Anyone with the right skill set and motivation can become a successful Hermann Sons Life insurance and annuities agent. Life insurance and annuities sometimes may be difficult to understand, but with the proper training, agents can earn a lucrative income selling for Hermann Sons Life. Here are some steps to help you become a successful Hermann Sons Life sales agent.
Prospecting
Are you taking care of and following up with your existing customers?
Are you asking for leads from customers?
Are you automatically giving quotes to other members of the family?
Are you working events or having a table setup?
Are you talking about Herman Sons Life and selling yourself?
Are you working on the orphaned list? Really working the orphaned list?
Are you tag teaming with another agent?
Join community professional’s group.
Host bingo at a senior center.
Do you carry your business cards with you everywhere you go and pass them out?
Do you email digital brochures to prospective customers?
Are you having regular conversations with your Regional Sales Manager?
Are you attending lodge meetings?
Are you sharing Hermann Sons Life Facebook and/or Instagram posts with your contacts?
Are you sending Thank You Notes for recently issued policies?
Are you attending community events?
Meeting With Your Client
The Agent’s Role – Life Insurance and Annuities may sometimes be difficult to explain to the client, but with the right skill set and motivation, anyone can become a successful agent.
In most cases, it is the agent who is the initial contact with the client. Maintaining the appropriate training and education requirements are essential in order to be fully prepared to explain and assist the client in understanding the products. It is the Agent’s duty to focus on the needs of the client thereby offering the most appropriate product to their client.
Meeting With Your Client
Needs Analysis Selling
Most people are not so financially sound that they could stop working tomorrow and be able to have enough resources to support their family for a long time into the future. However, this is precisely what happens when the primary bread winner of a family dies. For this reason, life insurance is a critical piece of a family’s financial profile. But how does a family determine the proper amount of insurance? – The answer is a Needs Analysis!
The inherent problems associated with analyzing needs are understood. Needs analysis can be quite uncomfortable for the client and the agent. What are some of the negative issues associated with obtaining a complete needs analysis?
Clients are uncomfortable sharing information.
Clients don’t feel it is an important step in purchasing a small Hermann Sons Life product. They know exactly what they want.
Agents feel uncomfortable asking the questions. What if the analysis recommends more insurance than they can afford?
It is hopeful that information in this section will help agents feel more comfortable when assisting clients complete the needs analysis process.
Why is needs analysis important?
Why do we need to complete a needs analysis for our clients?
It’s the Law!
Documented needs analysis protects the consumer and the agent.
Life insurance sales should be needs based. And when the client knows what they need it helps them plan for the future. You may have heard the old joke that “everybody talks about the weather, but nobody does anything about it.” Through proper needs analysis we have the opportunity to help our clients not just talk about their future but to understand and plan for their needs.
Needs analysis is the most reliable approach to determining the proper level of insurance. This type of analysis determines the amount of money needed to support the family and pay down outstanding liabilities, reduced by current asset holdings and future receipts of income.
When we do this we increase customer satisfaction. When customers are pleased with your service and recognize your planning professionalism they are more inclined to tell others. This will increase client referrals. Even if they do not take the coverage recommended by needs analysis, they are at least aware of their needs which may lead to future contacts.
As you prepare for the needs analysis process, it is important that you help your client to feel comfortable with you and what you can offer to them.
Today’s consumer has more accessibility to information than ever before. Yet when considering a major financial obligation like life insurance or annuities they often don’t do any investigation. Maybe it’s because of the complexity of the product or the lack of desire to consider their own mortality, but for whatever reason they will rely on the agent to take the first step. Your ability to best serve your client and the promise of a potential sale will essentially depend on your ability to put your clients at ease and teach them about the products you sell.
Remember, you are the professional! Help the client to understand how you can help them. Show confidence and knowledge. Use special words and phrases like needs-based selling, confidentiality and trust to help clients feel more comfortable.
Conducting the needs analysis interview
There are four basic steps to needs analysis:
Fact finding
Determining client objectives
Analyzing customer needs and amounts
Helping with product selection
Following these steps will allow you to identify and discuss:
Information which will determine your client’s potential for life insurance or annuities. (job, health, other insurance)
Financial problems that might arise or goals for when your client dies or retires. (debt)
Your client’s objectives and motivation to purchase. (children, college, new home, change in job, retirement, desired estate)
The specific form we use to record gathered information is the Needs Analysis Form. Plan to carry at least three copies to each appointment. You can start completing the form (or take notes) as you conduct the needs analysis interview. One will be used to complete information, sign and send to the Home Office. Another can be left with the client to use for a spouse or at a future date.
Step #1 – Fact finding
This first step includes the typical data gathering. What is their current financial situation?
Do they have other insurance in force?
Why are they interested in Hermann Sons Life? (Camp or dance, annuity vs. SAFE, etc.)
During the fact finding phase you often get a strong indication whether your client needs insurance and the first indicators of how much.
Step #2 – Determining Client Objectives
The next step involves discovering what the client’s overall objective is for purchasing life insurance or an annuity.
What percentage of income would you like your family to have when you die? What bills or expenses would you want liquidated? At what age do you want to retire?
What do you need for retirement income? Does your family have a history of longevity?
Many clients have never thought of these questions. You may have to help them with some objectives (e.g., mortgage, college).
Remember, these objectives become the motivation for their purchase today and future purchases.
Step #3 – Analyzing Customer Needs and Amounts
By determining the client’s objectives you know where they are and where they want to go. Now it’s time to determine how they can get there from here.
To apply suitability standards to your needs analysis you must analyze the objectives your customer indicated to determine the appropriate amount and type of coverage. Typically, customers need insurance to cover these six needs:
Income – Most people’s main source of income comes from employment. The money they make from work generally meets their needs. Death, however, brings an end to that source of income. A family that loses an income-earner as a result of premature death will face financial hardships unless another source of income has been provided for in advance. Life insurance can meet this need because it is designed to create dollars when an individual dies.
Mortgage – The most important legacy an income-earner should want to leave their family is a roof over their heads, especially when there are children involved. Life insurance can guarantee that survivors will keep their home or have the available funds for rent. At the least, estimate the actual cost for 120 months.
Debt Repayment – Debts create another cash need when a family member dies. Having a lump sum to liquidate these obligations will allow the surviving family to use other income for current living expenses rather than paying for past purchases.
Final Expenses – Cost associated with a funeral, probate and legal fees, possible medical bills and other associated expenses can cause great indebtedness. These costs are traditionally estimated between $15,000 and $20,000.
Child Care and Education – Children need to be cared for, especially after the death of a parent. Loss of wages can be a hardship unless covered by insurance. Plan on $8,000-$14,000 per year per child for child care and associated needs. (The number of years calculated will depend on the age of the child.) For college, plan on $20,000 to $40,000 per year per child. It will be more if it is a private university or if children fail to qualify for grants.
Emergency Funds –
The death of a wage-earner doesn’t affect the possibility of other emergencies occurring. Major home, auto or health expenses could still occur. Plan to set aside funds equaling one-half of your annual income for emergencies.
Also, look at the funds which will be available at death. This will include other life insurance and annuities (from Hermann Sons Life and others, including employer group), cash on hand, and other income.
Step #4 – Helping Your Client to Choose a Product
Once your client agrees that they have a life insurance or annuity need, you can present product choices and options. Explain to customers how the features of the product will solve their financial needs. By carefully reviewing appropriate amounts and explaining how they solve financial needs, you will meet suitability standards.
Knowing the Certificate Features
It is very important that agents are fully aware of our products and product features. Our clients look to you as the professional. You must have thorough knowledge of the products so you will know which plan(s) will do the best job for the client.
Unfortunately, choosing suitable products for clients is not as easy as drawing numbers out of a hat. It’s a precise science, but not a perfect one, and it takes considerable product knowledge and practice. Once you learn about the products, you must then learn to match them to the right customers.
Solid product training, like we provide during CE sessions, will help you to put customers at ease and make them more willing to listen to your ideas about their financial situations.
Putting It All Together
Earning the customers’ trust while discovering their needs will make your job of describing a product and presenting the results much easier. Be sure you have analyzed each detail carefully. Not every product may be suitable for a person’s needs. Our CE courses, regional workshops, and your professional experience will give you the ability and confidence you need to make good decisions.
Trust is earned through knowledge and professionalism.
Now, let’s talk more generally about the needs analysis process and our form. We all understand the benefits of needs analysis, the importance of completing the form, the hurdles associated with it, and general solutions.
So let’s talk specifics!
What if the client is hesitant or doesn’t want to complete a needs analysis?
Be prepared to steer them in the right direction. Use phrases that will help them understand the importance of needs analysis.
“Your personalized needs will best be met if I may ask you a few questions.”
What are some phrases that have helped you in the past?
“You mentioned ___ tell me more about ___.”
“What specific benefits are important to you when selecting a life insurance certificate?”
“What this means to you is (state unique benefit).”
Try using estimates. This will give you usable numbers which can still be helpful in defining need.
Do as much needs analysis as you can (through questions) without completing the form. The client will feel less pressured but you will still gain some knowledge to help with recommendations.
Leave a blank form for them to complete later on their own. Even if you don’t have all of the information, at least they will have a better idea of their needs when they complete the form on their own.
Although there are certain “rules of thumb” which may be used in order to estimate the insurance need, they are very simplistic and often do not consider such important factors as the family’s current net worth or the ages of the family members. Such rules of thumb can provide a wide disparity of solutions. Without looking at a family’s entire financial profile, it is difficult, if not impossible, to accurately determine the proper amount of life insurance. Proper needs analysis is always the best path.
When the needs analysis states they need more coverage than the family is willing to pay or able to afford that is OK – at least they are aware of what their needs are.
Any method used to determine a family’s insurance need will be an estimate. Circumstances will change almost on a daily basis. Therefore, it is important to review the insurance need regularly and make any necessary adjustments.
This gives you future opportunities to meet with your clients.
Matching Insurance Products with Customer Needs
Life insurance can be used to meet client needs by helping them to appropriately manage their risk. Insurance agents must learn to design an insurance portfolio that meets the client’s needs and those of his/her family and other dependents.
Life brings many changes and surprises because it is a continual process of beginnings and endings. We can offer our customers peace of mind for today and for tomorrow by knowing how to help them adjust their financial needs for the many changes and surprises that come with living life – what we call Life Events.
What is a “Life Event?” A life event occurs when life circumstances change and affect planning for the future.
The Most Common Life Events:
Getting out on your own/entering college
Getting married
Becoming parents/newborn
Establishing a career
Buying a home
Starting a business
Planning for dependents with special needs Retirement Divorce Death
Getting out on your own/entering college – Getting out on your own can be exciting and a little scary. It is the time when young adults begin taking responsibility. It is important that no matter where life takes these young people we are there to support them. It is at this point when they may begin to think about owning their own life insurance plans and we should be available to assist them.
Establishing a career – Pursuing a career can be a rewarding experience. It may be the first time to manage money without the help of their parents. Undoubtedly, they will be full of questions and uncertainties. Taxes, insurance, retirement, it may be more than they can handle alone. We have watched them grow up and now they are beginning their lives and making their own choices. When they are uncomfortable discussing financial issues with their parents, you can be there to help them make wise choices about their employer benefits and possibly a Hermann Sons Life product to supplement their portfolio.
Getting married – Getting married is a big step. When planning a wedding, other decisions and plans may be put on hold. However, as soon as possible after the wedding, you should schedule an appointment with the new couple to update names, addresses and beneficiaries. In addition, this is a perfect time to discuss their life insurance and other insurance planning. Also, discuss their need to change beneficiaries with their employer benefits and supplement with Hermann Sons Life products if necessary.
Buying a home – Because home ownership is a substantial investment and a long-term commitment, most people want to protect this asset for their family. One of the methods is protecting against premature death through life insurance. When discussing coverage always remember to review coverage for all income contributors.
Parenting – Once the first child is born, financial planning for the future becomes even more essential. Should the child have life insurance? Should the life insurance coverage on parents be increased? Knowing what to expect will allow your customers to plan for the future and to increase their chances that they will not fall short of their financial goals. Indeed, this is the time to review and update their goals.
Starting a business – Business owners have the same need for insurance as families or individuals. The principal use of life insurance by business owners is Key Person Insurance.
Retirement – The number of people who are financially unprepared for retirement is staggering. One study revealed that more than half of adults in the U.S. were planning to depend solely on Social Security for retirement income. It’s never too late to start or improve a retirement plan. Basically there are three steps to retirement planning:
1. Estimating retirement income
2. Estimating retirement needs
3. Deciding on investments
Planning for dependents with special needs – Some clients may have dependents with special needs, such as a disabled child, spouse or sibling. There may come a time when they can no longer provide the vital physical and financial support that is needed for their special person to remain safe and secure. What happens next depends largely on the quality of their planning for this time. You can help your customers by informing them of life insurance and annuities that are specific to their unique situations.
Divorce – Those who have recently changed their marital status may have important financial and legal decisions to make. These decisions might deal with changes in property ownership and providing for children’s welfare. As the family insurance agent your assistance with these matters is crucial. Divorce is sometimes the flip side of marriage and often the bridge between marriage and remarriage so some of the same assistance you offer to married couples may be appropriate at this stage as well.
Death – The death of a spouse or loved one is a difficult time. Yet, during this period, many decisions need to be made and actions must be taken in the first few months after death. You can be a strong shoulder for your customer to lean on during this time. Read up on ways to help your customers handle these details. This may be a great time to suggest an annuity for the death proceeds that are not needed for current living expenses. Some of the decisions that must be made may include: employee/retirement/survivor benefits, veteran benefits, change of ownership, change of beneficiaries, etc.
Matching Products With Needs
Gather Information
Gathering appropriate information is crucial to matching needs. The Needs Analysis form provides the questions you should have answered to make a professional recommendation. However, knowing your customer also includes building a rapport. You will find out more useful information by engaging your customers in casual conversation during the interview.
Analyze Information
Now you must analyze the information you have gathered to see what product(s) may be most suited to your client’s needs. Remember, temporary needs are typically covered with Term Life and permanent needs with Whole Life. A temporary need is generally 1-30 years but that really depends on the age of the client. For example: If a client is 50 years old then 30 years would be a permanent need. However, if your client is 20 years old then a 30 year need would be temporary.
Some clients may not be able to afford the premiums for all of the permanent insurance they may need in their portfolios. In these cases you can recommend Term with the understanding that they should convert to Whole Life as soon as they can afford it. You can even set up a strategy where they convert small portions at specific intervals to make it more convenient and affordable. Or maybe the best plan is a combination of Whole and Term Life.
Present Recommendations
There are a couple of approaches you may take.
One-option Recommendation – when you are very secure in your solution for the customer’s needs, offer only one option. Always tell the customer why this is the best option.
Two-option Recommendation – if it appears that two different plans of action could be appropriate, then present both. Be sure to explain how each will provide the RESULTS they identified earlier.
Application Specifics
Applicant’s Full Name
We know it requests middle initial only, but the Underwriting Department would like the full and complete name.
Premium, Supplemental Contract, Lodge Dues
Check your math. If paying monthly, collect one month of lodge dues; if paying yearly, collect one year of lodge dues, etc.
Life Insurance: The Impact of Ownership
Who is the Owner?
The certificate owner is the person named in the insurance contract who has control of the certificate including all rights stipulated in the contract. Usually, this is the person whose life is insured, but it can be a parent (in the case of a junior member), or a beneficiary, such as the spouse.
The certificate owner has certain important rights to the certificate, including:
• paying the premium;
• naming beneficiaries;
• determining the various options within the life insurance certificate, such as settlement options;
• changing owners of the certificate in the future;
• borrowing from a cash buildup in the certificate; and changing any other feature in the insurance certificate.
Why is ownership important?
Many parents, especially those who pay the premiums for the certificate, feel that ownership goes hand in hand. It does not! When the junior holder turns 18 he or she becomes the owner if there is no named owner. Not only does the 18-year-old member have control of all rights of the certificate, but parents cannot seek information from the Home Office because of contract privacy laws.
Ownership has greater impact when major life events, such as divorce, occur.
Medical Information
Our agents are our field underwriters. This section must be completed in its entirety. Have the client follow along as you read the questions. Don’t paraphrase the questions. Always put the name of the primary family physician even if no adverse medical details exist.
Designating a Life Insurance Beneficiary
ben’e·fi’ci·ar’y n.
A beneficiary is the person or entity named (designated) to receive the death benefits of a life insurance certificate or annuity.
Choosing a life insurance beneficiary is an important part of enacting a new certificate. While many life insurance shoppers approach designating a beneficiary as an arduous task, general certificates have few rules on who can be a beneficiary, how the beneficiary must file claims and how the claims are paid.
