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Life Insurance Application &
Medical Exam

Wondering What's Next? The Life Insurance Application Process, Medical Exam and What To Do Afterwards

When you apply for life insurance, the carrier considers a host of factors to determine how much your life insurance premium will be. Life insurance providers vary in terms of how they weigh different factors, but all use specialists and statistics to help them determine the level of risk you represent. The basic question: How likely are you to die during the term you are covered?

Life Insurance Application

Medical Exam What to Expect

Medical Exam Preparation

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ACR3462744

Product Form Numbers

Product base plans, provisions, features and riders may not be available in all states and may vary by state

Whole Life

Product	Form #'s	State Applicability
GIWL	Policy Forms: ICC21-20532 Rev0621, 20532, 20532-5 and 20532-10 Rev0621. Rider Numbers: ICC23-23200, ICC15-15200, 15200, 15200-35, 13600-5, 15200-10, ICC23-23201, ICC15-15201, 15201, 15201-5, 15201-10 and 15201-35.	All States
American Elite Whole Life 2 (Conversion product only)	Policy Forms: ICC17-17917, 17917, ICC17-17917N, 17917N. Rider Numbers: ICC23-23601, 13601, ICC23-23601N-B, 13601N-B, 1CC14-14001,14001, ICC17-14001N-B, 14001N-B, ICC22-22995, 22995, ICC23-23995N-B, 23995N-B, ICC14-14012, 14012.	All States, except NY
Single Premium Whole Life (Conversion product only)	Policy Forms: ICC17-17918,17918, ICC17-17918, 17918. Policy Forms: ICC17-17918N, 17918N Rev032.	All States, except NY NY only
American Elite 2 (Conversion product only)	Policy Forms: 17917N-33 Rev0121. Rider Numbers: 13601N, 14001N, 23995N-B.	NY only NY only

Term

Product

Form #'s

State Applicability

SAT

Policy Forms: ICC21-19311 Rev0321, 19311, ICC21-19310 Rev0321, 19310, 19310N-33 Rev0321.

Policy Forms: 19311N-33 Rev0321.

Rider Numbers: ICC14-14012, 14012, ICC23-23601, 13601, 13601N, ICC14-14001, 14001, ICC22-22995, 22995.

Rider Numbers: 14012N, 14001N, 22995N.

All States, except NY

NY only

All States, except NY

NY only

Fixed UL

Product

Form #'s

State Applicability

Secure Lifetime GUL 3

Policy Forms: ICC15-15442, 15442.

Policy Forms: 15442N Rev0518.

Rider Numbers: ICC23-23600, 15600, 13600-5, ICC18-18012, 18012, ICC22-22995, 22995, 15972, 15972N, ICC14-14002, 14002, ICC23-23601, 13601, ICC15-15990, 15990.

Rider Numbers: 17600N, 18012N, 22995N, 14002N, 13601N, 15990N.

All States, except NY

NY only

All States, except NY

NY only

IUL

Product	Form #'s	State Applicability
Max Accumulator+ II	Policy Forms: 19646N Rev0120. Rider Numbers: 17600N, 18012N, 22995N, 13601N, 07620N, 14002N, 15996N, 18004N.	NY only
Max Accumulator+ III	Policy Forms: ICC22-22191, 22191,23191-5. Rider Numbers: ICC23-23600, 15600, 13600-5, ICC18-18012, 18012, ICC22-22995, 22995, 14306, ICC23-23601, 13601, 07620, ICC14-14002, 14002, 15996, 15997, ICC15-15994, 15994, ICCC18-18004, 18004.	All States
Value+ Protector III	Policy Forms: ICC16-16760, 16760. Policy Forms: 16760N Rev0618. Rider Numbers: 17600N, 18012N, 22995N, 13601N, 07620N, 14002N, 15992N, 18004N, 15990N. Rider Numbers: ICC23-23600, 15600, 13600-5, ICC18-18012, 18012, ICC22-22995, 22995, ICC23-23601, 13601, 07620, ICC14-14002, 14002, ICC15-15992, 15992, 15997, ICC18-18004, 18004, ICC15-15990, 15990.	All States, except NY and VT NY only NY only All States, except NY and VT
Protection Extend IUL (Conversion product only)	Policy Forms: 19471, ICC19-19471. Policy Forms: 19471N. Rider Numbers: 16110N, 15990N, 18012N, 22995N, 13601N, 14002N. Rider Numbers: 16110, ICC16-16110, 15990, ICC15-15990, 15997, 18012, ICC18-18012, ICC22-22995, 22995, ICC23-23601, 13601, 14002, ICC14-14002.	All States, except NY and VT NY only NY only All States, except NY and VT

