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The Family Legacy Qualifier
See if you qualify for a State-Regulated, Fixed-Rate Plan.
No medical exams. No jargon. Just peace of mind.
(1) If something happened tomorrow, who would be the primary loved one responsible for planning and paying for the funeral?
*
(1) If something happened tomorrow, who would be the primary loved one responsible for planning and paying for the funeral?
A
Spouse
B
Children
C
Grandchildren
D
A Close Friend or Relative
(2) How much protection do you feel that loved one
would need to cover everything?
*
(2) How much protection do you feel that loved one would need to cover everything?
A
$5,000 - $10,000
B
$10,000 - $15,000
C
$15,000 - $20,000
D
$20,000+
(3) Most of our programs are designed for those on a limited income. To make sure we design a plan that stays active and protects your family for the long haul, which of these monthly contributions feel most sustainable for you
*
(3) Most of our programs are designed for those on a limited income. To make sure we design a plan that stays active and protects your family for the long haul, which of these monthly contributions feel most sustainable for you
A
$40 – $60 per month
B
$60 – $80 per month
C
$80 – $100 per month
D
$100+ per month
(4) We specialize in plans that require NO medical exams.
To match you with the right program, do you have any life experience with these common health conditions? Select all that apply:
*
(4) We specialize in plans that require NO medical exams. To match you with the right program, do you have any life experience with these common health conditions? Select all that apply:
(5) What is your main goal for this protection?
*
(5) What is your main goal for this protection?
Name of the person who completed the
Family
Legacy Qualifier?
*
To what email address should we send your results?
*
At what number can we call or text you?
SUBMIT
