Leveraging the health of the internal medicine profession
Physician-exclusive life insurance rates for you and your spouse.
10-Year Level Term Life Insurance for Internists
Underwritten by New York Life Company
Term life insurance that you can depend on for premiums that will not go up for a full 10 years!
Group Life Insurance at Exclusive ACP Rates
Consider Your Personal Risk
How confidently could you rely on your employer’s life insurance coverage alone? Regardless of your employment status, do you have sufficient coverage to help protect your quality of life or your family’s current lifestyle if something were to happen to you?
ACP Member Insurance Program was created to help ensure members have access to an exclusively priced additional safety net as you advance through your career and life. When you purchase your own coverage, it’s portable, so it stays with you should you change jobs and as you advance through your career and life.
10 Year Level Term Life Insurance
- Benefits up to $2,000,000.
- Member exclusive rates.
- Accelerated death benefit for terminal illness.
- Can continue until age 75.
- Apply for your spouse.
- Accurate quotes.
- Professional service at no cost to our members.
* The current 20% premium credit is not guaranteed and is subject to change, however the 10-year Level Term Life Insurance coverage for ACP members has returned premium credits for several years.
All ACP Members, Associates, Medical Students, Physician Affiliates, Non-Physician Affiliates, Fellows and Masters under age 65, may request coverage for themselves, their lawful spouse under age 65 and all unmarried dependent children ages 15 days to 23 years (25 if a full-time student). In order to become insured, individuals must provide satisfactory evidence of insurability and pay the required premium.
A dependent, who is also a member, is eligible for either member or dependent coverage, but not both. If both the member and spouse are covered as members, neither may insure the other as spouse and only one may insure any eligible children.
This coverage is available only for residents of the United States (except territories) and Puerto Rico.
Valuable Living Benefit Provision “Accelerated Death Benefit”
The “Accelerated Death Benefit” option is available to help terminally ill insureds during a difficult and often financially challenging time. Under this provision, you may request one advance payment equal to 50% of your (or an insured dependent’s) in force life insurance to be paid while the terminally ill person is still alive. The request must be made at least 12 months prior to the insured person’s scheduled coverage termination age and the amount of insurance payable after the insured’s death will be reduced by this payment. (Premium contributions will not be reduced.)
This money can be used to help cover high prescription drug costs, medical bills, outstanding debts, to help pay for experimental treatments, the cost of modifications to your home, or for a family vacation – the choice is yours.
To qualify, a terminally ill insured must provide New York Life Insurance Company with proof of terminal illness and anticipated life expectancy (12 months or less), as well as any other necessary medical information requested. For additional details and limitations, please see the Certificate of Insurance.
Please note that receipt of Accelerated Death Benefits may affect your eligibility for public assistance programs and may be taxable. Prior to applying to receive such benefits, you should consult with the appropriate social services agency and seek the advice of a qualified tax advisor.
Pay Less If You’re a Qualified Non–Smoker
Non–smokers meeting the highest underwriting standards may qualify for “Super-Preferred” (the best under this Policy) rates. Other nonsmokers may qualify for “Preferred” Non Smoker (higher, but still exclusively-priced) or “Non Smoker” rates. Smokers may only qualify for “Preferred Smoker” or “Smoker” rates.
Save with Volume Discounts on Higher Amounts of Insurance
If you or your spouse becomes insured for coverage amounts of $250,000 through $499,999, you’ll receive a volume discount. For amounts $500,000 through $999,000 of coverage, you’ll receive an even bigger discount; and a larger discount still for amounts of $1 million to $2 million.
Benefits are paid for death from any cause, at anytime, anywhere in the world except suicide within 24 months from the issue date. The only amount payable will be a return of applicable contributions.
The validity of any amount of your life insurance which has been in force for two years during an insured’s lifetime will not be contested except for insurance eligibility provisions and nonpayment of premium contributions.
Continuing Insurance After the 10–Year Term Ends
Premiums are guaranteed to remain level for the first 10 years of coverage. At the end of the 10–year period, you may reapply for 10–year level term rates then in effect for a subsequent 10–year period, provided the insured person is under age 65 and otherwise eligible. If your application for a subsequent 10–year term of guaranteed rates is approved, your premium contribution will be based on the insured person’s age, health and tobacco/nicotine use at the time the subsequent term becomes effective and will be guaranteed for a new 10–year period.
If you and your spouse are not approved for a subsequent 10–year term of guaranteed rates, or you do not apply for a subsequent 10–year term, coverage will continue in force on a non–guaranteed rate basis, under which premium contributions increase as the insured ages.
Apply for Up to $2,000,000 of Coverage
Choose the amount of Member 10–Year Level Term Life Insurance you need to help protect you and your family for the next 10 years without the worry of premiums that could go up or benefits that could go down.
Amounts of Insurance:
- Members —$100,000 up to $2,000,000 in $10,000 multiples.
- Spouse —$100,000 up to $2,000,000 in $10,000 multiples, not to exceed 100% of member’s coverage.
- Child(ren) — $5,000 each ($500 for eligible children under age six months).
The total amount of coverage an individual may have under all group life insurance policies underwritten by New York Life Insurance Company may not exceed $2,000,000. In addition, the total amount of coverage an individual may have under all policies issued by New York Life Insurance Company to the Trustees of the American College of Physicians, Inc. Insurance Trust may not exceed the maximum benefit option for any insured person.