QoL Term

Product

Form #'s

State Applicability

QoL FlexTerm

Policy Forms: ICC21-19311 Rev0321, 19311, ICC21-19310 Rev0321, and 19310.

Rider Numbers: ICC14-14012, 14012, ICC14-14001, 14001, ICC23-23602, 15602, ICC23-23603,15603, ICC23-23604, 15604, AGLA 04CHIR-CA (0514), AGLA 04CRIR, AGLA 04TIR, ICC22-22995, 22995.

All States

QoL Fixed UL

Product

Form #'s

State Applicability

QoL Guaranteed Plus GUL II

Policy Forms: ICC15-15442 and 15442.

Rider Numbers: ICC23-23600, 15600, ICC18-18012, 18012, ICC22-22995, 22995,15972, WMDR, ICC14-14002, 14002, ICC23-23602, 15602, ICC23-23603,15603, ICC23-23604, AGLA 04CHIR, AGLA-04CRIR, AGLA 04TIR, 15604, ICC15-15990, and 15990.

All States

QoL IUL

Product

Form #'s

State Applicability

QoL Max Accumulator+ III

Policy Forms: ICC22-22191 and 22191.

Rider Numbers: ICC23-23600, 15600, 13600-5, ICC18-18012, 18012, ICC22-22995, 22995, 14306, 07620, ICC14-14002, 14002, 15996, 15997, ICC15-15994, 15994, ICC18-18004, 18004, ICC23-23602, 15602, ICC23-23603,15603, ICC23-23604, 15604, AGLA 04CHIR-CA (0514), AGLA 04CRIR, AGLA 04TIR.

All States, except NY and VT

QoL Value+ Protector III

Policy Forms: ICC16-16760 and 16760.

Rider Numbers: ICC23-23600, 15600, 13600-5, ICC18-18012, 18012, ICC22-22995, 22995, 07620, ICC14-14002, 14002, ICC15-15992, 15992, 15997, ICC18-18004, 18004, ICC15-15990, 15990, ICC23-23602, 15602, ICC23-23603,15603, ICC23-23604, 15604, AGLA 04CHIR-CA (0514), AGLA 04CRIR, AGLA 04TIR.

All States, except NY and VT

© 2024 Corebridge Direct Insurance Services, Inc. Agency services provided by Corebridge Direct Insurance Services, Inc. (“Corebridge Direct”), CA license # 0B57619 and AR license # 0100105378, a subsidiary of American General Life Insurance Company (“AGL”), Houston, TX and an affiliate of The United States Life Insurance Company in the City of New York (“US Life”). All companies above are wholly-owned subsidiaries of Corebridge Financial, Inc. AGL does not solicit, issue, or deliver policies or contracts in the State of New York. Corebridge Direct offers policies on behalf of affiliated and unaffiliated insurance companies. Guarantees are backed by the claims-paying ability of the issuing insurance company. Products may not be available in all states and product features may vary by state. All prices quoted are non-binding, and the ultimate premium amount for any policy is determined by the underwriting insurance company following application. For all companies mentioned, their financial professionals and other representatives are not authorized to give legal, tax, or accounting advice. For advice concerning your individual circumstances, consult the appropriate professional.
ACR3446520

ACR3560669

Life Insurance Application & Medical Exam

Wondering What's Next? The Life Insurance Application Process, Medical Exam and What To Do Afterwards

Life Insurance Application &
Medical Exam