Hermann Sons Life beneficiary rules are covered under Title 11 in the Charter and Laws of Hermann Sons Life.
The designation of a beneficiary is required.
Who may be a beneficiary?
A life insurance beneficiary is someone who receives death benefits when the insurance certificate holder dies. When an individual privately purchases a life insurance plan, he may designate anyone, regardless of relation, as a beneficiary. Some certificateholders elect to designate two or more beneficiaries.
Even though some life insurance owners leave their insurance benefits to a non-profit organization or some small business, owners choose to designate the business as a beneficiary, allowing the business to survive even if the owner passes away, Hermann Sons Life prefers a person be named as beneficiary.
Primary and Secondary Beneficiaries
Our insurance certificates provide for certificate holders to designate not only primary beneficiaries, but also contingent or secondary beneficiaries who may receive benefits if the primary designee is deceased. Life insurance is a long term arrangement, and beneficiaries may change over time. If a certificate holder designates a spouse, for example, the beneficiary may pass away before the certificate holder, leaving the benefits to be dispersed according to Article 80. In such cases, a contingent beneficiary would receive the insurance payout if the primary beneficiary is deceased.
Hermann Sons Life does not offer an Irrevocable Beneficiary option.
An irrevocable beneficiary is one that cannot be changed. Hermann Sons Life does not offer this.
Right to Change Beneficiaries
Every certificate owner has the right to change their beneficiaries according to Hermann Sons Life Laws. Every change must be applied for using the proper application form. The effective date of the change is the date it was signed by the certificate holder provided the application is in compliance with Hermann Sons Life Laws and approved.
Certificate vs. Will
All beneficiaries and changes to such are designated according to the certificate laws and are not affected by stated beneficiaries in a will.
Payment to Beneficiaries and Co-Beneficiaries
In the event two or more beneficiaries are designated and one or more pre-decease the member that portion of the benefit will be paid to the surviving beneficiary or beneficiaries, share and share alike. But should the pre-deceased beneficiary be a child of the member then that portion will be paid to the beneficiaries’ surviving child or children, share and share alike. Adopted children share equally with natural children.
This per stirpes-like distribution method is only used when children are beneficiaries.
If all beneficiaries pre-decease the member or if all the designated beneficiaries are unauthorized by Hermann Sons Life Laws, the proceeds of the certificate will be paid in the following manner:
Surviving spouse
Children of the member, share and share alike and if one child is deceased, to their children (share and share alike)
Surviving parents, share and share alike
Surviving brothers and sisters, share and share alike
Children of the brothers and sisters, in that portion and share that the brothers and sisters would have received if alive
Estate of the Insured
Adopted children and half blood children share equally with full blood children.
Divorced Spouse as a Beneficiary
The divorced spouse of a member is not eligible as a beneficiary unless the member has redesignated such after the divorce becomes final. (ie., Jane Doe, ex-wife)
A beneficiary forfeits their interest if they bring about the death of the member.
Spouses must give written consent on provided forms before you can designate anyone else as the beneficiary of a retirement plan.
Common law spouses are not entitled to benefits unless expressly designated as a beneficiary.
Minors as Beneficiaries
If the beneficiary is a minor, then the proceeds will be paid to the legally appointed and qualified guardian of the minor’s estate after required proof. When there is no legal guardian, Hermann Sons Life may hold the proceeds in trust until the child’s 18th birthday.
We cannot accept children, under the age of 18, as beneficiaries of annuities. Payment to beneficiaries of unsound mind are similar.
Lack of Proof for Claim
If no proof of claim is made within the required time as stipulated by the State of Texas, the funds will be forwarded to the State of Texas under the applicable laws. Avoid complications. Always encourage your clients to review and update their beneficiaries periodically.
The APPLICATION is a legal document and one of the most important parts of the insurance transaction. Take sufficient time to verify that all information is accurate and complete. Print legibly to avoid misinterpretations.
New Members and Lodge Assignments
Helping the new member to choose a lodge is an important part in the total sales process. Membership and the feeling of belonging to a group is a big part of who we are. Members who are active or who have a connection to their lodge are more likely to retain membership.
Lodge placement is the choice of the member.
It is the job of the agent to educate each new member about the lodge system and help them to decide which lodge is best for them. Most often new members will end up being placed in the same lodge of the agent but this is not always the case. Most new members will not know or really care about lodge placement. Your job will be to help them decide what lodge is best for them and their family. All agents want to see their lodge grow, but what is best for the member should trump any desire for personal lodge growth.
The following are guidelines that agents should discuss as clients are deciding on a lodge:
Tell your client about the Hermann Sons Lodge system. Hermann Sons Life operates under a lodge system. When a person joins Hermann Sons Life they also join a local lodge. Lodges have business meetings, social events, and support their members and the community in many ways. Dues charged by local lodges help support the lodge in all they do.
Tell your client specific details about lodges in their area.
Helpful lodge placement criteria.
Lodge placement is the choice of the member. Often the new member wants to belong to the lodge to which other family members belong(ed). Their personal choices should always be honored.
Traditionally, it is best if members are placed in the lodge closest to them. We want members to participate in their lodge. There is a better chance this will happen if the lodge is close.
Is the member going to participate in a school of dance?
It is always good if the junior is a member of the lodge that sponsors the dance class; although, if their parents are members of another lodge the child should be placed with the parents. Juniors from any lodge can participate in any school of dance.
A member can always change their lodge membership. If a member discovers they would like to belong to a different lodge they can transfer their membership at any time.
The Post Sale Relationship
Now that your client has become a member and their policy certificate has been issued, reach out to your client to make sure they understand what they have purchased. Do they have questions about the paperwork they received, do they understand the terms of the policy?
If you wrote this client a junior policy, this is also a good time to send a follow-up email with life insurance quotes for the parents.
Never forget about your clients, keeping in touch shows them your appreciation.
Certificate Provisions
A life insurance certificate is a legal contract between the insurance company and the certificate owner. It sets forth the terms of the agreement between the two parties of the contract:
The certificate owner sends in premium payments and in return the insurance company agrees to pay at certificate maturity as a death benefit or agrees to pay a death benefit at the death of the insured.
Here are some important provisions of Hermann Sons Life certificates and contracts:
Free Look – All Hermann Sons Life certificates or contracts provide a 30-day free look period to the certificate owner. Once the certificate or contract is approved, issued and delivered to the certificate owner, they have 30 days to review their purchase. We must refund all premiums paid to the certificate owner if they decide to exercise this provision.
All Hermann Sons Life certificates and contracts have this provision including the Annuity contracts.
Incontestability – Once a certificate has been in force for two years, Hermann Sons Life can no longer contest a certificate or revoke it. However, if there is a discovery of fraud, Hermann Sons Life can contest any claims and possibly pursue criminal charges.
Grace Period – If the certificate owner fails to make the premium payments, Hermann Sons Life will not cancel the certificate immediately. The certificate holder has a 31-day grace period.
APL (Automatic Premium Loan) – If any premiums are not paid when due or within the grace period, the premium along with lodge dues will be taken from the cash value of the certificate. If this loan balance exceeds the cash surrender value of the certificate the certificate will become null and void. APL balances can be repaid in any amount or frequency that the certificate owner desires.
Reinstatement – A Hermann Sons Life certificate owner can reinstate a certificate within three years of its lapse date provided that they pay all back premiums due plus interest. Other requirements may include providing evidence of insurability and paying any certificate loan balances.
Nonforfeiture Options – These are options in a permanent insurance certificate that must be made available to the certificate owner if they stop paying the premiums. These options are:
Cash surrender value – The certificate owner can receive the full amount of the cash accumulation as cash less any premium and lodge dues, interest and loan balances due.
Reduced Paid Up Insurance – Reduced Paid Up Insurance is a non-forfeiture option that gives the owner the right to a fully paid up, reduced death benefit if the owner decides he no longer wishes to pay premiums.
In order to exercise this option, the owner must contact the home office to receive the most accurate Reduced Paid Up amount. The home office will mail or email documents that the owner must sign and return in order to process the request.
Certificate Loans – When a certificate owner takes out a certificate loan, it is important for the owner to make payments on the loan. If no payments are made and the certificate loan and interest on the loan become greater than the total cash value of the certificate, the certificate will lapse.
In order to avoid cancellation of the certificate, the owner should pay enough of the loan and the interest to reduce the total outstanding loan amount to an amount lower than the total cash value of the certificate or pay off the entire loan plus interest.
Refund Options – An insurance company can declare certificate refunds annually, but these refunds cannot be guaranteed. There are several options available to certificate owners regarding refunds.
Paid Up Additions – The certificate owner can use the refunds to buy additional, paid up insurance at the insured’s attained age.
Annuity Information
Some of the best products we have available to our members are our annuity products.
We offer the following Annuities:
Non-Qualified Annuities
5-Year Annuity
Qualified Annuities
Traditional IRA - 5 or 9 Year Annuity
Roth IRA - 5 or 9 Year Annuity
SEP IRA - 5 or 9 Year Annuity
Inherited IRA - 5 or 9 Year Annuity
What is an annuity?
An annuity is an investment designed to accumulate private retirement funds.
Under current tax laws annuities are tax-deferred. No tax is due until you actually take the money out. (The only exception is with the ROTH IRA.) Only interest gain is taxable for nonqualified annuities.
The money you invest in an annuity can grow three ways: Your premium earns interest. Your interest earns interest. The money you would have paid in taxes remains in your account to earn interest.
Interest Rates
Hermann Sons Life’s current rates are listed in the quarterly interest rate information report. Guaranteed rates are specified by contract.
Withdrawals and Surrender Fees
After one year, up to a 10% withdrawal can be made per contract year without a surrender fee. Up to three partial withdrawals of at least $100 per certificate year are allowed as long as the total amount does not exceed 10% of the accumulation value at the beginning of that year.
Surrender Fees
All annuities have a surrender charge if more than 10% of the accumulation value is taken.
Here are the charges per year for the 5-Year Annuity:
Miscellaneous Information
Under IRS Regulation 1035, non-qualified tax-deferred annuities can be exchanged without taxation.
A variety of asset types can be rolled over and combined into one fixed annuity. Additional deposits can be made into the same annuity without starting a new surrender period.
Annuities in the form of life insurance avoid probate if the beneficiary is set up properly.
Qualified Retirement Accounts
Contributions based on an individual’s income are given special income tax treatment in a traditional IRA or Roth IRA. A traditional IRA requires mandatory withdrawals when you reach age 72. A Roth IRA does not.
Annuity Certification
Effective January 1, 2022, the Texas Department of Insurance requires insurance agents who want to sell annuities must take the “Annuity Best Interest” certification courses offered by approved providers. The courses include “Best-Interest” training, which outlines the requirements that agents act in the best interest of the consumer at the time the annuity recommendation is made.
The Annuity Best Interest course is four hours. NOTE: This course does not count towards your required 24-hour CE each license term.
Continuing Education (CE) requirements for annuities have not changed. Agents are required to complete eight hours of annuity-specific CE each license term after certification.
Annuity Best Interest Disclosure Forms
Insurance agents who sell annuities must disclose important information about annuity suitability. Annuity Best Interest disclosure forms help protect and educate consumers to ensure they understand certain basis features of these annuity contracts.
The Hermann Sons Life Agent – A Definition
Who are Hermann Sons Life agents and why are they so vital to the success of our company?
This question can be answered very simply by saying: They are the face of Hermann Sons Life. They are the voice of Hermann Sons Life. Their success translates into Hermann Sons Life’s success.
Hermann Sons Life agents may vary in age, level of experience, background, sex and area of residence, but two common feelings unite them all – first, the desire, commitment and determination to ensure that Hermann Sons Life remains a vital and thriving part of the fraternal insurance industry, and second, the satisfaction that is gained from delivering products that offer protection and enrichment for the lives of their members.
It is our agents that bring Hermann Sons Life to the families of Texas. For this we are truly indebted.
Duties And Responsibilities
The agent is in most cases the first and most influential contact that our members will have with our company. With this realization comes responsibility.
The Hermann Sons Life Agent… works to increase membership and keep Hermann Sons Life strong focuses on the needs of the client and member abides by the rules of our company and the laws of the Texas Department of Insurance protects the confidentiality of their clients understands the importance of education protects and guards all property entrusted to them is always growing and striving to be better is supportive of other agents and the Home Office is always ethical and conducts all business with the highest standards
The duties of the agent are expanded upon in the Letter of Agreement and this manual. Familiarize yourself with all aspects of the job and represent Hermann Sons Life and its members with respect and pride.
Effective January 1, 2023, every agent is required to sell a minimum of 6 Life Certificates, Annuity Contracts or Medicare Contracts per year. If the quota is not met by December 31, 2023, the Agent Contract will be terminated.
LICENSED AGENCY AGREEMENT
Hermann Sons Life
THIS AGENCY AGREEMENT (“Agreement”) is entered into between Hermann Sons Life (“HSL”) and ________________________ (“Agency”).
In consideration of the mutual covenants and agreements contained herein and intending to be legally bound, HSL and Agency agree as follows:
SECTION 1 APPOINTMENT, AUTHORITY, AND RESPONSIBILITY.
1.1 HSL appoints Agency to represent it in the marketing and selling of those insurance policies and annuities (referenced herein as “Certificate(s)”) listed on HSL’s Commission Schedules as may be amended by HSL from time to time. HSL retains the right to appoint other agencies in the same geographic territory as Agency. Agency is authorized to solicit and supervise the solicitation and procurement of applications for Certificates through Agency’s personnel who are licensed, qualified, and suitable for appointment as representing HSL in connection with solicitation and sale of Certificate(s), to forward Certificate applications to HSL for approval or rejection, to collect premiums, and to engage in related sales activities as directed by HSL.
1.2 Agency is an independent contractor. Agency shall have no authority, other than expressly granted herein, and no forbearance or neglect on the part of HSL shall be construed to waive any of the terms of the Agreement or to imply the existence of any authority not expressly given. Agency is not authorized to:
(a) make, alter, amend, waive, extend, or discharge any Certificate or Certificate rates, conditions, or provisions;
(b) waive or extend the time of payment of any premium due under any Certificate;
(c) waive any reach or proposed violation, or misrepresentation on the part of any insured or proposed insured;
(d) bind or obligate HSL to any liability except as expressly provided herein;
(e) use any advertising, lead generation or sales materials without prior written consent of HSL;
(f) make any endorsement or attach any instrument by way of illustration or otherwise to the Certificates of HSL (other than those illustrations or endorsements provided by HSL);
(g) receive any moneys due, or to become due, to HSL (except for initial premiums due with Certificate applications);
(h) incur any indebtedness in the name or on behalf of HSL.
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2.1 Agency shall recruit qualified persons or entities to solicit applications for Certificates and shall manage, supervise, and train such persons or entities (hereinafter “Agency’s Personnel”). HSL’s minimum qualifications for Agency’s Personnel include the following: successful background check completed by HSL, appointment by HSL, General Lines Life and Health License (if selling HSL life insurance), Annuity Best Interest Certified (if selling HSL annuities), and successful completion of HSL product and application training. HSL retains the right to refuse to appoint Agency’s Personnel and may, without notice and in its sole discretion refuse to permit Agency’s Personnel from soliciting or selling HSL’s Certificates. HSL shall have the right to at any time modify or cease to issue any Certificate(s), or to withdraw from any territory.
2.2 Agency’s authority to represent HSL shall be contingent on Agency’s conforming to all rules and guidelines as may be stated in this Agreement, HSL agent manual, HSL compliance manuals or other materials (the “Company Rules”) HSL provides to Agency. In addition, Agency shall comply with all federal, state, or local laws, rules, and regulations (the “Law and Regulations”) where HSL is doing business. Agency shall pay all federal, state, and other government taxes and license fees levied against Agency or its personnel by the laws of any government authority wherein Agency does business. Agency shall pay all expenses which it incurs in the performance of this Agreement.
SECTION 3 PRIVACY
Agency and Agency’s Personnel shall hold in strictest confidence all nonpublic personal financial information and nonpublic personal health information related to any insured or member or to any consumer or customer (as such terms are defined under applicable state or federal privacy laws) of HSL, obtained by Agency or Agency’s Personnel in the performance of Agency duties and obligations under this Agreement. Agency and Agency’s Personnel shall not disclose or use such information except as necessary to carry out Agency’s duties and obligations under this Agreement or as otherwise required under applicable state or federal law. This provision survives termination of this Agreement.
SECTION 4 COMPENSATION
4.1 HSL shall compensate Agency in accordance with the HSL Commission Schedule as amended from time to time, for the products indicated on the HSL Commission Schedule, for premiums received and accepted by HSL on Certificate applications written by Agency and its personnel.
