1. Preferred Underwriting Milner Internal Training Session

2. HTN- Definition Hypertension, or high blood pressure, is a condition commonly associated with narrowing of the arteries. This causes blood to be pumped with excessive force against the artery walls. It is a sign that the heart and blood vessels are being overworked.blood pressurearteries

3. HTN- Effects Untreated, hypertension will cause the heart to eventually overwork itself to the point where serious damage can occur. For instance, the heart muscle can thicken (hypertrophy) and function abnormally, or dilate and constrict less forcefully (dilated cardiomyopathy). There may also be injury to the brain, the eyes (retinopathy) and/or the kidneys (nephropathy). Hypertensive patients are also at increased risk of heart disease and stroke. Most cases of high blood pressure have no cure, but the overwhelming majority can be managed and controlled with diet and medication.hypertrophydilated cardiomyopathykidneysheart diseasestroke

4. HTN- Prevalence Hypertension is a major health problem in the United States, where more than 50 million people (1 in 4 adults) have the condition, according to the American Heart Association.

5. Underwriting Blood Pressure To determine the rating, the underwriter adds up and then averages all the BP readings for the last two years Taking HTN medications automatically eliminates you from the best category for all companies except Banner.

6. Family History Disease vs. Death Cardiovascular and Cancer - Most companies count strokes as cardiovascular disease while others do not Good Company Niches - FC will allow a client whose parent died of a stroke before age 60 into their Preferred Best category. - AIG only counts parents’ histories of CAD - Kemper counts family history of ovarian or breast cancer only for women and a family history of prostate cancer for men only Bad Company Niches - Banner- a parent’s death from CAD or cancer before age 60 puts a client down to Standard - ING- requires no family history of CAD or cancer before age 70 to get their best class

7. Tobacco Use Cigarette Use –Bad with Quitters It takes 3 years of being quit to get NT rates with ING, Zurich and FPENN –Good with Quitters It only takes 1 year of being quit to get up to PNT with PRU, WCL, GEN AM and Mass M Alternate Tobacco Use (use the cheat sheet)

8. Lipids Triglycerides –Fat floating in your blood used for energy Total Cholesterol LDL (low density lipoprotein) –Increases the risk of a heart disease HDL (high density lipoprotein) –Decreases the risk of a heart disease Chol/HDL ratio –The lower the ratio then the lower the risk for heart disease

10. Driving History Auto accidents are the leading cause of death in younger people. Drinking and excessive speed are the major contributors to driving fatalities. When there is bad driving history factors like age, lifestyle, job stability, financial status and alcohol/drug use can affect the rating. Most companies require a flat extra after a DUI, but some (like United of Omaha) allow one DUI with a good explanation about why it happened for Standard NT.

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12. Who is Fat?

13. Fat Kills Almost 300,000 deaths a year in the US are linked to excess weight. Additionally, the percentage of overweight and obese Americans has increased steadily over the last 25 years. People who are obese have almost three times the risk for heart disease as people with normal weights Obesity is also associated with a higher risk for hypertension, strokes, diabetes, certain cancers (esophageal, intestinal, kidney, and prostate), sleep apnea, and certain respiratory problems More than 50% of all deaths in US adult women can be attributed to obesity.