LifeSecure Agent Appointment

1. LifeSecure Agent Appointment For Agent Use Only. Not For Solicitation Purposes LS-0316 ST 10/08 LifeSecure Insurance Company – Brighton, MI Policy Series LS-0002

2. Step 1 Agent QUICK Appointment Quick Appointment Process • One page Appointment Process with proof of LTC CE at the time of Quick Appointment • Agent 6-digit writing number & access to Agent Portal • 180 days to submit 1st LTC application • Upon submission, full agent appointment package is required • Agent commissions may be delayed if full appointment paperwork is not received in a timely manner • Quick appointment is not available in the following state(s): NM & PA. Also not available when submitting a Worksite or Group/Association case For Agent Use Only. Not For Solicitation Purposes

3. Step 2 Agent FULL Appointment Agent Appointment Checklist • LifeSecure Agent Appointment Application • Commission Schedule “Exhibit 3” • Distribution Partner Hierarchy Form • LifeSecure Selling Agreement • ACH w/void check or deposit slip • Personal IRS W-9 Form • Assignment of Commissions Form, if applicable • Copy of ACTIVE insurance license(s) • Copy of LTC CE training & partnership training, according to state regulations For Agent Use Only. Not For Solicitation Purposes

4. Agent Appointment Application – Page 1 Agent Appointment Application • This is a 5 page document • There are questions requiring your response on pages 1, 2, 3 & 5 • Here on page 1 your MGA/Distribution Partner may pre-fill their information For Agent Use Only. Not For Solicitation Purposes

5. Agent Appointment Application – Page 2 Agent Appointment Application • On page 2 please be sure to complete the “Licensing Information” section • You may be appointed in up to 3 states at initial appointment • Copies of ACTIVE insurance licenses are required for each state • New states may be added with the submission of business and a copy of an active insurance license in that state, plus the state required LTC CE training/ partnership training For Agent Use Only. Not For Solicitation Purposes

6. Agent Appointment Application – Page 3 Agent Appointment Application • On page 3 please be sure to complete the “General Information” section For Agent Use Only. Not For Solicitation Purposes

7. Agent Appointment Application – Page 5 Agent Appointment Checklist • Page 5 requires the agent’s signature For Agent Use Only. Not For Solicitation Purposes

8. Agent Commission Schedule Agent Commission Schedule • Provides selling agent commission information • Please note: the different commission levels based upon applicant age, premium payment method and client type – Individual vs. Multi-Life clients • States can have specific guidelines For Agent Use Only. Not For Solicitation Purposes

9. Distribution Partner Hierarchy Form Distribution Partner Hierarchy • Provides Distribution Partner organization hierarchy information • This form and information is provided by your distribution partner and is used to place you (the writing agent) within the organization hierarchy For Agent Use Only. Not For Solicitation Purposes

10. LifeSecure Agent Selling Agreement – Page 1 LifeSecure Selling Agreement • The selling agreement is 13 pages in length. The selling agreement outlines the obligations and responsibilities of both the agent and LifeSecure • Agents must provide information on pages 1 and 8 • Here on page 1 agents must provide their personal information, not agency information For Agent Use Only. Not For Solicitation Purposes

11. LifeSecure Agent Selling Agreement – Page 8 Agent Selling Agreement • Page 8 requires the agent’s signature For Agent Use Only. Not For Solicitation Purposes

12. ACH – Direct Deposit Form ACH – Direct Deposit Form • LifeSecure pays ALL commissions via electronic fund transfer (EFT) • Please attach a copy of a void check or bank account deposit slip. This is only used to verify routing and account numbers For Agent Use Only. Not For Solicitation Purposes

13. W-9 Form W-9 FORM • The W-9 form is 3 pages in length and requires responses on pages 1 & 3 • The W-9 form must be completed by ALL agents, including those agents requesting assignment of their commissions, but remain eligible for the LifeSecure Rewards Program and contests! For Agent Use Only. Not For Solicitation Purposes

14. Assignment of Commissions Form Assignment of Commissions • The “Assignment of Commissions” form is required only when an agent is requesting to assign their commissions to another person or entity. • The “Assignor” is the Agent and the “Assignee” is the person or entity the agent is assigning their commissions to. For Agent Use Only. Not For Solicitation Purposes

15. LifeSecure Appointment Process Review! QUICK Agent Appointment Process • One page Appointment Process with proof of LTC CE at the time of Quick Appointment • Agent 6-digit writing number & access to Agent Portal within 48 hours • 180 days to submit 1st LTC application • Upon submission, a full agent appointment package is required • Commissions may be delayed if full appointment paperwork is not received • Quick appointment is not available in the following state(s): NM & PA FULL Agent Appointment Checklist • LifeSecure Agent Appointment Application • Commission Schedule “Exhibit 3” • Distribution Partner Hierarchy Form • LifeSecure Selling Agreement • ACH w/void check or deposit slip • Personal IRS W-9 Form • Assignment of Commissions Form, if applicable • Copy of ACTIVE insurance license(s) • Copy of LTC CE training/Partnership training, as required by state For Agent Use Only. Not For Solicitation Purposes

16. LifeSecure Agent Compliance Manual For Agent Use Only. Not For Solicitation Purposes

17. Questions? Please contact your Agent Support Call Center between the hours of 8:30 AM and 6:00 PM (EST) Toll free: (866) 582-7701 OR (810) 220-8770 For Agent Use Only. Not For Solicitation Purposes