4.2 HSL will pay all earned commissions, bonuses, prizes, and awards directly to Agency, from which Agency will pay Agency’s Personnel pursuant to whatever compensation agreement exists between Agency and Agency’s Personnel. If Agency’s Personnel qualify for a bonus, prize, or award, it will be awarded to the Agency and it will be up to the Agency to determine the disposition of the bonus, prize, or award. HSL retains the right to advertise/recognize cumulative group production of Agency, but will not be required to
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advertise/recognize individual production of Agency’s Personnel. Agency shall indemnify and hold HSL harmless from any liability, loss, cost, or expense, including attorney’s fees, incurred by HSL resulting from or in connection with any claim or action brought by Agency’s Personnel with respect to payment or nonpayment of compensation.
4.3 HSL may, upon not less than thirty (30) days’ notice, change the compensation provided herein with respect to Certificates issued after the date of such change.
4.4 The right of Agency to receive all compensation on Policies sold pursuant to this Agreement shall be vested in Agency. HSL shall pay compensation even after termination, subject to exceptions set forth in Section 4.5.
4.5 Payment of compensation to Agency may be terminated by HSL notwithstanding Section 4.4 when: (1) the total commission payable in the preceding calendar year is less than one thousand dollars ($1,000); or (2) this Agreement has been terminated for reasons set forth in Section 7.2 (e) or (f); or (3) Agency does any act which would result in termination pursuant to Section 7.2 (e) or (f) regardless of whether this Agreement has already been terminated.
SECTION 5 INDEBTEDNESS
5.1 Any of the following transactions between HSL and Agency shall be a loan and create a debtor-creditor relationship between HSL and Agency:
(a) the refund or return of any premium collected by Agency for which HSL has paid a commission; or
(b) any advance made by HSL to Agency against future compensation for any reason; or
(c) any other loan or debt between HSL and Agency.
5.2 The indebtedness created by any of the transactions listed in Section 5.1 is due and payable on demand and shall create a first lien on any compensation due or to become due to Agency. HSL retains the right to offset such indebtedness against any payment due to Agency. Any indebtedness not paid when due shall vest HSL with the authority and power to seek all available legal and equitable remedies against Agency to obtain repayment of the indebtedness.
SECTION 6 ASSIGNMENT
This Agreement shall not be assigned or otherwise transferred by Agency without the prior written approval of HSL. Any assignee shall be bound by the terms of this Agreement.
SECTION 7 TERMINATION
7.1 This Agreement shall remain in full force and effect until terminated upon thirty (30) days prior written notice given by either party to the other. Termination of this Agreement shall not affect any duties, obligations or liabilities incurred prior to termination except as otherwise provided herein. Within thirty (30) days of termination of the Agreement, Agency shall return to
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HSL all HSL materials (including any copies) and shall indemnify HSL for any cost incurred to secure HSL’s property should Agency fail to honor HSL’s demand.
7.2 This Agreement may be terminated immediately, without notice in the event of and as of the date of the occurrence of:
(a) bankruptcy, insolvency, receivership, liquidation, or assignment for the benefit of creditors by either party; or
(b) cancellation, suspension, or revocation of Agency’s insurance license by any governmental or regulatory authority having jurisdiction; or
(c) death or dissolution of Agency; or
(d) IRS levies; or
(e) failure to secure HSL any new paid life insurance or annuity during any period of 180 days.
(f) Agency’s breach of this Agreement by:
(1) the wrongful withholding of funds belonging to an applicant or HSL for a Certificate or Certificates; or
(2) the intentional or systematic inducement of insured(s) to lapse, relinquish, or surrender a Certificate or Certificates; or
(3) the intentional or willful failure to comply with the laws, rules, or regulations of HSL, any governmental or regulatory authority having jurisdiction; or
(4) any default in the performance of any material term or condition of this Agreement.
SECTION 8 BOOKS, ACCOUNTS, AND RECORDS
All books, accounts correspondence and other records of Agency relating to business transacted pursuant to this Agreement shall, at all times, be open to inspection by HSL or its designated representative and HSL may make copies thereof before or after the termination of this Agreement.
SECTION 9 AMENDMENT
This Agreement constitutes the entire contract between the parties and may not be amended or modified without the express written approval of an officer of HSL and Agency.
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SECTION 10 INDEMNIFICATION
Agency shall indemnify and hold HSL harmless from any liability, loss, cost, or suit brought against HSL resulting from or in connection with any unauthorized acts, any error or omission, or any breach of any of the provisions of this Agreement by Agency or Agency’s Personnel.
SECTION 11 MISCELLANEOUS
11.1 Should Agency or Agency’s Personnel engage, before or after termination of this Agreement, in any act prohibited by Section 7.2 (f)(1) or (f)(2), it may result in irreparable injury to HSL for which there may be no adequate remedy at law and Agency agrees HSL may obtain injunctive relief.
11.2 If any provision of this Agreement is deemed void, illegal, or unenforceable, the validity of the remining portions shall not be affected thereby. Any waiver of the rights of HSL under this Agreement on one occasion shall not constitute a continuing waiver of any such right.
11.3 This Agreement is performable in, and all sums due from one party to the other are payable in Bexar County, Texas, and all legal proceedings in regard hereto shall be instituted in Bexar County, Texas, and all parties hereby expressly waive any privileges they may have as to venue contrary to this provision. It is further expressly agreed that all provisions of this Agreement and any controversy that may arise thereunder shall be construed according to the laws of the State of Texas.
11.4 If HSL or Agency should bring a court action alleging breach of this Agreement or seeding to enforce, rescind, renounce, declare, void, or terminate this Agreement or any provisions thereof, the prevailing party shall be entitled to recover all if its legal expenses, including reasonable attorney’s fees and costs (including legal expenses for any appeals taken and attorney’s fees incurred as a result of Bankruptcy proceedings), and to have the same awarded as part of the judgment in the proceedings in which such legal expenses and attorney’s fees were incurred.
SECTION 12 COMPLETELY INTEGRATED AGREEMENT
This Agreement along with the Schedules of Commissions, and any other supplemental Addendums, contain the entire and complete Agreement between the parties, and each of the parties hereto agree that there are no prior or contemporaneous agreements, promises, or representations that are not set forth herein.
SECTION
13
SOCAL SECURITY/TAXPAYER IDENTIFICATION NUMBER CERTIFICATION
I, _____________________________, certify that:
1. The following is my correct taxpayer identification number or social security number:
2. I am not subject to backup withholding either because I have not been notified by the IRS that I am subject to backup withholding because of a failure to report all interest or
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dividends, or the IRS has notified me that I am no longer subject to backup withholding.
(NOTE: If you have been notified by the IRS that you are subject to backup withholding, cross out this Item #2 and attach an explanation.)
This Agreement is only effective upon signing by an authorized officer of Agency and HSL.
GENERAL AUTHORIZATION AND RELEASE
I hereby authorize HSL to contact any past employer, business associate, business partner, military service, court, law enforcement agency, insurance company, financial institution or any other person or entity to obtain information about my background, employment, schooling, business activities, and experience, character, criminal record, or financial status.
I hereby authorize any of the above persons, institutions, or entities to provide the above information to HSL and waive any release any claims I may have related to the providing of such information. I also authorize them to rely on a photocopy or facsimile copy of the authorization.
I also acknowledge that HSL may participate in programs which provide background and financial information on insurance agents, including debit balances. I authorize HSL to obtain information from these programs and to also waive and release any claims I may have related to the sharing of such information by HSL or the programs in which HSL participates.
This authorization is continuing and remains in effect until revoked by me in writing delivered to an officer of HSL.
I hereby certify that any representations and warranties made in this agreement are true. I understand that if any representation or warranty given in this Agreement is found to be incorrect or incomplete, it may be grounds for HSL to decline my application for appointment or immediate termination at the sole discretion of HSL.
For Agency (if a Partnership, all partners must sign)
(Signature) (Title) (Date)
For Hermann Sons Life
(Signature) (Title) (Effective Contract Date)
For HSL Use Only Commission Schedule Number _________________ Agency Number_________
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Licensed
Hermann Sons Life
THIS AGENT AGREEMENT (“Agreement”) is entered into between Hermann Sons Life (“HSL”) and ________________________ (“Agent”).
In consideration of the mutual covenants and agreements contained herein and intending to be legally bound, HSL and Agent agree as follows:
SECTION 1-- APPOINTMENT, AUTHORITY, AND RESPONSIBILITY.
1.1 HSL appoints Agent to represent it in the marketing and selling of those insurance policies and annuities (referenced herein as “Certificate(s)”) listed on HSL’s Commission Schedules as may be amended by HSL from time to time. HSL retains the right to appoint other agencies in the same geographic territory as Agent. Agent is authorized to solicit and supervise the solicitation and procurement of applications for Certificates provided that Agent is licensed, qualified, and suitable for appointment as representing HSL in connection with solicitation and sale of Certificate(s), to forward Certificate applications to HSL for approval or rejection, to collect initial premiums, and to engage in related sales activities as directed by HSL.
1.2 Agent is an independent contractor. Agent shall have no authority, other than expressly granted herein, and no forbearance or neglect on the part of HSL shall be construed to waive any of the terms of the Agreement or to imply the existence of any authority not expressly given. Agent is not authorized to:
(a) make, alter, amend, waive, extend, or discharge any Certificate or Certificate rates, conditions, or provisions;
(b) waive or extend the time of payment of any premium due under any Certificate;
(c) waive any reach or proposed violation, or misrepresentation on the part of any insured or proposed insured;
(d) bind or obligate HSL to any liability except as expressly provided herein;
(e) use any advertising, lead generation or sales materials without prior written consent of HSL;
(f) make any endorsement or attach any instrument by way of illustration or otherwise to the Certificates of HSL (other than those illustrations or endorsements provided by HSL);
(g) receive any moneys due, or to become due, to HSL (except for initial premiums due with Certificate applications);
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(h) incur any indebtedness in the name or on behalf of HSL.
SECTION 2 LICENSING AND APPOINTMENT OF AGENTS.
2.1 HSL’s minimum qualifications for appointment as an Agent include the following: successful background check completed by HSL, appointment by HSL, General Lines Life and Health License (if selling HSL life insurance), Annuity Best Interest Certified (if selling HSL annuities), and successful completion of HSL product and application training. HSL retains the right to refuse to appoint Agent and may, without notice and in its sole discretion refuse to permit Agent from soliciting or selling HSL’s Certificates. HSL shall have the right to at any time modify or cease to issue any Certificate(s), or to withdraw from any territory.
2.2 Agent’s authority to represent HSL shall be contingent on Agent’s conforming to all rules and guidelines as may be stated in this Agreement, HSL agent manual, HSL compliance manuals or other materials (the “Company Rules”) HSL provides to Agent. In addition, Agent shall comply with all federal, state, or local laws, rules, and regulations (the “Law and Regulations”) where HSL is doing business. Agent shall pay all federal, state, and other government taxes and license fees levied against Agent or its personnel by the laws of any government authority wherein Agent does business. Agent shall pay all expenses which it incurs in the performance of this Agreement.
SECTION 3 PRIVACY
Agent shall hold in strictest confidence all nonpublic personal financial information and nonpublic personal health information related to any insured or member or to any consumer or customer (as such terms are defined under applicable state or federal privacy laws) of HSL, obtained by Agent in the performance of Agent’s duties and obligations under this Agreement. Agent shall not disclose or use such information except as necessary to carry out Agent’s duties and obligations under this Agreement or as otherwise required under applicable state or federal law. This provision survives termination of this Agreement.
SECTION 4 COMPENSATION
4.1 HSL shall compensate Agent in accordance with the HSL Commission Schedule as amended from time to time, for the products indicated on the HSL Commission Schedule, for premiums received and accepted by HSL on Certificate applications written by Agent.
4.2 HSL will pay all earned commissions, bonuses, prizes, and awards directly to Agent. HSL retains the right to advertise/recognize Agent’s individual production but will not be required to advertise/recognize Agent’s individual production. Agent shall indemnify and hold HSL harmless from any liability, loss,
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cost, or expense, including attorney’s fees, incurred by HSL resulting from or in connection with any third-party claim or action brought by anyone with respect to payment or nonpayment of compensation for services rendered under this Agreement.
4.3 HSL may, upon not less than thirty (30) days’ notice, change the compensation provided herein with respect to Certificates issued after the date of such change.
4.4 HSL shall pay compensation even after termination, subject to exceptions set forth in Section 4.5.
4.5 Payment of compensation to Agent may be terminated by HSL notwithstanding Section 4.4 when: (1) the total commission payable in the preceding calendar year is less than one thousand dollars ($1,000); or (2) this Agreement has been terminated for cause as set forth in Section 7.2; or (3) Agent does any act which would result in termination pursuant to Section 7.2, regardless of whether this Agreement has already been terminated.
SECTION 5 INDEBTEDNESS
5.1 Any of the following transactions between HSL and Agent shall be a loan and create a debtor-creditor relationship between HSL and Agent:
(a) the refund or return of any premium collected by Agent for which HSL has paid a commission; or
(b) any advance made by HSL to Agent against future compensation for any reason; or
(c) any other loan or debt between HSL and Agent.
5.2 The indebtedness created by any of the transactions listed in Section 5.1 is due and payable on demand and shall create a first lien on any compensation due or to become due to Agent. HSL retains the right to offset such indebtedness against any payment due to Agent. Any indebtedness not paid when due shall vest HSL with the authority and power to seek all available legal and equitable remedies against Agent to obtain repayment of the indebtedness.
SECTION 6 ASSIGNMENT
This Agreement shall not be assigned or otherwise transferred by Agent without the prior written approval of HSL. Any assignee shall be bound by the terms of this Agreement.
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SECTION 7 TERMINATION
7.1 This Agreement shall remain in full force and effect until terminated upon thirty (30) days prior written notice given by either party to the other. Termination of this Agreement shall not affect any duties, obligations or liabilities incurred prior to termination except as otherwise provided herein. Within thirty (30) days of termination of the Agreement, Agent shall return to HSL all HSL materials (including any copies) and shall indemnify HSL for any cost incurred to secure HSL’s property should Agent fail to honor HSL’s demand.
7.2 This Agreement may be terminated immediately for cause, without notice in the event of and as of the date of the occurrence of:
(a) bankruptcy, insolvency, receivership, liquidation, or assignment for the benefit of creditors by either party; or
(b) cancellation, suspension, or revocation of Agent’s insurance license by any governmental or regulatory authority having jurisdiction; or
(c) death of Agent; or
(d) IRS levies; or
(e) failure to secure HSL six (6) new paid life insurance policies or annuities during a calendar year; or
(f) Agent’s breach of this Agreement by:
(1) the wrongful withholding of funds belonging to an applicant or HSL for a Certificate or Certificates; or
(2) the intentional or systematic inducement of insured(s) to lapse, relinquish, or surrender a Certificate or Certificates; or
(3) the intentional or willful failure to comply with the laws, rules, or regulations of any governmental or regulatory authority having jurisdiction; or
(4) any default in the performance of any material term or condition of this Agreement.
SECTION 8 BOOKS, ACCOUNTS, AND RECORDS
All books, accounts correspondence and other records of Agent relating to business transacted pursuant to this Agreement shall, at all times, be open to inspection by HSL or its designated representative and HSL may make copies thereof before or after the termination of this Agreement.
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SECTION 9 AMENDMENT
This Agreement constitutes the entire contract between the parties and may not be amended or modified without the express written approval of CEO or Vice President of Sales of HSL and Agent
SECTION 10 INDEMNIFICATION
Agent shall indemnify and hold HSL harmless from any liability, loss, cost, or suit brought against HSL resulting from or in connection with any unauthorized acts, any error or omission, or any breach of any of the provisions of this Agreement by Agency.
SECTION 11 MISCELLANEOUS
11.1 Should Agent engage, before or after termination of this Agreement, in any act prohibited by Section 7.2 (f)(1) or (f)(2), it may result in irreparable injury to HSL for which there may be no adequate remedy at law and Agent agrees HSL may obtain injunctive relief.
11.2 If any provision of this Agreement is deemed void, illegal, or unenforceable, the validity of the remining portions shall not be affected thereby. Any waiver of the rights of HSL under this Agreement on one occasion shall not constitute a continuing waiver of any such right.
11.3 This Agreement is performable in, and all sums due from one party to the other are payable in Bexar County, Texas, and all legal proceedings in regard hereto shall be instituted in Bexar County, Texas, and all parties hereby expressly waive any privileges they may have as to venue contrary to this provision. It is further expressly agreed that all provisions of this Agreement and any controversy that may arise thereunder shall be construed according to the laws of the State of Texas.
