OLI_LU_REQCODE

Title (OLI_LU_REQCODE)
Requirement Code

Definition
Code list used to specify the types of requirements.

Used By
InvoiceRequirementInfo (ReqCode)
LabTestResult (TestCode)
PreferredReqFulfiller (ReqCode)
RequirementInfo (ReqCode)
SpecialTestOrdered (TestCode)

Codes
DescriptionNameValueDefinitionNotes
1035 Exchange FormOLI_REQCODE_1035EXCFORM134
1035 Funds Amount FormOLI_REQCODE_1035AMTFORM706The form specifying a dollar amount that will be remitted on the exchanged policy.
2 App Packets RequiredOLI_REQCODE_TWOAPPPACK801When two policies have been ordered (and thus two application packets are required) but only one exam will be performed.
2 Urine Specimens Voided on Different DaysOLI_REQCODE_URINEX253
2 View Chest X-Ray, PA & LateralOLI_REQCODE_XRAYL94This is a 2 view X-ray including a posterior-anterior (PA) view and a lateral (side) view. PA means that the patient faces toward the film and away from the X-ray source.
Absolute AssignmentOLI_REQCODE_ABSASSIGN156Assignment by a policy owner of all control of and rights in the policy to a third party. An Absolute Assignment form is often required by ceding carriers for insurance policies.
Accelerated Death Benefit DisclosureOLI_REQCODE_ADTHBENEDISC170
Accident ReportOLI_REQCODE_ACCIDENT_RPT654In the case the claim is a result of an accident, details of the accident are needed.
Acknowledgement letterOLI_REQCODE_ACKNOWLEDGED927A brief letter stating that the request for benefits under a policy has been received.
Add'l Medical Info Needed from Attending PhysicianOLI_REQCODE_ADDLMEDICALINFO839Additional Medical Information needs to be provided via Attending Physician. This may also be referred to as an Attending Physician Statement (APS) Recheck.
Additional Chest X-RayOLI_REQCODE_CHESTXRAYRECHECK815This is a recheck of the Chest X-Ray. Recheck involves taking another set of X-rays rather than re-examining the original set. This is a 2 view X-ray including a posterior-anterior (PA) view and a lateral (side) view. PA means that the patient faces toward the film and away from the X-ray source.
Additional ECGOLI_REQCODE_ECGRECHECK814This is a recheck of the ECG. Recheck involves performing another test rather than re-examining the results of the original test.
Additional FormOLI_REQCODE_ADDLFORM902
Additional InformationOLI_REQCODE_ADDLINFO167Additional information is needed.
Additional Information from personal physicianOLI_REQCODE_INFOPERSPHY905
Additional Regulatory Jurisdiction FormOLI_REQCODE_ADDLREGFORM517See Requirement Details for jurisdiction form. In USA, the jurisdiction is the state.
Additional Underwriting ReviewOLI_REQCODE_ADDLUWREVIEW938Referred for review by senior underwriting staff.
Adoption AgreementOLI_REQCODE_ADPTAGR536Adoption Agreement is a copy of the court document that indicates the legal adoption of the specified children.
Agent's Covering LetterOLI_REQCODE_AGTCOVERLETTER837Letter from the agent providing client and/or application information related to insurability.This is normally associated with large dollar cases.
Agent AddressOLI_REQCODE_AGTADDR900
Agent StatementOLI_REQCODE_AGTSTMT152
AmendmentOLI_REQCODE_AMENDMENT126A change or addition to a legal document which, when properly endorsed, has the same legal power as the original document.
Analyze Additional Blood SampleOLI_REQCODE_BLOODRECHECKANA502
Analyze Additional Urine SpecimenOLI_REQCODE_URINERECHECKANA503May also be referred to as Home Office Specimen (HOS) recheck for specimen analysis.