You Name Your Beneficiary: Your beneficiary is the person(s) last designated by you in writing and recorded by or on behalf of New York Life Insurance Company. You may change this beneficiary designation at any time by written request. You are the automatic beneficiary for dependent insurance as described in the Certificate of Insurance. If you wish to name another beneficiary for spouse insurance, contact the Administrator for the applicable forms. You may select any person, persons, trust or other legal entity as your beneficiary. If, at the time of your death, there are no surviving beneficiaries, benefits will be paid to the executor or administrator of your estate, or at the option of New York Life, to the surviving relatives in the following order of survival: spouse; children equally; parents equally; or brothers and sisters equally.
Ownership of Insurance: “Owner” means the person or entity with rights of ownership of this insurance as described in the Certificate of Insurance. If a transfer of ownership has been recorded by or on behalf of New York Life, or if initial ownership is by other than the member according to the information provided on the application, references throughout this section to “you” or “member” will mean “owner” as applicable.
Effective Date: Insurance will take effect on the date your application is approved by New York Life Insurance Company provided the initial contribution is paid within 31 days after the date you are billed (send no money now) and any person to be insured is actively performing the normal activities of a person in good health of like age [NC residents: a person of like age] on the date of approval.
Any person who is not performing his/her normal daily activities as required will not become insured until the day he/she is performing such activities provided such date is within three months of the date insurance would have been effective, and the person is still eligible.
When Coverage Ends: Coverage will end when the insured person reaches age 75 (23 for children, 25 for children who are full-time students) or earlier if: (a) premium contributions are not paid when due, (b) ACP membership ends, (c) the group policy is terminated or modified by the Policyholder to end insurance for the group of insureds to which the member belongs, and (d) if the insured requests to terminate insurance. In addition, dependent coverage will terminate when your coverage ends, or when the dependent eligibility requirements are no longer being met. Upon your death, coverage for your insured dependents may continue as described in the Certificate of Insurance.
Renewal Payments And Claims: Once you are accepted you will have a 31–day grace period for your payment of renewal premium contributions. When you want to submit a claim, call or write the Administrator for claim forms.
Your Cost: To see the rate charts for this product, please visit the “Rates” tab and the Brochure PDF in the “Apply” tab.
The Policy features “Super-Preferred” and “Preferred” Non-Smoker Rates and you can benefit from volume discounts when you apply for higher amounts of insurance. Plus, send no money until you are approved.
The ACP Insurance Trust incurs costs in connection with this sponsored Program. To provide and maintain this valuable membership benefit, it is reimbursed for these costs.
P.O. Box 9947
Phoenix, AZ 85068-9952
A.G.I.A., Inc. is licensed/authorized to transact business in all 50 United States, and the District of Columbia. Their state of domicile is California. J. Christopher Burke CA Insurance License #0F709407. J. Christopher Burke AR Insurance License #8876308.
New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
Under Group Policy G-29103-0, on
Policy Form GMR/FACE/G-29103-0
New York Life is licensed/authorized to transact business in all 50 united states, District of Columbia, Puerto Rico and Canada. However, not all group policies it underwrites are available in all jurisdictions. Please check for current availability.
New York Life Insurance Company’s state of domicile is New York and their NAIC ID # is 55915.
Apply through our online portal today!
- Visit the link below to view the online application.
- Please complete all fields on the online form.
- Conveniently submit your application online.
Questions? Call ACP Member Insurance Program Customer Service Phone number at 1-855-749-7908.
If you do not wish to apply online, you may also download the application below, and mail in your completed application using the instructions below.
- Use the link below to download and print the form.
- Please complete all fields on the Application.
- Mail in your form to the ACP Member Insurance Program at PO Box 9947, Phoenix, AZ 85068
How New York Life Obtains Information and Underwrites Your Request For Group 10-Year Level Term Life Insurance
In this notice, references to “you” and “your” include any person proposed for insurance. Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualify for insurance , we will rely on the medical information you provide, and on the information you AUTHORIZE us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, LLC. (“MIB”). MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. If you apply for life or health insurance coverage, a claim for benefits is submitted to an MIB member company, medical or non- medical information may be given to MIB, and such information may then be furnished by MIB, upon request, to a member company.
Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application for insurance, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying New York Life in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.
MIB and other insurance companies may also furnish New York Life, its subsidiaries or the Plan Administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other applications for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.
New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing, however, this will not be done in connection with test results concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but we will not disclose our underwriting decision.
New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a “need to know” basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.
If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB’s information office is: MIB, LLC., 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 866- 692-6901. For Canadian residents, the address is: MIB Information Office, 330 University Avenue, Suite 501, Toronto, Ontario, Canada M5G 1R7, telephone 416-597-0590. Information for consumers about MIB may be obtained on its website at www.mib.com.
For NM Residents: PROTECTED PERSONS1 have a right of access to certain CONFIDENTIAL ABUSE INFORMATION2 we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.
1PROTECTED PERSON means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured person or prospective insured person.
2CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.
New York Life Insurance Company 7.15 ed.
How much life insurance do you need?
General rule of thumb, you need 5-10 times your annual income.
Your Annual Salary x 7 = Amount of Life Insurance You May Need.
30-Day FREE Look
When you become insured, you will be sent a Certificate of Insurance, summarizing your coverage. This website is only a brief description of some of the principal provisions and features. The complete terms are set forth in the group policy issued by New York Life Insurance Company to the Trustees of the American College of Physicians, Inc. Insurance Trust.
If you’re not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated, and you will be sent a full refund, no questions asked!
Questions? Call ACP Member Insurance Program Customer Service Phone number at 1-855-749-7908.
Underwritten by New York Life Insurance Company, 51 Madison Avenue, NY, NY 10010 under Policy Number G-29103-0 on Policy Form GMR-FACE/G-29103-0. Before applying, be sure to read through all tabs for more information on this coverage, including features, costs, eligibility, renewability, limitations, and exclusions.