11.4 If HSL or Agent should bring a court action alleging breach of this Agreement or seeding to enforce, rescind, renounce, declare, void, or terminate this Agreement or any provisions thereof, the prevailing party shall be entitled to recover all if its legal expenses, including reasonable attorney’s fees and costs (including legal expenses for any appeals taken and attorney’s fees incurred as a result of Bankruptcy proceedings), and to have the same awarded as part of the judgment in the proceedings in which such legal expenses and attorney’s fees were incurred.
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SECTION 12 COMPLETELY INTEGRATED AGREEMENT
This Agreement along with the Schedules of Commissions, and any other supplemental Addendums, contain the entire and complete Agreement between the parties, and each of the parties hereto agree that there are no prior or contemporaneous agreements, promises, or representations that are not set forth herein.
SECTION 13 SOCAL SECURITY/TAXPAYER IDENTIFICATION NUMBER CERTIFICATION
I, _____________________________, certify that:
1. The following is my correct taxpayer identification number or social security number: _____________________________________________.
2. I am not subject to backup withholding either because I have not been notified by the IRS that I am subject to backup withholding because of a failure to report all interest or dividends, or the IRS has notified me that I am no longer subject to backup withholding. (NOTE: If you have been notified by the IRS that you are subject to backup withholding, cross out this Item #2 and attach an explanation.)
This Agreement is only effective upon signing by Agent and either the CEO or Vice President of Sales of HSL.
GENERAL AUTHORIZATION AND RELEASE
I hereby authorize HSL to contact any past employer, business associate, business partner, military service, court, law enforcement agency, insurance company, financial institution or any other person or entity to obtain information about my background, employment, schooling, business activities, and experience, character, criminal record, or financial status.
I hereby authorize any of the above persons, institutions, or entities to provide the above information to HSL and waive any release any claims I may have related to the providing of such information. I also authorize them to rely on a photocopy or facsimile copy of the authorization.
I also acknowledge that HSL may participate in programs which provide background and financial information on insurance agents, including debit balances. I authorize HSL to obtain information from these programs and to also waive and release any claims I may have related to the sharing of such information by HSL or the programs in which HSL participates.
This authorization is continuing and remains in effect until revoked by me in writing delivered to the Vice President of Sales of HSL.
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I hereby certify that all representations and warranties made in this agreement are true. I understand that if any representation or warranty given in this Agreement is found to be incorrect or incomplete, it may be grounds for HSL to decline my application for appointment or immediate termination at the sole discretion of HSL.
For Agent (if a Partnership, all partners must sign)
(Signature) (Title) (Date)
For Hermann Sons Life
(Signature) (Title) (Effective Contract Date)
For HSL Use Only Agent Number ___________________
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Fraternal Insurance Counselor Code of Ethics
Preamble: As a fraternal life underwriter, I will maintain the utmost professional standards toward my members and at the same time maintain a position of trust and loyalty to my Society.
I believe it to be my responsibility:
To conduct my fraternal business according to high standards of honesty and fairness and to render that service to my members which, in the same circumstances, I would apply to or demand for myself. I will develop my ability and improve my knowledge through regular continuing education.
To provide competent and member-focused sales and service based on my members’ concerns, needs and input. I will present accurately and completely the facts essential to my members’ decisions and always place their best interest and welfare above any personal considerations. I will submit complete and accurate applications for membership and insurance on only those persons whom I believe to have the proper requirements that conform with my Society’s underwriting rules.
To engage in active and fair competition. I will refuse any person or persons any part of my commissions or earnings as an inducement to purchase an insurance or annuity product. I will follow applicable regulations as well as guidelines developed by my Society whenever a sale involves replacement of insurance.
To only use advertising and sales materials approved by my Society and the applicable regulatory authorities.
To respect my members’ confidences and hold in trust personal information.
To fairly and expeditiously handle member complaints or disputes.
To cooperate in a system of supervision and review that is designed to achieve compliance with this Code of Ethics and Principles of Ethical Conduct.
As a Fraternal Insurance Counselor, I pledge myself to uphold and maintain these principles and responsibilities.
Becoming A Fraternal Insurance Counselor (FIC)
All agents are strongly encouraged to enroll in the Fraternal Insurance Counselor (FIC) designation program. Enrolling in the FIC program must be initiated by the Hermann Sons Life Sales Department as Hermann Sons Life must be listed as your sponsor. Hermann Sons Life will contact the training company for you.
The FIC program requires that you complete four main courses:
FIC Basic – Part A - Introduction to Life Insurance
FIC Basic – Part B - Ethics for the Insurance Professional
FIC Intermediate – Needs Analysis
FIC Advanced – Introduction to Advanced Markets
The cost for the online textbook is $49 and includes the exam cost.
You must complete all four courses within three years of your initial enrollment date. A passing score is 70 or greater. You will receive immediate test results with the online exam.
Contact Ana Vasquez at ext. 235 for further information.
Agent Training
Hermann Sons Life sales agents receive training on a regular basis. Classroom instruction for agents is held at the time of hire and twice a year at regional workshops.
New Hire Training
Newly hired agents receive training and orientation. Training consists of reviewing sales techniques, introducing sales agents to forms needed in order to complete a sale, a history of our company and its culture, company mission and company benefits. Orientation consists of company policies and procedures.
Regional Workshops
Designed to educate agents on pertinent sales topics, sales policies and procedures, and requested training topics. Agents are encouraged to share their sales experiences related to the topic of discussion. Workshops are a great training resource for all agents and sessions are typically held two times a year. All agents are required to attend local workshop training sessions, unless excused.
Continuing Education Seminars
Continuing education hours will be offered by Zoom. Please keep track of your personal hours in case you need to get your hours online. Stay tuned and as class dates and times are set, agents will be notified.
Quick References
Home Office Staff
Name
Robin Czarnek 272 President and Chief Executive Officer robinc@hermannsonslife.org
* Modified Endowment contract. Cash withdrawal or loan may cause tax consequences.
Insurance * Before 6/1/23 10 Year Renewable, CT-10,
Effective 6-1/23 10 Year Renewable, CT-10, 20 YR LEVEL CLT 20
* Annual $60 certificate fee will not apply towards commissions.
Annuity Plans
Issued between Oct. 1, 1996 - Dec. 31, 2001 3% of initial deposit only
Issued after Dec. 31, 2001: 5 year 3% of all 1st yr. deposits only
Issued EFF. June 1, 2023 3% of all deposits year 1
Please refer to the Agent Contract Agreement or the Glossary of Terms for commission specifics including Rollovers, Conversions, Chargebacks, Premium Deduction Options, and other commission information.
Cash Bonuses and Awards
In addition to insurance and annuity sales commissions, Hermann Sons Life sales agents are eligible for the following Cash Bonuses and Awards:
Quarterly Sales Bonus
Special Campaigns
Agent’s Award Banquet Bonus and Awards
NAFIC Awards
Other Production Awards and Bonuses
Please review the following pages for details of each program
All Agents Quarterly Bonus
All agents are eligible for the bonuses listed above (annuity applications do not count towards the application bonus) if they meet either the Applications minimum OR the Premium Income minimums.
Agents are not competing against each other or in regions. They will only be striving to achieve the above required amounts to attain a bonus.
Special Campaigns
Throughout the year, the Vice President of Sales will announce campaigns that focus on sales of a specific product or a specific sales goal.
Cash bonuses and/or awards are announced at the beginning of each campaign.
Agents are encouraged to participate throughout the year in these campaigns. Participation helps to supplement their commission income, and shows interest in helping the Hermann Sons Life message reach as many new and current members as possible.
Grand President’s Club
Level 1
Cruise for 2 out of Galveston / Interior Room / 5 Day
30 Applications / can be a combination of life insurance and/or annuities
$80,000 Premium Income
Level 2
Cruise for 2 out of Galveston / Balcony Room / 5 Day
40 Applications / can be a combination of life insurance and/or annuities
$90,000 Premium Income
Level 3
Cruise for 2 out of Galveston / Balcony Room / 5 Day / Parking / $600 credit toward drink package or spa treatments
50 Applications / can be a combination of life insurance and/or annuities
$100,000 Premium Income
Agent’s Award and Bonuses
Category Qualifications Award Cash Bonus
Grand Presidents Club *
Level 1
$80,000 Premium Income
30 Applications minimum (can be a combination of life insurance and/or annuities)
70% Persistency
Level 2
$90,000 Premium Income
40 Applications minimum (can be a combination of life insurance and/or annuities)
70% Persistency
Level 3
$100,000 Premium Income
50 Applications minimum (can be a combination of life insurance and/or annuities)
70% Persistency
President’s Club*
Past PC Winners
Additional bonus for additional Premium Income
$30,000 1st Year PI – Entry Level 12 applications minimum 70% Persistency
$30,000 PI
$60,000 PI – Bronze Level
$90,000 PI – Silver Level
$120,000 PI – Gold Level
$150,000 PI – Platinum Level
$180,000 PI – Emerald Level
Executive Club*
Past EC Winners
Million Dollar Club *
Past MDC Winners
Cruise for 2 out of Galveston, Interior Room, 5 Day
Cruise for 2 out of Galveston, Balcony Room, 5 Day
Cruise for 2 out of Galveston, Balcony Room, 5 Day / Parking, $600 credit toward drink package or spa treatments
$200,000 PI – Diamond Level Jacket or Tote Bag
$12,000 1st Year PI 12 applications minimum 70% Persistency
All clubs awards are based on new business issued for one (1) contest year from January 1 through December 31 (the first and last business day of the year will determine the actual contest year).
*Annuity and matured annuity applications do not count towards these awards.
AGENT CLUB GIFTS
First-time President’s Club qualifiers may choose one of 2 gifts
Jacket Tote Bag with initials embossed on tag
NAFIC Awards
All Hermann Sons Life agents who have earned the FIC designation are eligible for National Association of Fraternal Insurance Counselor (NAFIC) awards. The qualifications for each award are listed below. Award period is January 1 through December 31.
FIC Service Award
Qualifications
• $2,000,000 in Sales Production
• 30 applications minimum
• 90% persistency
Award
• Certificate of recognition from NAFIC
• FIC dues paid for 1 year
• Plaque for 10, 20, 25 or 30 years of award eligibility
FIC Production Award
Qualifications
• Bronze -$30,000 First Year Commissions and 30 Applications
• Silver - $40,000 First Year Commissions and 30 Applications
• Gold - $50,000 First Year Commissions and 30 Applications
• Platinum - $65,000 First Year Commissions and 30 Applications
Award
• Certificate of recognition from NAFIC for each category
NAFIC President’s Award
Qualifications
Award
• $90,000 First Year Commissions and 30 Applications
• NAFIC Plaque
NAFIC Chairman’s Council
Members earn a seat on the Chairman’s Council for achieving $125,000 or more in earned first-year commissions.
Rising Star Award
Awarded to those agents who in their first four years of having their FIC designation meet the following:
i. 50 new life applications OR ii. 75 total new applications OR iii. 25 new insurance members
Other Production Awards and Bonuses
E & O Premium Payment (Annual)
A $20 bonus will be credited to an agent’s E&O premium for each approved and issued application (up to 12 applications). This credit will be given to each agent between January 1 and December 31 of the current year. Matured annuity applications will not be credited toward your E&O.
Note: This is a credit towards your E & O insurance payment of $240 and is not reflected as a cash award.
All agents are required to sell at least 12 Life Certificates or Annuity contracts in order to cover the cost of the E & O policy provided by Hermann Sons Life. Matured Annuity sales do not count towards the 12 required sales. If an agent has purchased their own E&O coverage, the policy must list Hermann Sons Life as the Certificate Holder on the Accord Form.
Most New Adult Members (Annual)
A cash bonus of $200 is awarded to the agent with the most submitted and approved new adult member applications. Award period is January 1 through December 31. Minimum of five approved adult certificates or contracts required.
Most 100% Families Bonus (Annual)
A cash bonus of $300 is awarded to the agent with the most submitted and approved 100% Family life certificates or annuity contracts (a minimum of six is required). A family can only be awarded a 100% Family Pin once. A 100% Family consists of the primary social group – parents and children. A single individual is not eligible. Award period is January 1 through December 31. Minimum of five 100% families submitted.
100% Family Bonus (Monthly)
A bonus of $25 will be paid to an agent who sells a policy to all members of a household, thereby the family becoming a 100% Hermann Sons Family. An agent can only receive this bonus one time per household. If the family grows with more members, there is no more opportunity for an agent to receive this bonus again. The 100% Family Bonus Request Form should be submitted to the Sales Department for payment of the bonus.
Last Agent Standing (Annual)
A cash bonus of $300 is awarded to agents who have at least one application submitted for each month. Award period is January 1 through December 31.
Adult Coverage (Monthly)
A $50 bonus will be paid if an adult application is written and approved within six months of writing a junior application in the same household. The adult application can be a Whole Life, a Term Life or an Annuity of at least $10,000 face value. The six months is calculated by the Junior Issue Date and the Adult Application Date.
Multi Product Bonus Program (Monthly)
A $100 bonus will be paid if multiple products are written at the same time for the same adult. Minimums that apply include:
$100,000 Term
$25,000 Whole Life
$10,000 Single Premium
$10,000 Annuity
Multiple products means two or more products written at the same time. Conversions do not apply. Roll overs do not apply.
The Illustration Program
The illustration program is located online in the Agent Only section of the Hermann Sons Life website.
If you have installation problems, please contact the Sales Department. If we cannot help with your installation problems, we will refer your call to the Information Technology Department.
Agents are reminded that they may access the illustration software via the Internet from any mobile device. This capability empowers the agent to provide insurance plan quotes whenever they have mobile connectivity. Quotes can be sent to the client from the mobile device via email.
Website: viscalc.com/app/invite/5s22xj
Sign in and create your own username and password.
Setting up the Illustration System on Your Phone
Agents can get premium quotes on the web form here: https://viscalc.com/app/invite/ghf44f
After they have create an account with the link above, they can then sign in at https://viscalc.com/app
Glossary of Insurance Terms
Accelerated Death Benefits - This feature allows you, under certain circumstances, to receive the proceeds of your life insurance certificate before you die. Such circumstances include terminal or catastrophic illness, the need for long-term care, or confinement to a nursing home.
Accidental Death Benefit - In a life insurance certificate, a benefit in addition to the death benefit paid to the beneficiary, should death occur due to an accident. There can be certain exclusions as well as time and age limits.
Actuary - A specialist in the mathematics of insurance who calculates rates, reserves, dividends and other statistics.
Adjustable Rate - An interest rate that changes based on changes in a published market-rate index.
Admitted Assets - Assets permitted by state law to be included in an insurance company’s annual statement. These assets are an important factor when regulators measure insurance company solvency. They include mortgages, stocks, bonds and real estate.
Agent - An individual who sells and services insurance certificates.
Annuitization - Process by which you convert part or all of the money in a qualified retirement plan or nonqualified annuity contract into a stream of regular income payments, either for your lifetime or the lifetimes of you and your joint annuitant. Once you choose to annuitize, the payment schedule and the amount is generally fixed and cannot be altered.
Annuitization Options - Choices in the way to annuitize. For example, life with a 10-year period certain means payouts will last a lifetime, but should the annuitant die during the first 10 years, the payments will continue to beneficiaries through the 10th year. Selection of such an option reduces the amount of the periodic payment.
Annuity - An agreement by an insurer to make periodic payments that continue during the survival of the annuitant(s) or for a specified period from a capital investment and the gain from that investment.
Assets - Assets refer to “all the available properties of every kind or possession of an insurance company that might be used to pay its debts.” There are three classifications of assets: invested assets, all other assets, and total admitted assets. Invested assets refer to things such as bonds, stocks, cash and income-producing real estate. All other assets refer to non-income producing possessions such as the building the company occupies, office furniture, and debts owed, usually in the form of deferred and unpaid premiums. Total admitted assets refer to everything a company owns. All other plus invested assets equal total admitted assets. By law, some states don’t permit insurance companies to claim certain goods and possessions, such as deferred and unpaid premiums, in the all other assets category, declaring them “non-admissible.”
Attained Age - The insured’s age at a particular time. For example, many term life insurance certificates allow an insured to convert to permanent insurance without a physical examination at the insured’s then attained age. Upon conversion, the premium usually rises substantially to reflect the insured’s age and diminished life expectancy.
Captive Agent - Representative of a single insurer or fleet of insurers who is obliged to submit business only to that company, or at the very minimum, give that company first refusal rights on a sale. In exchange, that insurer usually provides its captive agents with an allowance for office expenses as well as an extensive list of employee benefits such as pensions, life insurance, health insurance, and credit unions.