Analyze Blood SampleOLI_REQCODE_BLOODANA498
Analyze Blood Sample- Mark for CBCOLI_REQCODE_BLOODCBCANA501
Analyze Dried Blood SpotOLI_REQCODE_DRIEDBLOODSPOTANA504
Analyze Glucose Tolerance TestOLI_REQCODE_GTTANA507
Analyze Hair SampleOLI_REQCODE_HAIRANA506
Analyze Oral Fluid (Saliva)OLI_REQCODE_ORALFLUIDANA505
Analyze Urine HIVOLI_REQCODE_URINEHIVANA500
Analyze Urine SpecimenOLI_REQCODE_URINEANA499May also be referred to as Home Office Specimen (HOS) analysis.
Anti Money-Laundering Training CertificationOLI_REQCODE_AMLCERT701Producer required training for Anti Money-Laundering. This is a new requirement due to a United States Treasury Department ruling requiring Anti Money-Laundering Training Certification effective May 2006.
Application ClarificationOLI_REQCODE_APPCLAR157Clarify information provided on the application.
Application Delivery ServiceOLI_REQCODE_APPDELSVC633Service to deliver Application (physical or imaging) to Carrier (or their designee). See RequirementDetails for any explicit instructions.
Application Packet Fulfillment ServiceOLI_REQCODE_APPFULSVC600Prepare application packet which may include printing of required forms (Part I and any additional required forms), assembly and shipping/delivery to Applicant. See RequirementDetails for any explicit instructions. This is NOT a Teleinterview, but production of necessary forms and delivery to applicant.
Application Packet Pickup ServiceOLI_REQCODE_APPPICKUPSVC635Service to pickup/retrieve application packet with witnessing of signatures and delivery to Carrier (physical or imaging). See RequirementDetails for any explicit instructions.
Application Quality Control ServiceOLI_REQCODE_APPQCSVC634Service to perform quality control for Carrier. See RequirementDetails for any explicit instructions.
Application Signed DateOLI_REQCODE_APPSIGNEDDATE862
Application Supplement (other)OLI_REQCODE_APPSUPOTH315
Application Supplement - LTC RiderOLI_REQCODE_LTCRIDERSUPP941This is the application supplement form specific to adding a Long Term Care (LTC) rider on a life insurance policy.
Appointment - Renewal FeeOLI_REQCODE_APPTRENFEE534Renewal fee needed as a requirement to complete the appointing process.
Approval from Reinsurance companyOLI_REQCODE_REINSAPPROVAL151
APS # 2 OrderOLI_REQCODE_APSORDERGA2181
APS # 3 OrderOLI_REQCODE_APSORDERGA3182
APS # 4 OrderOLI_REQCODE_APSORDERGA4183
APS # 5 OrderOLI_REQCODE_APSORDERGA5184
Articles of IncorporationOLI_REQCODE_INCORPORATION662These are the documents that were filed when the corporation was incorporated.
Assignment of Commission FormsOLI_REQCODE_ASSGNCOMM527
Attending Physician Statement (APS) ReimbursementOLI_REQCODE_APSREIMBURSEMT190
Authorization - Credit CheckOLI_REQCODE_AUTHCREDCRD142This is the requirement code to request the authorization to perform a credit check. The credit check itself may be requested separately using type code 334, Financial/Credit Check.Despite its mnemonic, this requirement code should not be used to request a Credit Card Authorization.
Authorization - Electronic AccessOLI_REQCODE_ELECTRONICACCAUTH945
Authorization - Electronic Funds TransferOLI_REQCODE_AUTHEFT140
Authorization - OtherOLI_REQCODE_AUTHOTHER143
Authorization - Payroll DeductionOLI_REQCODE_AUTHPAYROLL141
Authorization - Telephone RequestsOLI_REQCODE_AUTHTELEREQ946
Authorization to Exercise Ownership RightsOLI_REQCODE_AUTHOWNERRIGHTS947
Authorization to Share InformationOLI_REQCODE_AUTHSHARE859
Auto RebalancingOLI_REQCODE_AUTOREBAL642Use this form to automatically rebalance the funds or amounts in your Variable Investment Options.
Backdating AcknowledgementOLI_REQCODE_BACKDATINGACK1003Client acknowledgement of carrier backdating policy, whether or not it was requested.
Backdating Request FormOLI_REQCODE_BACKDATINGREQFORM948This is the client requesting the backdate to happen.
