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NEA Life/AD&D Insurance Plans Non-Smoker Declaration 2007-2025 free printable template

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NEA Life/AD D INSURANCE PLANS NON-SMOKER DECLARATION If you wish to request non-smoker rates for yourself or your spouse for the plan indicated below please complete this form and either return it to the address listed below or fax it to 515-365-1520 NEA Insurance Operations P. O. Box 9389 Des Moines IA 50306-9389 Please refer to your last premium notice or your Schedule of Benefits for your certificate number. All changes will be effective the first of the month following the receipt of your...
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How to fill out NEA LifeADD Insurance Plans Non-Smoker Declaration

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How to fill out NEA Life/AD&D Insurance Plans Non-Smoker Declaration

01
Obtain the NEA Life/AD&D Insurance Plans Non-Smoker Declaration form.
02
Read the instructions included with the form carefully.
03
Fill in your personal information, including your name, address, and contact details.
04
Indicate whether you have not used tobacco products in the last 12 months.
05
If applicable, provide details about your smoking history.
06
Sign and date the declaration to attest to the accuracy of the information provided.
07
Submit the completed form to the designated address mentioned in the instructions.

Who needs NEA Life/AD&D Insurance Plans Non-Smoker Declaration?

01
Individuals applying for NEA Life/AD&D Insurance who want to qualify for non-smoker rates.
02
Current policyholders who have stopped using tobacco products and want to update their status.
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People Also Ask about

A term insurance applicant is categorized as a smoker if he/she has consumed tobacco in any form in the last 12 months. Compared to a non-smoker, the term insurance premiums for a person who smokes can be almost 30%-40% higher.
If you report inaccurate or false information about your tobacco use on an application, an insurer is allowed to retroactively impose the tobacco surcharge to the beginning of the plan year. However, the insurer is not allowed to cancel your coverage because of the false or incorrect information.
Generally if you haven't smoked for 12 months or more, you're considered a non-smoker. The non-smoking time length rules vary among insurance companies.
NEA® Accidental Death & Dismemberment Insurance Plan Accidental Death & Dismemberment insurance, issued by The Prudential Insurance Company of America, helps protect you and your loved ones in the event of a major accident. Coverage is guaranteed, and no medical exams are needed.
I declare that: I have not smoked tobacco or any other substances, and/or used smoking alternatives, for example: e-cigarettes, vaping, nicotine gum or patches, within the previous 12 months and I have no intention of restarting.
NEA Group Term Life coverage is portable. As long as you remain an NEA member and continue to pay your premiums when they are due, your coverage will remain in effect even if you change schools or retire.
The only way to access more affordable life insurance for smokers is to quit smoking. To qualify for the best non-smoker rates, you can't use tobacco at all. Even after you quit, you'll likely need to wait 1-2 years before you qualify for non-smoking rates.
Trusted life insurance protection for new NEA members and their families. Questions? Call 1-855-632-5433. Monday-Friday 8 a.m. – 8 p.m. ET and Saturday 9 a.m. – 1 p.m. ET.

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The NEA Life/AD&D Insurance Plans Non-Smoker Declaration is a document that individuals must complete to confirm their non-smoking status when applying for insurance coverage, which may affect premium rates and eligibility.
Individuals applying for the NEA Life/AD&D Insurance Plans who classify themselves as non-smokers are required to file the Non-Smoker Declaration.
To fill out the Non-Smoker Declaration, applicants need to provide their personal information, confirm their non-smoking status, and sign the declaration form to affirm the accuracy of their statement.
The purpose of the Non-Smoker Declaration is to assess risk and determine insurance premiums based on an individual's smoking status, as smokers often face higher premiums.
Applicants must report their name, date of birth, contact information, and confirm their non-smoking status, including the timeframe of their last tobacco use if applicable.
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