Chargeback – A reversal of commissions originally paid to an agent. Commissions from certificates that are returned within the 30-day Free Look Period will be charged at a rate of 100%. Chargeback commissions and/or amounts may be changed without notice. Agents will be notified as soon as possible of changes to this policy.
Churning – An illegal and unethical practice whereby an insurance agent unnecessarily replaces existing life insurance for the purpose of earning additional commissions.
Claim - A demand made by the insured, or the insured’s beneficiary, for payment of the benefits as provided by the certificate.
Commission - Fee paid to an agent or insurance salesperson as a percentage of the certificate premium. The percentage varies widely depending on coverage, the insurer and the marketing methods.
Coverage - The scope of protection provided under an insurance certificate.
Convertible - Term Life insurance coverage that can be converted into permanent insurance regardless of an insured’s physical condition and without a medical examination. The individual cannot be denied coverage or charged an additional premium for any health problems.
Death Benefit - The limit of insurance or the amount of benefit that will be paid in the event of the death of a covered person.
Dividend - The return of part of the certificate’s premium for a certificate issued on a participating basis by either a mutual or stock insurer. A portion of the surplus paid .
Exclusions - Items or conditions that are not covered by the general insurance contract.
General Account - All premiums are paid into an insurer’s general account. Thus, buyers are subject to credit-risk exposure to the insurance company, which is low but not zero.
Grace Period - The length of time (usually 31 days) after a premium is due and unpaid during which the certificate, including all riders, remains in force. If a premium is paid during the grace period, the premium is considered to have been paid on time.
Guaranty Association - An organization of life insurance companies within a state responsible for covering the financial obligations of a member company that becomes insolvent.
Hazardous Activity - Bungee jumping, scuba diving, horse riding and other activities not generally covered by standard insurance certificates.
Indemnity - Restoration to the victim of a loss by payment, repair or replacement.
Insurable Interest - Interest in property such that loss or destruction of the property could cause a financial loss.
Insurability Protection Rider - Life insurance rider that guarantees the insured the right to buy additional coverage without proving insurability.
Investment Income - The return received by insurers from their investment portfolios including interest, dividends and realized capital gains on stocks. It doesn’t include the value of any stocks or bonds that the company currently owns.
National Association of Insurance Commissioners (NAIC) - Association of state insurance commissioners whose purpose is to promote uniformity of insurance regulation, monitor insurance solvency and develop model laws for passage by state legislatures.
Paid-Up Additional Insurance - An option that allows the certificate holder to use certificate dividends and/or additional premiums to buy additional insurance on the same plan as the basic certificate and at a face amount determined by the insured’s attained age.
Policy - The written contract effecting insurance or the certificate thereof, by whatever name called, and including all clauses, riders, endorsements, and papers attached thereto and made a part thereof.
Policy or Sales Illustration - Material used by an agent and insurer to show how a certificate may perform under a variety of conditions and over a number of years.
Premium - The price of insurance protection for a specified risk for a specified period of time.
Qualified Versus Non-Qualified Policies - Qualified plans are those employee benefit plans that meet Internal Revenue Service requirements as stated in IRS Code Section 401a. When a plan is approved, contributions made by the employer are tax deductible expenses.
Rebating - The practice of returning the agent’s commission, or a portion of it, to the insured with the desire of assuring an insurance sale for the insurer.
Reduced Paid Up Insurance - Reduced Paid Up Insurance is a non-forfeiture option that gives the owner the right to a fully paid up, reduced death benefit if the owner decides he no longer wishes to pay premiums.
In order to exercise this option, the owner must contact the home office to receive the most accurate Reduced Paid Up amount. The home office will mail or email documents that the owner must sign and return in order to process the request.
Reinsurance - Insurance that an insurance company buys for its own protection. The risk of loss is spread so a disproportionately large loss under a single certificate doesn’t fall on one company. Reinsurance enables an insurance company to expand its capacity; stabilize its underwriting results; finance its expanding volume; secure catastrophe protection against shock losses; withdraw from a line of business or a geographical area within a specified time period.
Renewal - The automatic re-establishment of in-force status affected by the payment of another premium.
Reserve - An amount representing actual or potential liabilities kept by an insurer to cover debts to certificate holders. A reserve is usually treated as a liability.
Section 1035 Exchange - This refers to a part of the Internal Revenue Code that allows owners to replace a life insurance or annuity certificate without creating a taxable event.
Section 7702 - Part of the Internal Revenue Code that defines the conditions a life certificate must satisfy to qualify as a life insurance contract, which has tax advantages.
Solvency - Having sufficient assets – capital, surplus, and reserves – and being able to satisfy financial requirements – investments, annual reports, examinations – to be eligible to transact insurance business and meet liabilities.
State of Domicile - The state in which a company is incorporated or chartered. The company also is licensed under the state’s insurance statutes for those lines of business for which it qualifies.
Surrender Charge - Fee charged to a certificate holder when a life insurance certificate or annuity is surrendered for its cash value. This fee reflects expenses the insurance company incurs by placing the certificate on its books, and subsequent administrative expenses.
Surrender Period - A set amount of time during which you have to keep the majority of your money in an annuity contract. Most surrender periods last from 5 to 10 years. Most contracts will allow you to take out at least 10% a year of the accumulated value of the account, even during the surrender period. If you take out more than that 10%, you will have to pay a surrender charge on the amount that you have withdrawn above that 10%.
Term Life Insurance - Life insurance that provides protection for a specified period of time. Common certificate periods are one year, five years, 10 years or until the insured reaches age 65 or 70. The certificate doesn’t build up any of the non-forfeiture values associated with Whole Life certificates.
Tobacco Use - Is defined as any use of cigarettes, cigars, pipes, chewing tobacco or snuff, ecigarettes, vaping, nicotine gum or patches, water pipes and dissolvable tobacco.
Total Admitted Assets - This item is the sum of all admitted assets, and are valued in accordance with state laws and regulations, as reported by the company in its financial statements filed with state insurance regulatory authorities. This item is reported net as to encumbrances on real estate (the amount of any encumbrances on real estate is deducted from the value of the real estate) and net as to amounts recoverable from reinsurers (which are deducted from the corresponding liabilities for unpaid losses and unearned premiums).
Twisting - The act of inducing or attempting to induce a certificate owner to drop an existing life insurance certificate and to take another certificate that is substantially the same kind by using misrepresentations or incomplete comparisons of the advantages and disadvantages of the two certificate.
Underwriter - The individual trained in evaluating risks and determining rates and coverage for them.
Underwriting - The process of selecting risks for insurance and classifying them according to their degrees of insurability so that the appropriate rates may be assigned. The process also includes rejection of those risks that do not qualify.
Universal Life Insurance - A combination flexible premium, adjustable life insurance certificate.
Valuation - A calculation of the certificate reserve in life insurance.
Waiver of Premium - A provision in some insurance contracts which enables an insurance company to waive the collection of premiums while keeping the certificate in force if the certificate holder becomes unable to work because of an accident or injury. The Waiver of Premium for disability remains in effect as long as the insured is disabled.
Whole Life Insurance - Life insurance which might be kept in force for a person’s whole life and which pays a benefit upon the person’s death, whenever that might be.
HERMANN SONS LIFE FORMS & BROCHURES
AGENT ANNUITY FORMS
MEMBER SERVICES FORMS
DATE OF SIGNED/COMPLETED APPLICATION (must match date on Signature Page 6)
Application for Life Insurance & Membership
PROPOSED INSURED INFORMATION
AGE SEX BIRTHPLACE (City and State)
Is proposed insured a citizen of the United States? Yes No If no, does proposed insured plan to become a citizen? Yes No
OCCUPATION/JOB DESCRIPTION
OWNERSHIP INFORMATION Check if same as Proposed Insured.
OWNER’S
Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.
Page 1 of 7 Pages including Conditional Receipt
Certificate Illustration Routing Cover
TO BE RETURNED WITH APPLICATION/ILLUSTRATION
Applicant Please check one only
THE ILLUSTRATION
❏ Is correct as printed.
❏ Has been corrected.
NOTE: All corrections must be initialed by the Owner and the Agent.
❏ No illustration was provided due to application being written on emergency basis.
❏ Is revised due to a substandard rating by the Underwriter.
NOTE: Agent must have Owner sign two copies of the revised illustration.
One copy is returned to the Home Office and one copy is given to the Owner/Applicant.
THE OWNER/APPLICANT
SAMPLE
Please check one only
❏ Was given a copy of the illustration.
❏ Was NOT given a copy of the illustration.
❏ Requires a revised copy of the illustration.
Applicant/Owner Signature Agent Signature
An illustration conforming to the application will be provided to the Owner/Applicant no later than the time of the certificate delivery.
ROUTING COVER (Rev. 11/16)
Personal and Confidential
Needs Analysis Life Insurance
Obligations
Final Expense
Funeral, hospital, doctor bills, legal fees, and taxes due at time of death
Mortgage Cancellation
If I were to die today, amount needed to pay off mortgage
Debt Cancellation
If I were to die today, amount needed to pay off current debt (vehicle, credit cards, personal loans etc.)
College Expense
In the event of untimely death – amount to set aside to assist a child with college
Income Fund
Amount needed annually to continue current lifestyle
Insurance (HSL, etc.)
Accounts (401(k), IRAs, Annuities, etc.)
Date
Name Address
Bank Draft Authorization Request Form
Certificate No.
City State Zip
Email
Phone No.
Social Security No.
Please list all certificates you are requesting bank draft for: Certificate No. Issued To
I hereby give the above mentioned bank or credit union authorization to honor electronic drafts drawn from my account by Hermann Sons Life for insurance or annuity payments on the above listed accounts. I understand that if my bank rejects a draft request for any reason, it is still my responsibility to pay the defaulted amount immediately and I will contact Hermann Sons Life for payment options. I further understand that Hermann Sons Life is not responsible for bank overdraft charges or other related draft fees.
Signature of Account Holder
Mail completed form to: Hermann Sons Life, P.O. Box 1941, San Antonio, TX 78297-1941. Home Office Phone: 800-234-4124 or 210-226-9261 • Website: hermannsonslife.org
Health Insurance Portability and Accountability Act
Name of proposed insured/patient (please print)
Date of Birth
I authorize any physician, health care professional, hospital, clinic, laboratory, pharmacy, medical facility, pharmacy benefit manager or other health care provider that has provided services to me or on my behalf within the past 10 years (“My Providers”) to disclose my entire medical record and any other protected health information concerning me with Hermann Sons Life, a life insurance company. This includes information on the diagnosis or treatment of Human Immunodeficiency Virus (HIV) infection and sexually transmitted diseases. This also includes information on the diagnosis and treatment of mental illness and the use of alcohol, drugs and tobacco.
By my signature below, I acknowledge that any agreements I have made to restrict my protected health information do not apply to this authorization and I instruct any physician, health care professional, hospital, clinic, medical facility or other health care provider to release and disclose my entire medical record without restriction.
This protected health information is to be disclosed under this Authorization so that Hermann Sons Life may: 1) underwrite my application for coverage, make eligibility, risk rating and policy issuance determinations; 2) obtain reinsurance; 3) administer claims and determine or fulfill responsibility for coverage and provisions of benefits; 4) administer coverage; and 5) conduct other legally permissible activities that relate to any coverage I have or have applied for with Hermann Sons Life.
A copy of this authorization is as valid as the original. I understand that I have the right to revoke this authorization in writing, at any time, by sending a written request for revocation to Hermann Sons Life at 515 South St. Mary’s Street, San Antonio, TX 78205-3430. I understand that my information that is disclosed pursuant to this authorization may be re-disclosed and is no longer covered by federal rules governing privacy and confidentiality of health information.
This authorization, and all authority to disclose information pertaining to me, shall expire 90 days from the date of the signature below, unless earlier revoked by me in writing.
SAMPLE
I understand that if I refuse to sign this authorization to release my complete medical record Hermann Sons Life may not be able to process my application. I acknowledge that I have received a copy of this authorization.
I understand and agree that Hermann Sons Life may disclose all or some of the information that it collects about me to MIB, company reinsurers, and contractors and others who may perform business services for Hermann Sons Life relating to my application or insurance coverage (generally known as “service providers” or “business associates”).
Signature of Proposed Insured/Patient or Personal Representative Date
Description of Personal Representative’s Authority or Relationship to Proposed Insured/Patient
Witness/Agent
Date
Replacement of Life Insurance or Annuities
This document must be signed by the applicant and the producer, if there is one, and a copy left with the applicant.
You are contemplating the purchase of a life insurance certificate or annuity contract. In some cases this purchase may involve discontinuing or changing an existing policy or contract. If so, a replacement is occurring. Financed purchases are also considered replacements.
A replacement occurs when a new certificate or contract is purchased and, in connection with the sale, you discontinue making premium payments on the existing policy or contract, or an existing policy or contract is surrendered, forfeited, assigned to the replacing insurer, or otherwise terminated or used in a financed purchase.
A financed purchase occurs when the purchase of a new life insurance certificate involves the use of funds obtained by the withdrawal or surrender of or by borrowing some or all of the policy values, including accumulated dividends, of an existing policy to pay all or part of any premium or payment due on the new certificate. A financed purchase is a replacement.
You should carefully consider whether a replacement is in your best interest. You will pay acquisition costs and there may be surrender costs deducted from your policy or contract. You may be able to make changes to your existing policy or contract to meet your insurance needs at less cost. A financed purchase will reduce the value of your existing policy and may reduce the amount paid upon the death of the insured.
We want you to understand the effects of replacements before you make your purchase decision and ask that you answer the following questions and consider the questions on the back of this form.
1. Are you considering discontinuing making premium payments, surrendering, forfeiting, assigning to the insurer, or otherwise terminating your existing policy or contract? __________ YES __________ NO
2. Are you considering using funds from your existing policies or contracts to pay premiums due on the new certificate or contract? __________ YES __________ NO
If you answered “yes” to either of the above questions, list each existing policy or contract you are contemplating replacing (include the name of the insurer, the insured or annuitant, and the policy or contract number if available) and whether each policy or contract will be replaced or used as a source of financing: INSURER CONTRACT OR INSURED OR REPLACED (R) OR NAME POLICY# ANNUITANT FINANCING (F)
SAMPLE
Make sure you know the facts. Contact your existing company or its agent for information about the old policy or contract. If you request one, an in-force illustration, policy summary or available disclosure documents must be sent to you by the existing insurer. Ask for and retain all sales material used by the agent in the sales presentation. Be sure that you are making an informed decision. The existing policy or contract is being replaced because:
I certify that the responses herein are, to the best of my knowledge, accurate:
Applicant’s Signature and Printed Name Date
Producer’s Signature and Printed Name Date
I do not want this notice read aloud to me. __________ (Applicants must initial only if they do not want the notice read aloud.)
HSL 11.01.16
Replacement of Life Insurance or Annuities
OFFICE COPY
Page 1 of 2
This document is not considered complete without both pages.
Life Insurance Buyer’s Guide
This Buyer’s Guide is intended to help guide you when shopping for life insurance. It explains the importance of the following:
● Examining your needs (Why are you purchasing life insurance?)
● Making sure you understand life insurance and the different plans available
● Determining which plan(s) meet your needs
● Other important information
EXAMINE YOUR NEEDS
When you buy life insurance, you want coverage that fits your needs. Review your own insurance needs and circumstances. Choose the kind of policy(s) and benefits that most closely fit your needs. A comprehensive Needs Analysis is a dependable way to calculate the financial needs of surviving family members. Individuals and families using this form privately, or with the aid of a Hermann Sons Life agent, can closely determine current needs and anticipated future needs. Examining needs will help ascertain the amount of death benefit and the type(s) of life insurance plans to purchase.
UNDERSTANDING LIFE INSURANCE
All life insurance plans are not the same. Certain plans give coverage for your lifetime and others cover you for a specific number of years. Some build cash value and others do not. Various plans may offer other benefits while you are still living. Your choice should be based on your needs and what you can afford. There are two basic types of life insurance: term life and whole life. Term insurance usually has lower premiums in the early years, but does not build up cash value like whole life insurance.
SAMPLE
Term Life plans provide coverage for a stated period of time. At the end of that term the contract ends or, depending on the certificate, may be renewed with premium rates based on the attained age. In a level term plan the coverage ends at a stated time and is not renewable. Generally in a level term plan, the premium payment and death benefit also are level. A renewable term plan may be renewed, without proof of medical insurability, at designated times until a specific age. Premiums at renewal will be based on attained age and therefore will be higher. Premium costs, after age 45, rise rapidly and may become unaffordable in senior years. Term Life does not have cash value or provisions for automatic premium loans. Premiums unpaid 30 days after the payment due date will lapse the contract.