Background Check Authorization FormOLI_REQCODE_BCKGRNDAUTH514
Background Check ResultsOLI_REQCODE_BCKGRNDRESULT515
Bank Draft Authorization Card (Bank information)OLI_REQCODE_BANKDRFTAUTH220
Bankruptcy DetailsOLI_REQCODE_BANKRUPTCYDETAILS949
Beneficial Owner Certification FormOLI_REQCODE_BENEFICIALOWNER1021A form to obtain, verify, and record information for each individual owning 25% or more of the equity interests of a legal entity and who has management responsibility for the legal entity.
Beneficiary - Change ofOLI_REQCODE_BENEFCHANGE221
Beneficiary ClarificationOLI_REQCODE_BENEFCLARIF222
Beneficiary Form for Early Death BenefitOLI_REQCODE_BENEFITEARLYDEATH693This form is required at issue when the Early Death Benefit is elected for certain products with Joint last to die coverage.
Beneficiary Form - UTMAOLI_REQCODE_BENEFORMUTMA950UTMA is the Uniform Transfers to Minors Act.
Beneficiary InformationOLI_REQCODE_BENEFICIARYINFO1026A Beneficiary Information form is used to collect detailed information about each beneficiary on a contract.
Billing Control NumberOLI_REQCODE_BILLCTRLNUM314
Blood A/G RatioOLI_REQCODE_BLOODAGRATIO542A/G Ratio (Albumin/Globulin Ratio)
Blood AFPOLI_REQCODE_BLOODAFP572Blood AFP (Alpha Fetoprotein)
Blood AlbuminOLI_REQCODE_BLOODALBUMIN621Blood Albumin
Blood AlcoholOLI_REQCODE_BLOODALCHOHOL592Blood Alcohol
Blood Alkaline PhosphataseOLI_REQCODE_BLOODALKPHOS627Blood Alkaline Phosphatase
Blood AmphetamineOLI_REQCODE_BLOODAMPHETAMINE594Blood Amphetamine
Blood Analysis - AmylaseOLI_REQCODE_BLOODAMYLASE823Test measures the amount of Amylase in the blood. Useful For The Evaluation Of Pancreatic Function; To Diagnose And Manage Pancreatitis.
Blood Analysis - CBC w/ Hemoglobin & HematocritOLI_REQCODE_BLOODCBCH32
Blood Analysis - CBC with DifferentialOLI_REQCODE_BLOODCBCDF33
Blood Analysis - CKOLI_REQCODE_BLOODCK824Test measures the blood level of Creatine Kinase found in certain muscles and the brain. Used in the diagnostic work up of myocardial and skeletal muscular injury.
Blood Analysis - Fasting Blood SugarOLI_REQCODE_BLOODFBS36
Blood Analysis - Fingerstick MicrotainerOLI_REQCODE_BLOODFNGR37
Blood Analysis - for CholesterolOLI_REQCODE_BLOODCHOL34
Blood Analysis - for CreatinineOLI_REQCODE_BLOODCREA35
Blood Analysis - for GGTPOLI_REQCODE_BLOODGGTP38Blood Gamma-Glutamyl Transpeptidase (GGTP) test.
Blood Analysis - for HematocritOLI_REQCODE_BLOODHCT39
Blood Analysis - for Hemoglobin CountOLI_REQCODE_BLOODHCB40
Blood Analysis - for Hepatitis ScreensOLI_REQCODE_BLOODHPSC41
Blood Analysis - for Serum CreatinineOLI_REQCODE_BLOODSCREA42
Blood Analysis - for SGOTOLI_REQCODE_BLOODSGOT43
Blood Analysis - for SGPTOLI_REQCODE_BLOODSGPT44
Blood Analysis - SMA 12 Blood ProfileOLI_REQCODE_BLOODSMA1245
Blood Analysis - SMA 24 Blood ProfileOLI_REQCODE_BLOODSMA2446
Blood Analysis - Thyroid Profile TestOLI_REQCODE_BLOODTHYR48
Blood Analysis - TriglyceridesOLI_REQCODE_BLOODTRIG47
Blood Analysis - Vitamin B12OLI_REQCODE_BLOODVITAMINB12825Test measures the amount of Vitamin B12 in the blood. Used Primarily To Detect B12 Deficiency and as an aid in the diagnosis of Pernicious anemia; also used in the investigation of folic acid deficiency.
