian’s public documents describe a voice signature, and its packets come in state versions, so use the one for the applicant’s state. No public document here prints a deadline for sending disclosures after a phone sale; take that deadline from the carrier’s agent guide and your state’s rules.

Which answers end an application, and which lead to a graded plan

Transamerica, Columbian and Security National each publish a form that states which answer leads to which plan, the only three among the carriers we could read. The matrix lines up 25 conditions and flags across those forms. Read each cell as the result when that answer is the only “yes” on the form; a second “yes” can move the result down a tier or end the application.

The columns are Transamerica’s Life Application L122 1012T PA, the 2012 Pennsylvania print for its Immediate, 10-Pay and Easy Solution products (parts C2 to C4); Columbian’s FE 2022 questions as printed on its public reinstatement form ICC21 A746-CL (parts P1 to P3); and Security National’s Loyalty Plan application ICC25-LP APP of August 2025 (sections S1 and S2). “Knockout” is each form’s own stop rule. Columbian’s Select is a full-benefit plan and Classic Advantage its graded plan. All three forms were read on October 14, 2026.

How each form routes the answers

Transamerica (L122). Any “yes” in Part C2 ends the application. One “yes” in Part C3 routes it to the Graded Death Benefit product, and two end it. Part C4 counts only when Part C3 is all “no”: all “no” routes to Preferred, one “yes” to Standard, two or more to Graded.

Columbian (FE 2022). Any “yes” in Part 1 means do not submit. One “yes” in Part 2 routes to Classic Advantage, the graded plan, and two mean do not submit. One “yes” in Part 3 routes to Classic Select, and two route to Classic Advantage. All “no” routes to Classic Elite.

Security National (Loyalty, 2025). Any “yes” in Section One ends the application. Any “yes” in Section Two routes to the Modified Plan, and more than three end it. All “no” routes to Preferred.

One applicant, three forms

A hypothetical applicant shows how far the forms diverge. She is 68. Her cancer treatment ended three years ago, with no cancer care or advice since. She has used insulin since age 45, with no complications. Her COPD was diagnosed five years ago and is treated with a daily inhaler, and she does not use oxygen. Run through each form’s printed rules:

1. Transamerica: cancer within four years is a Part C3 “yes” (C3 Q5). One C3 “yes” routes to the Graded Death Benefit product, and Part C4 is never reached.
2. Columbian: nothing in Part 1, but two Part 2 answers are “yes”: COPD, ever (P2 Q1), and insulin used before age 50 (P2 Q6b). Two Part 2 answers mean do not submit.
3. Security National: nothing in Section One. The cancer is more than two years old and her insulin began after 40, so the only “yes” is COPD treated in the past two years (S2 Q4D). One Section Two “yes” routes to the Modified Plan.

Same answers, three results: graded, do not submit, modified. Each carrier’s database checks and underwriters can still change the outcome, which is why any tier set before the application is an estimate.

Level, graded, modified and guaranteed issue: seven carriers’ early-benefit rules

A graded or modified plan pays less than the face amount when death from natural causes comes in the first policy years, and carriers limit that early benefit in different ways. The table shows each carrier’s plan names and early-benefit rule as its public document prints them, read on October 14, 2026, sorted by carrier name.

Columbian’s 2020 overview also capped graded sales: “Sales of graded death benefit policies may not exceed 30% of applications issued and paid in the past 365 days.”

The labels do not travel between carriers. Foresters calls its premiums-plus-interest plan graded, Security National calls a premium refund plus 10% modified, and ELCO Mutual’s graded plan pays a percentage of the face amount. Fidelity Life’s guaranteed issue plan reduces the benefit for three years; every other plan with a printed formula reduces it for two. Quote the formula, not the label.

Two regulatory texts frame these plans. The first is the Insurance Compact’s graded-benefit standard, for policies filed through the Compact. It names the two designs in the table, a graded benefit that is “a percentage of the ultimate face amount” and one “equal to premiums paid plus interest”, or “a combination of the two”. It limits the reduced period to “not more than the first three policy years”, sets the reduced benefit at no less than “the amount of premiums paid to the time of death with interest”, requires “the full ultimate face amount” for accidental death at any time, and puts “This policy has a limited graded death benefit – Please read your contract carefully.” on the cover page. It also requires the specifications page to show “the dollar amounts of the early duration reduced benefits for death from natural causes” for each policy year and, for a premiums-plus-interest design, to “describe the calculation and state any interest rate or other coefficient”, so the issued policy carries the exact schedule a brochure summarizes.

The second, NAIC Model 570, which states adopt in their own form, says an advertisement for a policy with graded or modified benefits “shall prominently display any limitation of benefits”, and that “no medical examination required”, where issue is not guaranteed, needs a disclosure that issuance “may depend upon the answers to the health questions set forth in the application.”

Prescription and medication flags in the public forms

Medication counts as treatment on these forms. Columbian asks whether the applicant was “diagnosed or treated (including taking medication)” for congestive heart failure, Alzheimer’s disease, dementia or ALS, so a heart-failure prescription alone answers its Part 1 question “yes”. Security National’s Section Two asks about conditions the applicant was “diagnosed, tested positive for, treated, prescribed medication, or been given advice” for in the past two years.