Many term plans have the option to convert to a Whole Life plan without evidence of medical insurability but with certain face value limits. In some Term Life plans a conversion credit is available to offset the initial premiums on the Whole Life plan.
Whole Life plans are designed to provide coverage for the lifetime of the insured. Whole Life payments are typically level, but are initially more expensive than a Term Life plan for the younger and middleaged insured. A limited pay Whole Life plan may provide for payments to end after a specific number of years and the plan is then paid in full. Hermann Sons Life also offers an Annual Premium Flex Life plan which is a Whole Life certificate with an interest sensitive accumulation account. It has a level guaranteed death benefit with adjustable cash values.
This is Page 1 of the Online Version. Also available in booklet form.
Now that the agent has collected your personal and medical information, here is what happens next:
1. The agent will review all medical and personal information collected on the application to verify accuracy and completeness. If all information is complete, the agent will deliver the application to the Underwriting Department for processing. If the agent discovers any information missing or incomplete, the agent may contact you to clarify.
2. Once your application is delivered to the Underwriting Department, it is input into our computer system to begin the formal review by the Underwriter. Based on your medical history, your personal avocations and the amount of insurance you are requesting, the Underwriter will decide whether or not a paramedical exam is required, if medical records will be requested or if a follow-up interview* is necessary.
If a paramedical exam is not necessary, the Underwriter will determine whether or not your application for insurance can be approved at this time. Once you are approved, the Underwriter will issue your insurance contract and it is delivered to your local agent. Your local agent will then contact you to set an appointment to deliver your contract to you.
SAMPLE
If a paramedical exam is necessary, the Underwriter will order the exam from a third party at no cost to you! Paramedical exams are performed by licensed paramedical examiners in your area. The exams typically include questions about your medical history, your height and weight, blood pressure is taken and a urine specimen and blood sample may be collected. The paramedical exam typically takes at most 30 minutes to complete.
3. Once the Underwriter receives the results of the paramedical exam, the Underwriter will determine if further records or information are necessary and whether or not your application for insurance can be approved.
If you are rated or declined, you are encouraged to contact the Underwriter to discuss the reasons for this decision.
* Typically necessary when higher amounts of coverage are applied for.
This is the second page of the four-page pamphlet
MEMBER
FATHER/HUSBAND
MOTHER/WIFE
CHILDREN
100% Hermann Sons Life Family
PLEASE LIST ALL DEPENDENTS. PLEASE RETURN FORM WITH APPLICATION.
CHECK IF LODGE NAME NEW MEMBER
OTHER FAMILY MEMBERS
SAMPLE
HOUSEHOLD ADDRESS Street City Zip
SUBMITTED WITH APPLICATION BY AGENT
100% (Revised 11/16)
Adult Member Name
Adult Certificate No.
Junior Member Name
Associated Junior Certificate No.
Junior Member Issue Date
Adult Coverage Bonus Form
Agent's Name Agent's No.
AGENT: Please return this form to the Marketing Department.
NOTE: Application must be approved and issued to receive bonus.
SAMPLE
For Home Office Use Only:
Application Approval Date:
Alcohol Usage Questionnaire
TO
COMPLETED BY APPLICANT
Name Date of Birth
1. Do you presently use alcoholic beverages? Yes No If "yes," please record quantity in each category below (glasses, ounces or bottles on a daily, weekly or monthly basis).
2. Did you ever drink substantially more than as outlined above? Yes No If "yes," please complete:
3. Have you ever consulted a doctor or received treatment because of your alcohol use? Yes No If "yes," indicate dates, names and addresses of any doctors, hospitals or treatment centers:
4. Have you ever been charged with impaired driving, lost your job or been arrested due to the influence of alcohol? Yes No If "yes," give details:
5. Has any member of your immediate family been treated for or died due to excessive alcohol? Yes No If "yes," give details:
I declare that the above information is true and complete and shall form part of the application on my life.
Signature of the Proposed Insured Date
Application for Accidental Death Benefit Rider
Application for a $ ___________________________________ Accidental Death Benefit
Hermann Sons Life Accidental Death Benefits are limited to 100% of the certificate face value(s) to a cumulative maximum of $250,000 on any individual life.
In connection with Certificate Number ______________ issued to in the amount of $ as a basis for such application, I make the following representations and I further agree that this request shall not be binding until accepted and approved by the Home Office. I represent that my present occupation is and has been since day of ___________________ 20 , that of and that my duties are , and it is not my intention to change my occupation to one more hazardous.
I have not engaged in the following during the past three years: skin diving or scuba diving; parachuting; sky diving; hang gliding or ballooning; underground exploration; horse, auto (stock, drag, etc.) or motorcycle racing; mountain climbing or rodeo performing; or any other hazardous sports.
If you have engaged in any hazardous sports, give details:
I further represent that I am now in good health and free from any abnormalities or medical disorders. (If there are any exceptions to this, give details.)
Abnormality/Disorder Date
SAMPLE
Physician Consulted Result
I also agree that upon approval of this application, the Accidental Death Benefit Rider shall become effective upon payment of the required premium as of the day of 20 in accordance with the laws of Hermann Sons Life.
Dated at , this day of , 20
Applicant Name
Agent Name Agent No.
Home Office approval Date
Application for Reinstatement
Application for Reinstatement
To the best of your knowledge and belief:
1. Within the past three years (or the period since the date of the policy, whichever is shorter) have you:
A. Been declined, postponed, rated or charged an extra premium or offered a policy different from that applied for, or have been refused reinstatement or renewal of life insurance?
B. Been in a hospital, clinic or institution for examination, observation, diagnosis, operation or treatment?
C. In addition to any doctors or hospitals listed for Question 1B have you:
(1) consulted or been treated or examined by any other doctors or other practitioners?
(2) been treated for any other cause(s) not named under Question 1B?
2. Do you now have or are you receiving treatment for any abnormality, deformity, disease or disorder?
3. Have you applied for or are you now receiving disability benefits from any source?
4. Within the past 10 years have you:
A. had or been told you had Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC) or AIDS related conditions?
B. received advice or treatment in connection with any of the categories mentioned in Question 4A?
C. tested positive for antibodies to the AIDS (Human T-cell Lymphotropic, Type III) virus?
GIVE DETAILS OF ALL "YES" ANSWERS ABOVE
NO QUESTION NO. DISEASE OR INJURY DATES RESULTS NAMES & ADDRESSES OF DOCTORS
SAMPLE
5. Do you currently or have you ever used tobacco in any form? YES NO If "Yes," give type, amount and date last used: ____________________________________________________________ If a former user, when did you quit? ______________________ 6. Current height _________________
Please note: "You" and "Your" refer to the applicant. "We," "Us" and "Our" refer to Hermann Sons Life (The Grand Lodge of the Order of the Sons of Hermann in the State of Texas).
CIRCLE ANSWER AND PROVIDE DETAILS FOR ANY POSITIVE RESPONSES PLEASE PRINT IN BLUE OR BLACK INK ONLY
Name Date of Birth
1. Do you have or have you ever been diagnosed with Attention Deficit/Hyperactivity Disorder (ADD/ADHD)? Yes No
2. When was this diagnosed?
3. List all physicians who have treated you for this condition (Provide name, type of doctor and address)
4. Date you last consulted above physician? How often do you see?
5. Have you ever been hospitalized or seen in the emergency room due to your condition? Yes No If yes, provide dates, names and addresses for all treatment locations.
6. Have you received any treatment or medications for the condition? Yes No If yes, provide details, including medications being taken and when last used.
7. Is medication taken all year long or on a modified schedule?
8. Are symptoms: Improved Same More Severe
9. Are you receiving psychotherapy, counseling or behavior modification? Yes (provide details) No
10. Do you have any depression or other mood disorder problems associated with ADD/ADHD? Yes (provide details) No
11. Please provide any additional information you feel is important concerning your ADD/ADHD:
I understand that this declaration will be relied upon by Hermann Sons Life in determining my insurability. I understand that any material misstatement in this declaration, or elsewhere, could render the certificate, if issued, voidable. I declare that the above answers are true and complete to the best of my knowledge.
Signature of the Proposed Insured or Guardian Date
6. Has your license or certificate been revoked or suspended? Yes No
7. Do you intend to apply for a higher grade of certificate? Yes No
8. Are you a member of the Air Force, Army, Navy or Coast Guard or in any other branch of the armed services (including Reserve or National Guard)? Yes No
9. Give details of flying experience by hours
Type of Flying
a. Regularly scheduled airlines
b. Non-scheduled commerical, including charter or taxi flights
c. Flights in company-owned planes for transportation of employees
d. Flight instruction
e. Private or pleasure flying
Pilot
Crew
Pilot
Crew
Pilot
Crew
Student
Instructor
Pilot
Crew
SAMPLE
f. Military
(except see "h" for proficiency, etc.) (Complete No. 11)
g. Sightseeing, photography, surveying, crop dusting, test or experimential (Describe in No. 13)
h. All other flying including military proficiency and qualification for flight pay (Describe in No. 13)
Pilot
Crew
Paratrooper
Pilot
Crew
Pilot
Crew
Passenger
Name
Crop Dusting Questionnaire
TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY
Date of Birth
1. Type of pilot certificate (please specify exact type)?
a. Date of issue?
b. Date of last renewal?
2. Total hours flown as a pilot?
3. Total agricultural hours (crop dusting)?
4. Type of plane flown (please check below and specify type)
a. Specially designed crop dusting plane (Piper Pawnee, Thrush, A.G. Wagon, Continental Helicopter, etc.) Yes No
b. Converted plane (bi-wing and upper wing, etc.) Yes No
c. Other (please specify type)?
5 Do you operate from more than one base during the year? Yes No
6. Location of base of operation:
a. Address
b. City/State/Zip
c. How long have you been operating from this location?
7. Location of previous base of operation?
a. Address
b. City/State/Zip
c. How long were you there?
SAMPLE
8. Have you ever had an aircraft accident or been grounded, fined or reprimanded for violations of air regulations? Yes No
9. Additional details to any "yes" answers above:
I hereby agree that these changes shall be an amendment to and form a part of the original application and of any policy issued thereunder, and that such changes shall be binding on any person who shall have or claim any interest in such policy.
Signature of the Proposed Insured Date Witness CROP DUSTING (Rev. 11/1/16)
Name
TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY
Date of Birth
Source Date
1. Name and address of physician(s) consulted for diabetes? (If Kaiser, obtain patient number)
Name Address
Date last consulted?
Details How often do you consult your physician?
2. Date of diagnosis? What were your symptoms?
3. Do any of your parents, brothers or sisters have diabetes? Yes No
Details
4. How is your diabtes controlled? (Check all that apply) Diet Oral Medication(s) Insulin
List medications
5. Do you test your own blood sugar? Yes No How often?
Readings: Fasting Non-fasting
6. Any loss of work or disability associated with diabetes? Yes No
Diabetes Questionnaire SAMPLE
Details
7. Have you ever had:
a. Diabetic coma Yes No e. Kidney trouble Yes No
b. Insulin shock Yes No f. Neuropathy or numbness/tingling Yes No
c. Heart trouble Yes No g. Retinopathy or eye problems Yes No
d. High blood pressure Yes No
Details
8. Have you ever been hospitalized due to your diabetes? Yes No If yes, when and where?
Signature of the Proposed Insured Date DIABETES (Rev. 11/1/16)
GRAND LODGE OF THE ORDER OF THE SONS OF HERMANN IN THE STATE OF TEXAS DRUG USAGE QUESTIONNAIRE
Drug Usage Questionnaire
TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY
Name __________________________________________________________
Date of Birth ____________________
1. Are you currently using or have you ever used or abused illegal or controlled substances? Yes No If "yes," check the names of all drugs used or write in the name of drugs not listed.
How much? _____________________________________ How often? __________________________________ Date of your first use? ____________________________ Date of your last use? _________________________
2. Have you ever consulted a physician, counselor or clergy because of drug or alcohol use? Yes No If "yes," provide dates, names and addresses of all treatment facilities:
SAMPLE
3. Have you ever been charged with a driving violation due to drugs or alcohol or failed or refused to take a breathalyzer test? Yes No
If "yes," provide details:
4. a. Have you ever experienced job difficulties, missed work, had family problems or had legal problems due to drug or alcohol use? Yes No
b. Have you ever been in an altercation or arrested or charged with an alcohol-related offense? Yes No
If "yes," provide details:
(Name and address of transferring company)
Please consider this letter as an assignment of all my rights, title and interest in life insurance certificate number _________________________ for ___________________________________ to Hermann Sons Life. I understand that I am irrevocably waiving all rights, claims and demands under the certificate.
The purpose of the assignment is to effect a non-taxable exchange of this contract under Internal Revenue Code Section 1035 for a contract with Hermann Sons Life. I certify that the contract is not subject to any assignment, pledge, collateral assignment or other lien and that no proceedings in bankruptcy or insolvency, voluntary or involuntary, have been instituted by or against me and that I am not subject to any form of guardianship.
I understand that Hermann Sons Life will surrender the contract and that it is the current insurance company’s responsibility to pay the surrender proceeds in a timely manner for my benefit to:
HERMANN SONS LIFE P.O. BOX 1941 SAN ANTONIO, TEXAS 78297
Member's Signature
SAMPLE
Social Security Number
Date
Contract is: Attached Lost
Officer Authorization (Home Office use only)
Hermann Sons Life Officer Signature
Hermann Sons Life Officer Title
Date
Certificate No. Product Amount
Certificate No. Product Amount
Certificate No. Product Amount
Agent Name Agent No.
Date of Application
Bonus qualification information is listed in the Agent's Manual and may be subject to change.
Sales Department Approval
Notice & Consent Form for AIDS Virus (HIV) Testing
TO BE COMPLETED BY APPLICANT
PLEASE PRINT IN BLUE OR BLACK INK ONLY
To evaluate your eligibility for insurance or insurance benefits, it is requested that you consent to be tested for the AIDS virus (HIV). By signing and dating this form, you agree that this test may be performed and that underwriting decisions will be based on the test results.
DISCLOSURE OF TEST RESULTS:
All test results will be treated confidentially. The results of the test will be reported to the insurer identified on this form. Results of the test will not otherwise be disclosed except as allowed by law or as stated below
MEANING OF TEST RESULTS:
While positive HIV antibody results do not mean that you have AIDS, they do mean that you may be at increased risk of developing AIDS or AIDS-related conditions. The test is a test for antibodies to the HIV virus, the causative agent for AIDS, and shows whether you have been exposed to the virus.
Positive HIV antibody test results could adversely affect your application for insurance. This means that your application may be declined, that an increased premium may be charged, or that other policy changes may be necessary.
RELEASE OF RESULTS:
The results of this test may be released to the following:
1.The proposed insured.
2.The person legally authorized to consent to the test.
3.A licensed physician, medical practitioner, or other person designated by the proposed insured.
4.An insurance medical information exchange under procedures that are designed to assure confidentiality, including the use of general codes that also cover results of tests for other diseases or conditions not related to AIDS, or for the preparation of statistical reports that do not disclose the identity of any particular proposed insured.
5.A reinsurer, if the reinsurer is involved in the underwriting process, under procedures that are designed to assure confidentiality.
6.Persons who have the responsibility to make underwriting decisions on behalf of the insurer.
SAMPLE
7.Insurer legal counsel who needs such information to effectively represent the insurer in regard to matters concerning the proposed insured.
The Insurer may contact you for the name of a physician or other health care provider to whom you may authorize disclosure and with whom you may want to discuss the results.
CONSENT:
I have read and I understand this Notice and Consent Form. I voluntarily consent to testing and disclosure as described above. I understand that I have the right to request and receive a copy of this form. A photocopy of this form shall be as valid as the original.