Blood Anti-HVCOLI_REQCODE_BLOODANTIHVC567Blood Anti-HVC (Hepatitis C)
Blood Apolipoprotein A1OLI_REQCODE_BLOODAPOLIPOPROTEINA1709test for the amount of Apolipoprotein A1 in a blood specimen
Blood Apolipoprotein BOLI_REQCODE_BLOODAPOLIPOPROTEINB710test for the amount of Apolipoprotein B in a blood specimen
Blood Apolipoprotein Ratio A1/BOLI_REQCODE_RATIOA1TOB711test for the ratio of Apolipoprotein A1 to B in a blood specimen
Blood BarbituratesOLI_REQCODE_BLOODBARBS611Blood Barbiturates
Blood Basophils %OLI_REQCODE_BLOODBASOPHILSPCT565Blood Basophils Percentage
Blood Basophils ABSOLI_REQCODE_BLOODBASOPHILSAB538Blood Basophils Absolute Count (ABS)
Blood BCGTOLI_REQCODE_BLOODBCGT571Blood BCGT (Beta Chorionicgonadotroph)
Blood BenzodiazepinesOLI_REQCODE_BLOODBENSODIAEPINES582Blood Benzodiazepines
Blood Beta-2 MicroglobulinOLI_REQCODE_BLOODB2MICGLOBULIN557Blood Beta-2 Microglobulin
Blood BUNOLI_REQCODE_BLOODBUN544Blood BUN (Blood Urea Nitrogen)
Blood CalciumOLI_REQCODE_BLOODCALCIUM540Blood Calcium
Blood Cardiac Relative RiskOLI_REQCODE_BLOODCRR766Calculation used to indicate risk of Coronary Artery Disease using a blood specimen.
Blood CBC BandsOLI_REQCODE_BLOODCBCBANDSPCT566Blood CBC Bands
Blood CDTOLI_REQCODE_BLOODCDTONLY546Blood CDT (Carbohydrate-Deficient Transferrin) not included as part of a Blood Profile A test for excessive alcohol consumption. Drinking 50 - 8- gm (4- 5 drinks) per day for several weeks may elevate the CDT in serum. CDT may also rise in biliary cirrhosis among other causes.
Blood CDTOLI_REQCODE_BLOODCDTDEP741A test for the amount of Carbohydrate Deficient Transferrin in a blood specimen Carbohydrate Deficient Transferrin (CDT) is a test for excessive alcohol consumption. Drinking 50 - 8- gm (4- 5 drinks) per day for several weeks may elevate the CDT in serum. CDT may also rise in biliary cirrhosis among other causes.
Blood CDT - QuantitativeOLI_REQCODE_BLOODCDTQ789a test for the amount of Carbohydrate Deficient Transferrin (CDT) in a blood specimen
Blood CEAOLI_REQCODE_BLOODCEA586Blood CEA (Carcinoembryonic Antigens)
Blood Cholesterol/HDL CholesterolOLI_REQCODE_BLOODCHOLHDL715test for the ratio of total Cholesterol to HDL-Cholesterol in a blood specimen
Blood Cocaine MetabolitesOLI_REQCODE_BLOODCOCAINE550Blood Cocaine Metabolites
Blood CotinineOLI_REQCODE_BLOODCOTININE549Test measures the amount of cotinine in the blood. Cotinine is associated with exposure to tobacco smoke and nicotine.
Blood cPSAOLI_REQCODE_BLOODCPSA618Blood cPSA (Prostate Specific Antigen, Complexed)
Blood CRPOLI_REQCODE_BLOODCRP765A test for levels of Blood C Reactive Protein in a blood specimen.
Blood Differential - Atypical LymphOLI_REQCODE_BLOODDIFFATYPICALLYMPH717This test identifies abnormal lymphocytes in a blood specimen.
Blood Differential - BlastOLI_REQCODE_BLOODDIFFBLAST718This test measures the number of Blasts in a blood specimen.
