Take a Quiz

Please finish this assessment and we can make a suitable recommendation and build you an insurance profile. In less than 15 minutes we can get you a better rate and more coverage.

Please enable JavaScript in your browser to complete this form.
What is your gender? Sex at Birth
Or call us at 1-800-975-2863. All we really need is your gender, current state of residency, full name, date of birth, phone number and email address and we can get back with you. However the more information you provide the better you can help us get you an accurate price point and a quote.
Or call us 1-800-975-2863. All we really need is your gender, current state of residency, full name, date of birth, phone number and email address and we can get back with you. However the more information you provide the better you can help us get you an accurate price point and a quote.
What is your name?
Or call us at 1-800-975-2863. All we really need is your gender, current state of residency, full name, date of birth, phone number and email address and we can get back with you. However the more information you provide the better you can help us get you an accurate price point and a quote.
What is your date of birth?
Or call us at 1-800-975-2863. Life insurance is largely based upon age so this will help us get the most accurate price point.
Or call us at 1-800-975-2863. We will call you every once in a while but promise not to bombard you with phone calls.
Or call us 1-800-975-2863. To send you a quote, follow up or do a policy review we have better things to be doing than spamming you all day.
Or call us at 1-800-975-2863. If does not apply leave blank.
Do you have any existing life insurance or annuity contracts?
Do you currently have any policies or get coverage through your employers? Always review your policies or call us at 1-800-975-2863.
Or call us at 1-800-975-2863. You have come to the right place we have helped thousands of clients, individuals, families and businesses find the right policy at a reasonable price point. We can do a much better job than your current agent/ company or no deal. If does not apply or not sure leave blank or type N/A.
What are you intentions with your existing life insurance or annuity contract? Please select all that apply
Or call us at 1-800-975-2863. If does not apply leave blank.
Or call us at 1-800-975-2863. You have come to the right place we have helped thousands of clients, individuals, families and businesses find the right policy at a reasonable price point. We can do a much better job than your current agent/ company or no deal. If does not apply leave blank or type N/A.
Are you currently employed?
Or call us at 1-800-975-2863. If does not apply leave blank.
Or call us at 1-800-975-2863. Once you retire or leave your employer there is a good chance you will lose coverage if you have a policy through your work. If does not apply leave blank or type N/A.
Do you currently have a retirement account? Participate in a retirement plan at work/ previous employer?
Or Call 1-800-975-2863. If does not apply leave blank or select no option.
Savings and investments such as 401k, IRA etc. Or call us at 1-800-975-2863. If does not apply leave blank.
Or call us at 1-800-975-2863. The average retirement age in the United States is age 65 for men and 62 for women according to Forbes.
Have you used tobacco products within the last 12 months?
Or call us at 1-800-975-2863. We are looking for regular usage not occasional.
Are you currently married? Do you have anyone who is dependent on the income that you or your spouse are bringing in?
Or call us at 1-800-975-2863. You can select both options if the answers are different. If does not apply leave blank.
You may also include your spouse or overall household income. Or call us at 1-800-975-2863. If does not apply leave blank or type N/A.
Selected Value: 0
Or your spouse. You can call us at 1-800-975-2863. Slide the scale from 1 to 30 years timeframe. If does not apply please leave blank.
This could be just for you or your overall total household/ family expenses. Or call us at 1-800-975-2863. If does not apply leave blank or type N/A.
This could be just for you or your overall total household. This would include mortgage, student loan, credit card, medical, auto loans, personal debt, unpaid bills, investment and business liabilities etc. Or call us at 1-800-975-2863. If does not apply leave blank or type N/A.
Height
Or call us at 1-800-975-2863. If does not apply leave blank.
Or call us at 1-800-975-2863. If does not apply leave blank.
How likely are you to purchase life insurance or an annuity from us?
Not at all Likely Extremely Likely
Or call us at 1-800-975-2863. ‘Nothing is certain except death and taxes’ – Benjamin Franklin, 1789
What type of coverage or plan would you be looking for? Please Select all that apply.
Or call us at 1-800-975-2863. Please do not purchase a policy from anyone else until you have had an opportunity to speak with us. Remember that having something is better than having nothing. If does not apply leave blank.
Why are you looking for life insurance? Please select all that apply
Or call us at 1-800-975-2863. Please do not purchase a policy from anyone else until you have had an opportunity to speak with us. Remember that having something is better than having nothing. If does not apply leave blank.
How much are you comfortable spending on life insurance or what do you feel is an appropriate premium?
Or call us at 1-800-975-2863. We can work around this budget. Do not begin drafting your first months premium until you get a policy in the mail, have had a chance to properly look at it and make sure you understand and are satisfied. Remember that having something is better than having nothing. If does not apply leave blank.
How much are you comfortable putting towards an annuity?
Or call us at 1-800-975-2863 and we can help you calculate your retirement income needs. Round to the nearest amount. If does not apply leave blank.
Would you like to replace your current coverage/ rollover your existing account/ purchase a new policy?
How are your accounts performing❓ Are you receiving the maximum possible benefit? Always review your policies or call us at 1-800-975-2863.
When would you like your income payments to begin?
Or call us at 1-800-975-2863 and we can help you calculate your retirement needs. If does not apply leave blank.
Would you say you are in good health?
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Or call us at 1-800-975-2863. We will work with underwriting to get you the best rating class possible and in most cases you do not need a medical exam. If does not apply leave blank.
Do you have any major health conditions that we need to be concerned about? Select all that apply
Or call us at 1-800-975-2863. We will work with underwriting to get you the best rating class possible and in many cases you do not need a medical exam. If does not apply leave blank or type N/A.
Or call us at 1-800-975-2863. You may enter your health conditions and the names of the medication you take, dosage and frequency but not necessary at this point. If does not apply leave blank or type N/A.
Are you satisfied with your current company and agent?
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Or call us at 1-800-975-2863. We can do a much better job than your current agent/ company or no deal. If does not apply leave blank.
Or call us at 1-800-975-2863. You have come to the right place we have helped thousands of clients, individuals, families and businesses find the right policy at a reasonable price point. We can do a much better job than your current agent/ company or no deal. If does not apply leave blank or type N/A.
How likely are you to recommend our products/ services?
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Or call us at 1-800-975-2863. We can do a much better job than your current agent/ company or no deal. If does not apply leave blank.
Save and Resume Later