Signature of Proposed Insured or Parent/Legal Guardian
Proposed Insured
Name
Respiratory Questionnaire
TO BE
COMPLETED BY APPLICANT
PLEASE PRINT IN BLUE OR BLACK INK ONLY
Date of Birth
1. CHECK ALL THAT APPLY: Allergy Asthma Bronchitis Other
2. Age at onset? ____________________ 3. Date last noticed?
4. Have you had any wheezing? Yes No If "yes," explain:
5. Have you stopped any activity for a short time? Yes No If "yes," explain:
6. How often do these episodes occur in a year's time (weekly, monthly, etc.)
7. How long do these episodes last?
8. Have you ever been treated with: Antihistamines? Yes No Oxygen? Yes No Inhalants? Yes No Ephedrine? Yes No Other?
9. Is medication being taken now? Yes No If "yes," what? How often?
10. Have you required medical attention or hospitalization? Yes No If "yes," give details below:
SAMPLE
DO NOT USE FOR AVIATION TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY
Name Date of Birth
Auto racing Ballooning Parachuting Snowmobile racing Boat racing Hang gliding Professional athletics Other Boxing Motorcycle racing Scuba or skin diving
1. What national clubs or associations are you affliated with in connection with this activity?
2. List any special licenses, professional or amateur titles you hold in connection with this activity?
3. Do you participate for monetary gain or profit? Yes No Earnings in last 12 months?
4. In what geographical locations do you normally participate in this sport or avocation? (i.e. type of track or body of water, etc.)
5. Do you or have you ever participated in any experimental forms of this sport or avocation? Yes No If "yes," give details:
6. How long have you been participating in this sport or avocation?
7. Frequency of participation: 1-2 years ago Past 12 months Next 12 months
8. What is the greatest height-depth-speed you have attained?
9. How many times have you attained this height-depth-speed? Total Last 12 months
10. What is the average height-depth-speed?
11. What is the average length of time you spend in each instance of participation in this activity?
12. The following questions are to be answered by those participating in motor sports:
Sport, Amusement or Avocation Questionnaire SAMPLE
a. Type of motor sport?
b. Make and model of vehicle?
c. Is it modified?
d. Class?
e. What HP?
f. Engine displacement?
g. Type of fuel?
h. Estimated top speed?
13. The following questions are to be answered by those participating in scuba and other diving activities:
a. What equipment do you use?
b. Do you own this equipment? Yes No c. Do you dive alone? Yes No
14. Would you prefer this policy to be issued with extra premium (if necessary) or exclusion rider (if possible)?
I agree that all statements and answers to the above questions are complete and true to the best of my knowledge and belief, and I agree that they will be a part of the application for issue, reinstatement or change of a policy of insurance on my life.
Signature of the Proposed Insured Date
Signature of Witness SPORT-AMUSEMENT-AVOCATION (Rev. 11/1/16)
Term Conversion Application
PROPOSED INSURED INFORMATION
FULL NAME (Last, First, Middle)
MAILING ADDRESS
AGE SEX BIRTHPLACE (City and State)
OCCUPATION/JOB DESCRIPTION
FIRM NAME
BENEFICIARY DESIGNATION
Please
Please
OWNERSHIP INFORMATION
OWNER’S FULL NAME (Last, First, Middle)
OWNER’S FULL NAME (Last, First, Middle)
Tobacco Usage Questionnaire
TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY IF FILLING OUT BY HAND
Name Date of Birth
1. Are you currently or have you ever used any tobacco products? q Yes q No
If "Yes," what type? _____ Chewing tobacco _____ Cigarettes _____ Cigar _____ Pipe _____ Vaporizing
Other
How often used?
2. When was the last time you used any tobacco products?
Please indicate the status of the original certificate: _____ Enclosed _____Lost
If certificate is lost, please attach the Lost Certificate Affidavit form. You may download the Lost Certificate Affidavit form on our website at hermannsonslife.org
I hereby represent, to the best of my knowledge and belief, that all answers to all the above questions are complete and true, and I agree that they shall form a part of the application and become a part of any contract of insurance issued as a result of such application.
SAMPLE
Signature of Proposed Insured
PAYOR’S NAME
PROPOSED INSURED’S NAME
Waiver of Premium Rider Payor Information
PAYOR’S MEDICAL INFORMATION
1. (a) Exact Height ft. in.
(b) Weight lbs.
2. Have you gained or lost weight within the last two years? Gained Lost (If “YES”, give amount and reason.)
3. Do you currently or have you ever used tobacco, nicotine or vape products?
If “YES,” give type, amount and dates used.
4. Have you ever had a life insurance application declined, postponed, rated, modified, or withdrawn?
If “YES”, give name of company(ies), date and reason.
5. Have you ever had your driver’s license suspended or revoked; or ever been convicted of DWI or DUI; or in the past 3 years been convicted of more than one moving violation?
If “YES,” please provide driver’s license number and details.
6. Except as prescribed by a physician, have you ever used, or been convicted for the sale or possession of cocaine or any other narcotic or illegal drug?
If “YES,” complete the Drug Usage Questionnaire.
7. Have you ever been treated for, received counseling, been advised to seek counseling, or joined a support organization because of ALCOHOL or DRUG usage?
If “YES,” complete the Alcohol Usage Questionnaire.
8. Have your PARENTS, BROTHERS or SISTERS ever had diabetes, cancer, high blood pressure, heart disease or a congenital disorder?
If “YES”, give relationship, condition, age at diagnosis and current age or age at time of death.
9. Have you ever been treated or evaluated at a hospital, clinic or other facility, or been advised to have any test or surgery not yet completed? (If “YES”, explain.)
YES NO
10. Have you had or been told you had AIDS,AIDS Related Complex or AIDS related symptoms? Or have you ever tested positive for antibodies to the AIDS (Human T-cell Lymphotropic Type III; HTLV-III)?
11. Have you received treatment by a member of the medical profession in connection with any of the categories mentioned in #10?
12. To the best of your knowledge and belief, in the past 10 years, have you been medically treated for, or been diagnosed as having:
a) Any disorder of the heart, circulatory, blood or immune system? (Examples include chest pain, heart murmur, heart attack, abnormal heart beat, high blood pressure, varicose veins, shortness of breath, disorder of blood vessels, anemia, etc.)
b) Cancer, tumor, cyst, growth or enlargement of the lymph gland?
c) Any disorder of the Respiratory System? (Examples include Allergies, Asthma, Bronchitis, Emphysema, Tuberculosis, Reactive Airway Disease, or other lung disorders.) If “YES,” complete the Respiratory Questionnaire.
d) Any disorder of the digestive system, such as disease of the stomach, intestines, rectum, liver, gallbladder, esophagus, diarrhea of more than one week’s duration, ulcer, hermorrhoids, polyps or hernia, etc.?
e) Any disorder of the urinary system? (Examples include references to the urinary organs or functions such as albumin, blood, sugar or pus in the urine; diseases of the kidney, bladder, etc.?)
f) Diabetes, abnormal blood sugar, thyroid, adrenal, parathyroid, pituitary or other glandular disorders. If “YES,” to diabetes or abnormal blood sugar, complete the Diabetes Questionnaire.
g) Depression, anxiety, bipolar disorder, obsessive compulsive disorder, neurosis, psychosis, schizophrenia, attention deficit disorder (ADD/ADHD), affective disorders, eating disorder, hallucinations or any other mental behavoral, psychological, or psychiatric disorders?
If “YES,” to ADD/ADHD complete the Attention Deficit/ Hyperactivity Disorder Questionnaire.
h) Any disorder of the nervous system, such as epilepsy, convulsions, loss of consciousness, dizziness, paralysis, headaches, nervousness, mental disorder, or received psychiatric treatment or attempted suicide, etc.?
i) Any disorder of the muscles, skin or bone? (Examples include gout, arthritis, collagen disease (connective tissue disease), disorders of the back, joints, extremities, muscles, etc.; or received chiropractic or therapist consultation.)
j) Any disorder or the male or female reproductive organs? (Examples depending on gender include menstrual disorder, complications of pregnancy, Caesarean section, or prostate disorder, etc.)
k) Any disorder of eyes, ears, nose or throat? (Except for cataracts, not necessary to include vision corrected with glasses or contact lenses.)
If
Application for Annuity & Membership
Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed. FULL NAME (Last, First, Middle) MAILING ADDRESS
(City and
SEX If, at any time, the sole primary beneficiary that is stated is someone other than the spouse, the spouse’s signature is required.
dues (if applicable).
Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.
Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.
Needs and Financial Objectives to Review Before the Purchase of an Annuity
To be completed by Hermann Sons Life Agent (Definition of concepts on reverse side)
1. Is the applicant asking for a recommendation from the Hermann Sons Life Agent regarding the investment benefits of a Hermann Sons Life Annuity?
______ Yes - Continue to Questions 2, 3, 4 and 5.
______ No - The applicant has decided on the investment choice independently. Have member sign below that they do not wish information regarding how this annuity addresses their financial plans, tax status or how this product meets their overall investment objectives.
2. Does the applicant understand the withdrawal restrictions and penalties during the first five years of the contract?
3. If the applicant is filing an annual federal income tax return, is he/she aware that the gain is taxable to them or their beneficiaries when withdrawn from the annuity and not as it is earned (tax deferred vs. tax free)?
4. Is the applicant looking for a conservative investment product with safety of capital and a return that approximates a bank certificate of deposit (is the applicant risk adverse)?
5. What is the applicant’s investment objective during the next five years with this annuity?
______ Funds will be needed five or more years away
______ Accumulation of funds to leave to beneficiaries upon applicant’s death (If this is the goal, is a life insurance product better suited to the client’s needs?)
______ Other items or needs
Agent Conclusion: A thorough discussion of the above factors in items 2-5 indicates a Hermann Sons Life Fixed Annuity reasonably meets the applicant’s financial needs.
______ Check here if member does not wish to sign
Page 1 of 2
Buyer’s Guide to Fixed-Rate Deferred Annuities
This booklet is intended to help guide you when shopping for annuity products. It explains the importance of the following:
● What is an annuity?
● What are the different types of annuities?
● How do I decide what is best for me?
● What other important information should I consider?
WHAT IS AN ANNUITY?
An annuity is an investment contract sold by a life insurance company. It accumulates value and provides income for contract holders in their later years.
You fund an annuity (in a single deposit or multiple deposits) and the insurer promises to pay out money from the annuity to you in a series of payments. Only an annuity can pay an income that can be guaranteed to last as long as you live. The annuitant can choose what type of payment schedule works best for them.
An annuity may be qualified (Traditional IRA, ROTH IRA, etc.) or non-qualified.
An annuity is not a savings account. It is a retirement account. If you buy an annuity, it should be for long-term financial planning.
WHAT ARE THE DIFFERENT TYPES OF ANNUITIES?
It’s important to understand the differences among various annuities so you can choose the kind that best fits your needs. Hermann Sons Life offers only fixed-rate annuities.
Annuities differ in several ways:
● How many premiums you pay
SAMPLE
● How the money in the annuity earns interest
● When the company makes income payments to you
How many premiums you pay: Single premium or multiple premium annuities
You pay the insurance company only one payment for a single premium annuity. You make a series of payments for a multiple premium annuity; for one type of multiple premium annuity, a flexible premium annuity, you pay whenever you want, within set limits.
How the money in an annuity earns interest: Fixed, variable and indexed annuities
Fixed
During the accumulation phase of a fixed deferred annuity, your money earns interest at rates set by the insurance company or in a way spelled out in the annuity contract. The company guarantees the contract will earn no less than a minimum rate of interest. Once you begin to receive payments in the annuitization phase, the amount of each payment is set and will not change. Hermann Sons Life sells only fixed annuities.
Personal and Confidential
Needs Analysis/Best Interest
Obligations
Mortgage Cancellation
If I were to die today, amount needed to pay off mortgage
Debt Cancellation
If I were to die today, amount needed to pay off current debt (vehicle, credit cards, personal loans etc.)
College Expense
In the event of untimely death – amount to set aside to assist a child with college
Income
Amount needed annually to continue current lifestyle.
What You Should Know About The Annuities I Can Sell and How I Am Paid
I am licensed to sell annuities in Texas. Before I can recommend an annuity to you, I must tell you which types of annuities and other financial products I am allowed to sell. I must also tell you which companies I represent and how I am paid for the annuities I sell. Do not sign this form unless you have read and understand it.
National producer number in Texas: (NPN#)_________________________________________________________________
What products is your agent licensed to sell you?
I am licensed to sell the following products in Texas: Fixed or fixed indexed annuities
Variable annuities
Life insurance
Mutual funds Stocks/bonds Certificates of deposits
How is your agent paid for their work?
Whose annuities can your agent sell to you?
I am authorized to sell:
Annuities from only one insurer
Annuities from two or more insurers
Annuities from two or more insurers, although I primarily sell annuities from:
Depending on the annuity you buy, the agent may be paid in the following way:
• A commission, which is usually paid by the insurance company or by other sources. If I’m paid by other sources, they are:
If you have questions regarding how your agent will be paid for the sale of this annuity, please ask your agent.
By signing below, you acknowledge that you have read and understand the information in this document.
Client signature Date Agent signature Date
Information Needed In Order To Make An Informed Annuity Purchase
What is the purpose of this form?
To recommend an annuity that effectively meets your needs, objectives, and situation, I need information about you, your financial situation, insurance needs, and financial objectives. If you do not provide all of the information, or if you provided inaccurate information, you could lose legal protections under the Texas Insurance Code.
Check the appropriate box below then sign and date the form:
I did not provide all information at this time.
I provided all information to make an informed Annuity purchase.
Client signature
Date
Agent Recommendation or Independent Decision
Do not sign this form unless you have read and understood it.
What is the purpose of this form?
To recommend an annuity that effectively meets your need, objectives, and situation, I consider your financial situation, insurance needs , and financial objectives.
Acknowledgment and signatures
I understand that if I buy an annuity without an agent recommendation, I may lose legal protections under the Texas Insurance Code.
I made an independent decision to purchase this annuity.
I considered my agent recommendation when deciding to purchase this annuity.
Client signature
Date
Agent signature
Date
Replacement of Life Insurance or Annuities
This document must be signed by the applicant and the producer, if there is one, and a copy left with the applicant.
You are contemplating the purchase of a life insurance certificate or annuity contract. In some cases this purchase may involve discontinuing or changing an existing policy or contract. If so, a replacement is occurring. Financed purchases are also considered replacements.
A replacement occurs when a new certificate or contract is purchased and, in connection with the sale, you discontinue making premium payments on the existing policy or contract, or an existing policy or contract is surrendered, forfeited, assigned to the replacing insurer, or otherwise terminated or used in a financed purchase.
A financed purchase occurs when the purchase of a new life insurance certificate involves the use of funds obtained by the withdrawal or surrender of or by borrowing some or all of the policy values, including accumulated dividends, of an existing policy to pay all or part of any premium or payment due on the new certificate. A financed purchase is a replacement.
You should carefully consider whether a replacement is in your best interest. You will pay acquisition costs and there may be surrender costs deducted from your policy or contract. You may be able to make changes to your existing policy or contract to meet your insurance needs at less cost. A financed purchase will reduce the value of your existing policy and may reduce the amount paid upon the death of the insured.
We want you to understand the effects of replacements before you make your purchase decision and ask that you answer the following questions and consider the questions on the back of this form.
1. Are you considering discontinuing making premium payments, surrendering, forfeiting, assigning to the insurer, or otherwise terminating your existing policy or contract? __________ YES __________ NO
2. Are you considering using funds from your existing policies or contracts to pay premiums due on the new certificate or contract? __________ YES __________ NO
If you answered “yes” to either of the above questions, list each existing policy or contract you are contemplating replacing (include the name of the insurer, the insured or annuitant, and the policy or contract number if available) and whether each policy or contract will be replaced or used as a source of financing: INSURER CONTRACT OR INSURED OR REPLACED (R) OR NAME POLICY# ANNUITANT FINANCING (F) 1. 2.
SAMPLE
Make sure you know the facts. Contact your existing company or its agent for information about the old policy or contract. If you request one, an in-force illustration, policy summary or available disclosure documents must be sent to you by the existing insurer. Ask for and retain all sales material used by the agent in the sales presentation. Be sure that you are making an informed decision.
The existing policy or contract is being replaced because:
I certify that the responses herein are, to the best of my knowledge, accurate:
Applicant’s Signature and Printed Name Date
Producer’s Signature and Printed Name Date
I do not want this notice read aloud to me. __________ (Applicants must initial only if they do not want the notice read aloud.)
Date
Name
Address
Annuity Contribution/Withdrawal Request Form
Annuity No.
City State Zip
Email
Phone No.
Social Security No.
Please check one: Contribution (see Section 1) Withdrawal (see Section 2)
SECTION 1 - CONTRIBUTION REQUEST
Contribution amount: $ _______________________ For prior year?* Yes No
* Prior year contributions only apply to IRA accounts and will only be accepted if received before the year’s tax filing deadline (generally April 15).
SAMPLE
Signature of Annuitant ____________________________________________________________
SECTION 2 - WITHDRAWAL REQUEST
As of the current date, I elect not to have Federal income tax withheld. I understand I am still liable for any and all taxes and penalties incurred regarding these withdrawals.