Blood Differential - MetamyelocyteOLI_REQCODE_BLOODDIFFMETACYTE719This test measures the number of Metamyelocytes in a blood specimen.
Blood Differential - MonocyteOLI_REQCODE_BLOODDIFFMONOCYTE720This test measures the number of Monocytes in a blood specimen.
Blood Differential - MyelocyteOLI_REQCODE_BLOODDIFFMELOCYTE721This test measures how many Melocytes are in a blood specimen.
Blood Differential - PromyelocyteOLI_REQCODE_BLOODDIFFPROMYELOCYTE722This test measures the number of Promyelocytes in a blood specimen.
Blood Direct BilirubinOLI_REQCODE_BLOODDIRECTBILIRUBIN612Blood Direct Bilirubin
Blood DrawOLI_REQCODE_BLOODDRAW356The client indicates what they want the paramed to obtain (blood, urine, saliva, etc). For a particular client, the agreement might be that they obtain a blood spot vs. a blood draw (vein). This is usually determined by other factors such as age, face amt. and possibly if certain conditions exist. For instance, if the person is 30 years old, doesn't smoke and has no pre-existing conditions, only a urine sample might be ordered, versus a urine and blood. Then the customer defines the lab requirements for each specimen being collected by the paramed. Basically, a requirements matrix is created showing what can be collected by the paramed and what lab tests will be performed on each specimen. For example, if theywant a blood draw, then they might indicate the following lab tests be performed: Blood (for Hepatitis Screen), Blood (for serum Creatinine), etc.
Blood Eosinophils %OLI_REQCODE_BLOODEOSINOPHILSPCT640Blood Eosinophils Percentage
Blood Eosinophils ABSOLI_REQCODE_BLOODEOSINOPHILSAB551Blood Eosinophils Absolute Count (ABS)
Blood FerritinOLI_REQCODE_BLOODFERRITIN545Blood Ferritin
Blood Free PSAOLI_REQCODE_BLOODFREEPSA570Blood Free PSA (Prostate Specific Antigens)
Blood Free PSA RatioOLI_REQCODE_BLOODFREEPSARATIO569Blood Free PSA (Prostate Specific Antigens) Ratio
Blood Free T3OLI_REQCODE_BLOODFREET3748A test for levels of Free T-3 in a blood specimen.
Blood Free Thyroxine IndexOLI_REQCODE_BLOODFREETHYROXINEIDX750A test to determine the Free Thyroxine Index in a blood specimen.
Blood FructosamineOLI_REQCODE_BLOODFRUCTOSAMINE558Blood Fructosamine
Blood FT4 - Free ThyroxineOLI_REQCODE_BLOODFT4744A test for Free Thyroxine in a blood specimen.
Blood GGTOLI_REQCODE_BLOODGGT636Blood Gamma Glutamyltransferase (GGT) test.
Blood Globulin - (Total Protein minus Albumin)OLI_REQCODE_BLOODGLOBULINTPMA714test for the amount of Globulin in a blood specimen
Blood GlucoseOLI_REQCODE_BLOODGLUCOSE713test for the amount of Glucose in a blood specimen
Blood Glucose - 1/2 HourOLI_REQCODE_BLOODGLUCOSEHALFHOUR553Blood Glucose - 1/2 Hour Fast
Blood Glucose - 2 HourOLI_REQCODE_BLOODGLUCOSE2HOUR552Blood Glucose - 2 Hour Fast
Blood Glycated ProteinOLI_REQCODE_BLOODGLYCATEDPROTEIN589Blood Glycated Protein
Blood GTT - 1.0 hour drawOLI_REQCODE_BLOODGTT1HRDRAW723A GTT where blood is drawn at 1.0 hour intervals
Blood GTT - 1.5 hour drawOLI_REQCODE_BLOODGTT15HRDRAW724A GTT where blood is drawn at 1.5 hour intervals
Blood GTT - 2.5 hour drawOLI_REQCODE_BLOODGTT2P5HRDRAW725A GTT where blood is drawn at 2.5 hour intervals
Blood GTT - 3.0 hour drawOLI_REQCODE_BLOODGTT3HRDRAW726A GTT where blood is drawn at 1.0 hour intervals
Blood HAAOLI_REQCODE_BLOODHAA740A test for the amount of Hemoglobin Associated Acetaldehyde in a blood specimen.
