Everest Revises Underwriting for Heart & Arthritis Conditions

Everest announced in October that they have revised their underwriting regarding heart/stroke & musculoskeletal/arthritic conditions, and have released an updated New Business and Underwriting Manual for their Medicare supplement business.

Everest noted that a notable percentage of declinations were associated with the following two questions:

• Within the past two (2) years: Have you had or been treated for or been advised by a physician to have treatment for heart attack, heart disease, heart valve disease, coronary artery disease, carotid artery disease (not including high blood pressure), peripheral vascular disease, congestive heart failure, enlarged heart, stroke, brain hemorrhage, transient ischemic attacks (TIA) or heart rhythm disorders or do you have an implanted stent, cardiac defibrillator, or pacemaker?
• Within the past two (2) years: Have you been treated for degenerative bone disease, crippling/disabling or rheumatoid arthritis or have you been advised by a physician to have a joint replacement that has not been performed?

Effective October 16, 2017, Everest made a corporate decision to begin accepting underwritten applications if the heart/stroke or musculoskeletal/arthritic question, #8(c) and #8(d) in the generic application (question #’s may vary by state), are answered “Yes.”

Note: Approval is still subject to revised underwriting criteria.

New Underwriting Criteria:  The new underwriting criteria are detailed on pages 28-30 of the revised New Business & Underwriting Manual and are intended to provide agents the ability to identify what considerations will be reviewed for potential approval – please read them carefully and as always, contact your Underwriters for clarification.

The revised Manual can be accessed on the Agent Portal under the Document(s) Management section (see screen shot below) for download or print (hard copies are NOT available).  If you are having difficulty logging into the Everest Agent Portal, please call the Everest contracting team at 1-844-301-0395, Agents should press Option #4 and then press #1 for assistance with the Agent Portal or E-Application questions.

Everest has begun filing of a modified application in all states.  This revised application will better represent the changes noted above and improve your ability to determine if a case will be considered up front or not, before wasting time with a submission that will be declined.  In the interim, the detail provided in the New Business & Underwriting Manual will help agents out.