The flags the public forms name, medication by medication:

• Insulin. Transamerica routes insulin used in the past two years to Standard (C4 Q8c) and diabetes diagnosed before 18 to Graded (C3 Q4). Columbian routes insulin used before age 50 to Classic Advantage (P2 Q6b). Security National routes insulin used before age 40 to Modified (S2 Q4F). An applicant who started insulin at 45 trips Columbian’s threshold and not Security National’s.
• Oxygen. Transamerica counts oxygen used in the past year with sleep apnea included (C3 Q6e); Columbian counts oxygen ever used except for sleep apnea (P2 Q1); Security National asks whether the applicant depends on oxygen (S2 Q6). Oxygen used only for sleep apnea is a “yes” on Transamerica’s form and a “no” on Columbian’s.
• Prescription drug misuse. Transamerica and Security National name prescription drugs inside their alcohol and drug questions (C3 Q6a and C4 Q8d; S2 Q4H).
• The medication list. Security National’s application asks for “a complete list of medications (including oxygen), and the dosages and time periods”, and its completion guide tells the agent to enter “all current prescriptions taken”.
• No medical history at all. Columbian’s 2020 overview made applicants aged 71 or older with no prescription drug history ineligible for its Elite plan, and those 71 or older who had not seen a doctor in the past three years ineligible for any coverage.

Drug-by-drug lists sit in carriers’ agent-only prescription guides, so no drug name in this guide is matched to a tier; use the carrier’s own guide from your agent portal for that. Treat the prescription history as part of the application: Security National orders one on every plan.

How a pre-vetted screen estimates a tier

A pre-vetted transfer adds health and medication questions to the interest, age and state check, and estimates a Guaranteed Issue or Level/Graded tier before the handoff. The estimate prices the transfer, at $250 per Guaranteed Issue transfer and $300 per Level/Graded transfer. It does not settle the plan: the carrier makes every underwriting decision.

The matrix shows why there are two estimates, not three. Each form above either routes the answers to one of its health-question plans, the family a Level/Graded estimate points to, or stops the application; when the health-question forms stop it, guaranteed issue is the plan family left. The screen does not split level from graded, because that split depends on the carrier, as the hypothetical applicant shows, and on database checks no screener runs. You present, recommend and complete the application with the carrier you choose, and which plan the prospect can get is a conversation for you, the licensed agent; see where the screener stops and the licensed agent starts.

If you would rather hear every health answer yourself, an interest-verified live transfer stops at interest, age and state, at $110 per transfer. If you want the health and medication answers gathered before the call connects, see pre-vetted final expense transfers. Whoever screens your transfers, ask which questions sit behind the estimate, one of the questions to put to any transfer vendor before you buy.

How this underwriting guide was built: sources and changelog

This guide uses only documents a carrier publishes with no restriction on public use, read on October 14, 2026, and links each carrier’s own copy; we host none. The matrix comes from three application forms: Transamerica L122 1012T PA, Columbian ICC21 A746-CL (checked against its policy-change form ICC21 A747-CL) and Security National ICC25-LP APP. The early-benefit table adds product documents from Corebridge, ELCO Mutual, Fidelity Life and Foresters, and overviews from Columbian (2020) and Security National (2023). The telesales table adds Columbian’s telesale and eApp disclosure packets (5376CFG-TX-FE and 5354CFG-TX), found through its public forms search.

Left out, because each carries a restriction: Transamerica’s Final Expense Guide (form 84405), marked “For agent use only. Not for public distribution.”; Columbian’s point-of-sale underwriting guide (5398CFG), agent reference guide (5378CFG) and eApp guide (5365CFG), marked “For agent use only. Not for use with consumers.”; Foresters’ PlanRight Producer Guide (503306 US), marked “For producer use only. Not for use with the public.”; Corebridge’s simplified issue underwriting guide (AGLC201453), marked “For financial professional use only - not for public distribution.”; Americo’s Final Expense Products at a Glance, marked “For agent use only. Not for public use.”; and Security National’s underwriting and medication guides, which carry a confidentiality agreement. Mutual of Omaha’s producer documents, and the Royal Neighbors, Gerber Life and Aetna sites, did not load from our network that day, so they are not in this edition.

Edition notes: Transamerica introduced a digital product, FE Express Solution, in September 2024, and its questions are not on the L122 form. We found no public copy of the Part 1 to Part 3 health questions on Columbian’s new-business application, ICC21 A745-CL (its telesale packet reprints only pages 3 and 5 of 5); its reinstatement form prints the same Part 1 to Part 3 questions as its FE 2022 policy-change form and states the routing. Check the current form for your applicant’s state before you quote.

• Changelog, October 14, 2026: first edition, built from the documents above as read that day.
• October 22, 2026: every linked document re-read before publication; each still says what this guide quotes, and Columbian’s public forms list still shows the FE 2022 forms and Rev. 11/21 packets used here.