Blood HBeAbOLI_REQCODE_BLOODHBEAB638Blood Hepatitis B E-Antibody
Blood HBeAgOLI_REQCODE_BLOODHBEAG539Blood Hepatitis B E-Antigen
Blood HBsAgOLI_REQCODE_BLOODHBSAG568Blood Hepatitis B Surface Antigen
Blood HDLOLI_REQCODE_BLOODHDL543Blood HDL (High Density Lipoprotein)
Blood Hepatitis 5-1-1p/c100p BandOLI_REQCODE_BLOODHEP511PC100PBAND756a test to detect Hepatitis 5-1-1p/c100p in a blood specimen.
Blood Hepatitis AOLI_REQCODE_BLOODHEPA754a test for Hepatitis A in a blood specimen
Blood Hepatitis A IgMOLI_REQCODE_BLOODHEPAIGM755A test for Hepatitis A Immunoglobulin M (IgM) antibodies in a blood specimen.
Blood Hepatitis B Core AntibodyOLI_REQCODE_BLOODHEPBCOREANTIBODY752a test for the Hepatitis B Core Antibody in a blood specimen
Blood Hepatitis B Surface AntibodyOLI_REQCODE_BLOODHEPBSURFANTIBODY751A test for the Hepatitis B Surface Antibody in a blood specimen.
Blood Hepatitis c22p BandOLI_REQCODE_BLOODHEPC22PBAND761A test for the presence of Hepatitis c22p in a blood specimen.
Blood Hepatitis c33c BandOLI_REQCODE_BLOODHEPC33CBAND757a test to detect Hepatitis c33c in a blood specimen.
Blood Hepatitis Core IgMOLI_REQCODE_BLOODHEPCOREIGM753a test for the Hepatitis Core IgM in a blood specimen
Blood Hepatitis hSOD BandOLI_REQCODE_BLOODHEPHSODBAND763A test for the presence of Hepatitis human Superoxide Dismutase (hSOD) in a blood specimen.
Blood Hepatitis NS5 BandOLI_REQCODE_BLOODNS5PBAND762A test for the presence of Hepatitis NS5 in a blood specimen.
Blood HomocysteineOLI_REQCODE_BLOODHOMOCYSTEINE590Blood Homocysteine
Blood Indirect BilirubinOLI_REQCODE_BLOODINDIRECTBILIRUBIN624Blood Indirect Bilirubin
Blood IronOLI_REQCODE_BLOODIRON541Blood Iron
Blood LDHOLI_REQCODE_BLOODLDH620Blood LDH (Lactate Dehydrogenase)
Blood LDL/HDL RatioOLI_REQCODE_BLOODLHLHDLRATIO548Blood LDL/HDL Ratio
Blood LDL CholesterolOLI_REQCODE_BLOODLDLCHOL716test for the amount of Low Density Lipoprotein (LDL) Cholesterol in a blood specimen
Blood Lymphocytes %OLI_REQCODE_BLOODLYMPHOCYTESPCT554Blood Lymphocytes Percentage
Blood Lymphocytes ABSOLI_REQCODE_BLOODLYMPHOCYTESAB555Blood Lymphocytes Absolute Count (ABS)
Blood MarijuanaOLI_REQCODE_BLOODMARIJUANA597Blood Marijuana Metabolites
Blood MCHOLI_REQCODE_BLOODMCH625Blood MCH (Mean Corpuscular Hemoglobin)
Blood MCHCOLI_REQCODE_BLOODMCHC588Blood MCHC (Mean Corpuscular Hemoglobin Concentration)
Blood MethadoneOLI_REQCODE_BLOODMETHADONE581Blood Methadone
Blood MethaqualoneOLI_REQCODE_BLOODMETHAQUALONE580Blood Methaqualone
Blood Monocytes ABSOLI_REQCODE_BLOODMONOCYTESABS616Blood Monocytes Absolute Count (ABS)
Blood MVCOLI_REQCODE_BLOODMVC575Blood MVC (Mean Corpuscular Volume)
Blood Neutrophils %OLI_REQCODE_BLOODNEUTROPHILSPCT613Blood Neutrophils Percentage
Blood OpiatesOLI_REQCODE_BLOODOPIATES596Blood Opiates
Blood PCPOLI_REQCODE_BLOODPCP595Blood Phencyclidine
Blood PhosphorusOLI_REQCODE_BLOODPHOSHORUS573Blood Phosphorus
Blood PlateletsOLI_REQCODE_BLOODPLATELETS560Blood Platelets
Blood Pressure ReadingOLI_REQCODE_BLOODPRESS12Request for an initial blood pressure reading.