Withhold Federal income tax at a rate of _____% (not less than 10% per IRS). I understand I am liable for any additional tax or penalty if I do not withold enough.
PLEASE NOTE: If you do not elect to waive withholding or specify a percentage to be withheld, or if your election is not clear, we are required to withhold 10% from your request for Federal income tax.
Net Withdrawal Amount: $ _________________________
I understand any Federal withholding requested above, as well as any applicable surrender charges from Hermann Sons Life as defined in my annuity contract, will be taken out of my account in addition to the requested Net Withdrawal Amount above. I also understand that any Federal withholding election above will be assessed on the total Net Withdrawal Amount requested regardless of how much of said withdrawal is subject to Federal income taxation.
Signature of Annuitant _______________________________________________________________
Mail completed form to: Hermann Sons Life, P.O. Box 1941, San Antonio, TX 78297-1941. Home Office Phone: 800-234-4124 or 210-226-9261 • Website: hermannsonslife.org
TRANSFER REQUEST
The term IRA will be used below to mean Traditional IRA and SIMPLE IRA, unless otherwise specified.
PART 1. RECIPIENT
Name (First/MI/Last)
Individual requesting the transfer
Date of Birth Phone
Email Address
Account Number
ACCEPTING ACCOUNT TYPE (Select one)
Traditional IRA
Inherited Traditional IRA
SIMPLE IRA
Inherited SIMPLE IRA
PART 2. ACCEPTING IRA TRUSTEE OR CUSTODIAN
To be completed by the IRA trustee or custodian receiving the assets
Name
Address Line 1
Address Line 2
City/State/ZIP
Phone
Contact Name
PART 3. RELATIONSHIP OF RECIPIENT TO CURRENT IRA OWNER
RELATIONSHIP TYPE (Select one)
I am the current IRA owner.
I am the former spouse of the current IRA owner.
I am the spouse beneficiary of the original IRA owner transferring assets to my own IRA.
I am the beneficiary of the original IRA owner transferring assets to an inherited IRA.
PART 4. CURRENT IRA OWNER
Name (First/MI/Last)
Social Security Number
Account Number Suffix
Organization Number
SAMPLE
CURRENT ACCOUNT TYPE (Select one)
Traditional IRA
Inherited Traditional IRA
PART 5. CURRENT IRA TRUSTEE OR CUSTODIAN
Name
Address Line 1
Address Line 2
City/State/ZIP
Phone
SIMPLE IRA
Inherited SIMPLE IRA
PART 6. REQUIRED MINIMUM DISTRIBUTION (RMD) OR LIFE EXPECTANCY PAYMENT INSTRUCTIONS
To be completed if the recipient is the current IRA owner and is required to take an RMD this year or is a beneficiary receiving life expectancy payments IF YOU HAVE NOT YET TAKEN YOUR REQUIRED PAYMENT FOR THIS YEAR, COMPLETE THE FOLLOWING. (Select one)
Distribute my RMD or life expectancy payment to me before transferring my IRA assets.
Retain my RMD or life expectancy payment amount. I understand that I am responsible for satisfying my RMD or life expectancy payment.
Include the amount that represents my RMD or life expectancy payment in the transfer. I understand that I am responsible for satisfying my RMD or life expectancy payment.
/ 2325 (Rev. 1/2020)
SAMPLE
(Name and address of transferring company)
Re: Policy No. ________________________ Name _________________________________________ (At transferring company) (Full name of client)
Please consider this letter as an assignment of all my rights, title and interest in the policy identified above to Hermann Sons Life.
The purpose of the assignment is to effect a non-taxable exchange of this contract under Internal Revenue Code Section 1035(a) and Revenue Rule 72-358 for a contract with Hermann Sons Life with ______________________________________.
(Name of transferring company)
Acceptance by Hermann Sons Life of this assignment and of the policy values from other companies should not be construed as a guarantee that the transaction will qualify as a bone fide 1035 exchange.
PLEASE COMPLETE AND RETURN THE ENCLOSED COST BASIS.
Member's Signature Date
Spouse's Signature Date
Contract is: Attached Lost
Social Security Number
Social Security Number
By signature of an authorized officer below, Hermann Sons Life accepts assignment of the above contract for purpose of complying with client's intention of effecting a non-taxable exchange under Section 1035.
Please issue a check payable to Hermann Sons Life for the FULL VALUE of the contract and forward to: HERMANN SONS LIFE P.O. BOX 1941 SAN ANTONIO, TX 78297 Officer Title Date
Partial Value 1035 Exchange Request
(Name and address of transferring company)
Re: Policy No. ________________________ Name _________________________________________ (At transferring company) (Full name of client)
Please consider this letter as a partial assignment of all my rights, title and interest in the policy identified above to Hermann Sons Life in accordance with IRS Notice 2003-51 and Revenue Ruling 2003-76.
The purpose of the partial assignment is to effect a non-taxable exchange of a portion of this contract under Internal Revenue Code Section 1035(a) and Revenue Rule 72-358 for a contract with Hermann Sons Life with ______________________________________.
(Name of transferring company)
Acceptance by Hermann Sons Life of this assignment and of the policy values from other companies should not be construed as a guarantee that the transaction will qualify as a bone fide 1035 exchange.
PLEASE COMPLETE AND RETURN THE ENCLOSED COST BASIS IN ACCORDANCE WITH REVENUE RULING 2003-76.
Member's Signature Date
Spouse's Signature Date
Contract is: Attached Lost
Social Security Number
Social Security Number
By signature of an authorized officer below, Hermann Sons Life accepts assignment of the above partial contract for purpose of complying with client's intention of effecting a non-taxable exchange under Section 1035.
Please issue a check payable to Hermann Sons Life in the amount of $ _________________ and forward to: HERMANN SONS LIFE
P.O. BOX 1941 SAN ANTONIO, TX 78297
Officer Title Date
SAMPLE
SAMPLE
SAMPLE
SAMPLE
Application for Matured Annuity & Membership
FULL NAME (Last, First, Middle)
MAILING ADDRESS
Address Change Request Form
Date Certificate No.
Name Address
City State Zip
Email
Phone No. Social Security No.
I request an address change on the following certificate(s):
Certificate No. Issued To New Mailing Address
SAMPLE
Signature of Insured
Agent Replacement Compliance Letter
TO BE COMPLETED WITH THE SUBMISSION OF AN APPLICATION
I, the undersigned Hermann Sons Life agent, represent that:
(A) I used only Hermann Sons Life approved sales material on the member's application listed below; and
(B) All copies of all sales materials used in this sales presentation were left with the applicant named below in accordance with Section 1114.051(f) of the Texas Insurance Code.
Agent's Signature
SAMPLE
Date Signed by Agent
Applicant's Printed Name
Application for Decrease of Insurance
I, , a member in good standing, born on ____________________, do hereby attach Certificate No. , issued to me under Plan on in the face amount of $ , and hereby request the above certificate be reissued under the same Plan in the face amount of $
I agree to pay the premium rates according to the table of rates at age of entry and that the new certificate shall bear the same effective date as the original effective date.
SAMPLE
Name of Certificate Owner (Please type or print)
Address
Social Security No.
Telephone No.
Signature of Certificate Owner Date
NOTICE: Submitting this form may impact certificate beneficiary designations. Please complete the Application for Change of Beneficiary form if applicable.
Please indicate the status of the original certificate: Enclosed Lost
If certificate is lost, please attach the Lost Certificate Affidavit form. (You may download the Application for Change of Beneficiary and Lost Certificate Affidavit forms from the website at hermannsonslife.org or request the forms by calling the Home Office at 210-226-9261 or 800-234-4124.)
Date
Name Address
Bank Draft Authorization Request Form
Certificate No.
City State Zip
Email
Phone No.
Social Security No.
Please list all certificates you are requesting bank draft for:
SAMPLE
Name of bank or credit union to be drafted
Name(s) of authorized users on bank account
Type of account:
Checking - attach voided check
Savings - attached voided deposit slip
Draft frequency: Monthly
Routing No.:
Account No.:
Draft Date: 1st of month drafting
Quarterly 15th of month drafting
Semi-annually
Annually
Amount Per Draft: $ _________ (Annuities Only)
I hereby give the above mentioned bank or credit union authorization to honor electronic drafts drawn from my account by Hermann Sons Life for insurance or annuity payments on the above listed accounts. I understand that if my bank rejects a draft request for any reason, it is still my responsibility to pay the defaulted amount immediately and I will contact Hermann Sons Life for payment options. I further understand that Hermann Sons Life is not responsible for bank overdraft charges or other related draft fees.
Signature of Account Holder
Beneficiary Change Request Form
Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.
Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.
Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.
Please Choose One Designation: If Living Otherwise *
And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.
I request the beneficiary on the above mentioned certificate be changed as I have designated on this form. I understand that this request for change of beneficiary shall take effect as of the date I signed this form provided this form has been received and approved by the Vice President of Operations and COO as being in compliance with the Laws of Hermann Sons Life governing beneficiaries. Any reference to a beneficiary “if living” shall mean if living at the time of my death. The “and” designation implies that the named beneficiaries will share equally unless otherwise stated. If payment to a trust is provided herein, a copy of such trust must be enclosed. Hermann Sons Life will not be responsible for the performance of the trustee’s duties as trustee.
Signature of Spouse
(Only required if change requested is for an annuity and the annuitant’s spouse is not listed as the sole first beneficiary.)
Signature of Current Owner
Signature of Disinterested Witness
Mail completed form to: Hermann Sons Life, P.O. Box 1941, San Antonio, TX 78297-1941. Home Office Phone: 800-234-4124 or 210-226-9261 • Website: hermannsonslife.org
Change of Agent Notification
Member's Name
Certificate No. Region Lodge Name
This is to inform the Home Office that will be my new representative. I ask for this change because
SAMPLE
Member signature Date
Address
City State Zip Home Phone Cell Phone
Agent's Name Agent's No.
Names of other family members:
Certificate Number
Certificate Number
Certificate Number
Certificate Number
Certificate Number
Certificate Number
Certificate Number
Certificate Number
Death Notice
Lodge
To the Grand Vice President-Secretary/Treasurer of Hermann Sons Life:
No.
We report herewith that _____________________________________________________________________, Certificate No. , a member of this lodge, died on the _____________ day of ____________________ A.D. ____________________ at the age of ____________________ years.
❏ Married
He/She was ❏ Single ❏ Widowed
SAMPLE
He/She had been a member of Hermann Sons Life since the ____ day of __________, _____.
His/Her death benefit certificate designates as beneficiaries (Please give full name or names of beneficiaries)
Address, if known:
_________________________ Texas, this the _____________ day of ___________________, _____________.
President
Secretary
BURIAL NOTICE
We, the undersigned members of _______________________________________ Lodge, Hermann Sons Life, located in , Texas, hereby certify that , a member of Lodge, Hermann Sons Life, was buried on the ______ day of , , and that we were present at visitation/funeral services of said member.
Witness Witness
Date
Name Address
Lodge Transfer Request Form
Certificate No.
City State Zip
Email
Phone No.
Social Security No.
I request to transfer lodge membership on the following certificate(s):
Certificate No. Issued to Lodge I request transfer to
SAMPLE
The reason for my transfer request is:
☐ The lodge I request to transfer to is a more convenient location for me.
☐ The lodge I request to transfer to has members that are friends or relatives.
☐ Other - Please explain: _______________________________________
Signature of Current Owner
Date Certificate No. __________________
I have made a diligent effort to locate the above mentioned certificate, but have been unsuccessful. Please accept this request for a Statement of Insurance for my records. Should I locate the misplaced certificate once this form has been submitted, I agree to promptly surrender it to the Hermann Sons Life Home Office.
SAMPLE
Signature of Current Owner
Mail completed form to: Hermann Sons Life, P.O. Box 1941, San Antonio, TX 78297-1941. Home Office Phone: 800-234-4124 or 210-226-9261 • Website: hermannsonslife.org
Request Form
In regard to the above mentioned certificate, I request the name be changed to:
SAMPLE
Signature of Current Owner
Date
Name
Address
Ownership Change Request Form
Certificate No.
City State Zip
Email
Phone No.
Social Security No.
I assign and transfer, without any exception, limitation or reservation whatsoever all of the rights, title and interest in and to the above mentioned certificate to:
SAMPLE
2.
Please Choose One Designation: If Living Otherwise *OR* And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.
Once approved, this document gives the new owner(s) all contractural rights, including but not limited to surrendering, taking a loan against and changing beneficiary of the certificate. Changing ownership may generate a tax consequence. Please speak with your competent tax advisor regarding any tax applicable to this transaction.
Signature of Current Owner
State of County of This instrument was acknowledged before me on by Notary Public’s Signature (Personalized Seal)
BROCHURES
210-527-9113 OR 877-437-6266
A PLAN FOR EVERY NEED
LIFE OFFICE Mary’s St. 78205 877-437-6266 www.hermannsonslife.org
We strengthen community.
The mission of Hermann Sons Life is to strengthen community through financial protection and service. And we do this in several ways.
As a life insurance company, we strive to offer products designed to protect the financial future of every member of your family – from newborns to seniors. We want to be your life insurance company “for today, for tomorrow, for life.”
As a non-profit organization, we offer benefits not provided by commercial life insurance companies. Our members have access to a youth camp, a dance program and a retirement home. And, they enjoy the opportunity to work side-byside on projects that strengthen the communities in which they live.
When you choose to be a part of the Hermann Sons Life family, you aren’t just recognizing the importance of life insurance, you’re choosing to strengthen community.
Please look inside for information on the life insurance and annuity products we offer and the benefits you will enjoy as a member/policyholder.
General Information Brochure
8.5” x 14”
to 3.5” x 8.5”
Offers a condensed look at Hermann Sons Life including our three major benefits - Retirement Home, Camp and Schools of Dance - as well as general information about our products.
Can be personalized with agent’s name and contact information.
Protecting every member of the family
strengthen community through financial protection and service.
Product Information Brochure
Size: 8.5” x 14” folded to 3.5” x 8.5”
Offers a more detailed description of each life insurance and annuity product.
Can be personalized with agent’s name and contact information.
BUY FROM US?
companies offer pre-need burial are designed to cover final most of these plans don’t the
don’t need the money for final you can leave the proceeds Plan to your children and or to a trust or foundation. how the money is spent and gets to spend it! remember, life insurance proceeds tax-free to your beneficiary or beneficiaries.
Annuity Brochure
Size: 8.5” x 14” folded to 3.5” x 8.5”
Offers a detailed look at our annuity products and how they work.
Senior Adult
Expense Plan
Can be personalized with agent’s name and contact information. SAFE Plan Brochure
Size: 8.5” x 11” folded to 3.5” x 8.5”
Offers an overview of Senior Adult Final Expense Plan.
Can be personalized with agent’s name and contact information.
FLYERS
There is a flyer available for each of our three main benefits. On the back of each flyer is information on the benefit including eligibility requirements and other details. Each one is 8.5” x 11” flat. Each one can be personalized with the agent’s name and contact information.
To learn more about the life insurance products we offer for your children and the benefits they may enjoy as members contact the Sales Department at 210-527-9113 or 877-437-6266 or sales@hermannsonslife.org www.hermannsonslife.org
A Benefit for Members
Sons Life operates a Retirement Home for its members located near Comfort in the beautiful Texas Hill Country.
To learn more about the life insurance products offered by Hermann Sons Life and the benefits you may enjoy as a member contact: the Sales Department at 210-527-9113 or 877-437-6266 or sales@hermannsonslife.org www.hermannsonslife.org
SCHOOLS OF DANCE
A BENEFIT FOR MEMBERS
Sons Life operates tuition-free Schools of Dance throughout South and Central Texas. The dance school year parallels the school year.
To learn more about the life insurance products we offer for your children and the benefits they may enjoy as a member call the Home Office Sales Department at 210-527-9113 or 877-437-6266 sales@hermannsonslife.org www.hermannsonslife.org
Hermann
Photos Courtesy of Tracy Brucks Photography, LLC
Hermann
POSTCARD
This is a 8.5” x 5.5” postcard that will be personalized with the agent’s photo and contact information. It can be used by new agents to introduce themselves to potential clients. Other agents can use it to contact existing clients about a possible update on their life insurance needs.
PERK SPOT FLYER
This is an 8.5” x 11” flyer that promotes the Perk Spot member benefit. It is included in each new certificate or agents can request some to carry with them when calling on clients.
Hermann Sons Life and Perkspot have teamed up to offer our members a discount program that will save you money on a wide range of products and services. To sign up,
ORDER FORM
The order form for brochures, flyers and stationery can be found on the Agent Only part of the website. Send the order form to the Sales Department at the Home Office or email to sales@hermannsonslife.org