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State:
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Health Class:
Preferred Plus
Preferred
Standard Plus
Standard
Birthdate:
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
Gender:
Male
Female
Smoker/Tobacco:
Yes
No
Type of Insurance:
10 Year Term
15 Year Term
20 Year Term
25 Year Term
30 Year Term
Lifetime
Face Amount:
$25,000
$50,000
$75,000
$100,000
$125,000
$150,000
$200,000
$250,000
$300,000
$400,000
$500,000
$600,000
$700,000
$750,000
$800,000
$900,000
$1,000,000
$1,500,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$10,000,000
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