Blood Pressure Reading 2OLI_REQCODE_BPREADING2826Blood pressure reading second time point
Blood Pressure Reading 3OLI_REQCODE_BPREADING3827Blood pressure reading third time point
Blood ProBNPOLI_REQCODE_BLOODPROBNP712A test for ProBNP in a blood specimen.
Blood Profile (for HIV)OLI_REQCODE_BLOODHIV3Request to analyze blood for HIV
Blood Profile (Glycohemoglobin) - for testing diabetesOLI_REQCODE_BLOODDIAB4Request to analyze blood for Glycohemoglobin. Also called HbA1c.
Blood Profile & Urine SpecimenOLI_REQCODE_BLOODURINE1Collect and analyze blood and urine specimens
Blood Profile recheckOLI_REQCODE_BLOODRECHECK329
Blood Profile with CDTOLI_REQCODE_BLOODCDT322Blood Profile with CDT (Carbohydrate-Deficient Transferrin)
Blood Profile with Drug ScreenOLI_REQCODE_BLOODDRUG323
Blood profile with Hepatitis B ScreenOLI_REQCODE_BLOODHEPBSCRN321
Blood Profile with PSA screenOLI_REQCODE_BLOODPSA324
Blood PropoxypheneOLI_REQCODE_BLOODPROPOXYPHENE593Blood Propoxyphene Metabolites
Blood PSAOLI_REQCODE_BLOODEQPSA739A test for the Prostate Specific Antigen in a blood specimen where equal molar concentrations of free PSA and PSA-ACT are measured equivalently
Blood RBCOLI_REQCODE_BLOODRBC614Blood RBC (Red Blood Count)
Blood Segmented NeutrophilsOLI_REQCODE_BLOODSEGNEUT559Blood Segmented Neutrophils
Blood Serum FibronogenOLI_REQCODE_BLOODSERUMFIBRINOGEN609Blood Serum Fibronogen
Blood Serum HemolysisOLI_REQCODE_BLOODSERUMHEMOLYSIS608Blood Serum Hemolysis
Blood Serum HIV IFAOLI_REQCODE_BLOODSERUMHIVIFA742an IFA test for the presence of antibodies to HIV-1 in a blood specimen
Blood Serum HIV InterpretationOLI_REQCODE_BLOODSERUMHIVINT731A test for HIV in a blood specimen.
Blood Serum IndexOLI_REQCODE_BLOODSERUMINDEX637Blood Serum Index
Blood Serum LipemiaOLI_REQCODE_BLOODSERUMLIPEMIA610Blood Serum Lipemia
Blood T-3 TotalOLI_REQCODE_BLOODT3TOTAL745A test for T3 in a blood specimen.
Blood T-3 UptakeOLI_REQCODE_BLOODT3UPTAKE747A test for levels of T-3 Uptake in a blood specimen.
Blood T4 - ThyroxineOLI_REQCODE_BLOODT4749A test for levels of Thyroxine in a blood specimen.
