Genworth Long Term Care General Agents

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Name	Description	Category
Non Partnership Policies
LTC Application Part 1 of 4	Use for both the individual policy and the shared policy. Only 1 application per couple required. Get Required Forms Below	LTC
LTC HIPAA Form 2 0f 4	Required on all Long Term Care Applications
LTC Suitability 3 of 4	Required on all Long Term Care Applications
LTC Rate Change 4 of 4	Required on all Long Term Care Applications
Partnership Policies
LTC NY Partnership App Part 1 of 5	New York Partnership Plan Get Required Forms Below Also Requires Correct Consumer Participation Agreement (CPA)	LTC
LTC HIPAA 2 of 5	Required on all Long Term Care Applications	LTC
LTC Suitability 3 of 5	Required on all Long Term Care Applications
LTC Rate Change 4 of 5	Required on all Long Term Care Applications
Select one from below
CPA - Dollar for Dollar 50	Consumer Participation Agreement	LTC
CPA - Dollar for Dollar 100	Consumer Participation Agreement	LTC
CPA - Total Asset 50	Consumer Participation Agreement	LTC
CPA - Total Asset 100	Consumer Participation Agreement	LTC
Annuity Applications
SecureLiving Independence	Annuity Application	Annuity
SecureLiving SmartRate	Annuity Application	Annuity
SecureLiving Stable 5	Annuity Application	Annuity

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Genworth Life and Long Term Care General Agents

Access Brokerage Services	14 Roosevelt Avenue Port Jefferson Sta., NY 11776 (631) 473-7244
"Access to Life Products, Access to Quality Service, Access to Top Compensation"	info@accessbrkg.com