Select A Product
SBLI SuperTerm 10:
Premiums are guaranteed and locked in for 10 years.
SBLI SuperTerm 15:
Premiums are guaranteed and locked in for 15 years.
SBLI SuperTerm 20:
Premiums are guaranteed and locked in for 20 years.
SBLI SuperTerm 25:
Premiums are guaranteed and locked in for 25 years.
SBLI SuperTerm 30:
Premiums are guaranteed and locked in for 30 years.
Residency
Are you a resident of Connecticut?
Yes
No
Amount of Coverage
Choose amount of insurance desired
$100,000
$150,000
$200,000
$250,000
$300,000
$350,000
$400,000
$450,000
$500,000
$550,000
$600,000
$650,000
$700,000
$750,000
$800,000
$850,000
$900,000
$950,000
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
-or-
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Rate Information
Name:
(optional)
Gender:
Male
Female
Date of Birth:
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
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25
26
27
28
29
30
31
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
Tobacco use:
When was the last time you used Tobacco products:
never
2 years or longer
Less than 1 year
3 years or longer
More than 1 year
5 years or longer
Risk Classification:
Please choose between standard or select
(Not sure? review
understanding risk classification.
)
Standard Tobacco
Non Smokers Only
Standard Non-Tobacco
Select
SelectPlus
UltraSelect