Blood T-Cell: %T-4OLI_REQCODE_BLOODTCELLPERCENTT4732A test that detects the percent of T-4 cells in a blood specimen
Blood T-Cell: %T-8OLI_REQCODE_BLOODTCELLPERCENTT8733A test that detects the percent of T-8 cells in a blood specimen
Blood T-Cell: Absolute Lymph T4OLI_REQCODE_BLOODTCELLABSLYMPHT4735A test that detects the number of T-4 cells in a blood specimen
Blood T-Cell: Absolute Lymph T8OLI_REQCODE_BLOODTCELLABSLYMPHT8736A test that detects the number of T-8 cells in a blood specimen
Blood T-Cell: I-3 Positive Suppressors (T8)OLI_REQCODE_BLOODTCELLI3POSSUPPT8738A test to detect positive suppressors of HIV in a blood specimen
Blood T-Cell: T-4/T-8 RatioOLI_REQCODE_BLOODTCELLT4T8RATIO737A test that detects the ratio of T-4 to T-8 cells in a blood specimen
Blood T-Cell: Total WBCOLI_REQCODE_BLOODTCELLTOTALWBC734A test that provides the total t-cells in a blood specimen
Blood Total BilirubinOLI_REQCODE_BLOODTOTALBILIRUBIN626Blood Total Bilirubin
Blood Total ProteinOLI_REQCODE_BLOODPROTEIN622Blood Total Protein
Blood TSH - Thyroid Stimulating HormoneOLI_REQCODE_BLOODTSH746A test for Thyroid Stimulating Hormone in a blood specimen.
Blood Uric AcidOLI_REQCODE_BLOODURICACID628Perform a Uric Acid test on a blood sample.
Blood Very Low Density Lipid (VLDL)OLI_REQCODE_BLOODVREYLOWDENSLIPID743a test for VLDL in a blood specimen.
Blood WBCOLI_REQCODE_BLOODWBC556Blood White Blood Count
Body TemperatureOLI_REQCODE_TEMPERATURE828Temperature reading
Business ClarificationOLI_REQCODE_BUSINESSCLARIF345
Business Submission FormOLI_REQCODE_BUSSUBFORM223
Buy-Sell AgreementOLI_REQCODE_BUYSELLAGR224
Carrier FormOLI_REQCODE_CARRFORM531Specific carrier form should be described in RequirementDetails.
Carrier-specific supplemental info formOLI_REQCODE_SPPIF510Supplemental Producer's Personal Information Form (SPPIF)
Carrier-specific Tax Withholding FormOLI_REQCODE_TAXELECTIONFORM708This is a carrier specific form that is used to elect withholding options and to communicate information regarding backup withholding. It has no link to a specific IRS form, although it must be approved for use by the IRS.
Case Level Requirements DeterminationOLI_REQCODE_CASEREQDET632In an outsource Case Management agreement, this is the diagnosis of the necessary underwriting requirements at a case level.
Cash With Application FormOLI_REQCODE_CWA225
Catheterization ReportOLI_REQCODE_CATHRPT86Typically this information would be provided within the Attending Physician Statement (APS) report. This would only be used when an underwriter wants to request a service provider for a specific Cath Report.
Certificate of mailingOLI_REQCODE_CERTOFMAILING952
Certified Copy of Trust AgreementOLI_REQCODE_TRUSTAGREEMENT131
Change of Name FormOLI_REQCODE_CHGOFNAME901
Child Rider SupplementOLI_REQCODE_CHILDRIDERSUPP818A supplement form used to document additional information about the insured covered on a child rider.
Claimant InterviewOLI_REQCODE_CLAIMANTINTERVIEW659The interview with the claimant for the purposes of evaluating the claim.
Claim FormOLI_REQCODE_CLMFORM650Provides details regarding a claim.
Client identity verification, 2 out of 3 methodOLI_REQCODE_DUALID1013Verification of client identity by doing any two of the following (the "two out of three method"):* Referring to information from a reliable source containing the name and address of the person being identified and verifying that the name and address are those of the person.* Referring to information from a reliable source that contains the name and date of birth of the person being identified and verifying that the name and date of birth are those of the person.* Referring to information that contains the name of the person being identified and confirming that the individual has a deposit account or credit card or other loan account with a Canadian financial entity and verifying that information.In utilizing this "two out of three" method of identity verification, the Regulations require that the information that is referred to must be from different sources and that the person whose identity is being verified cannot be utilized as a source.
COD FormOLI_REQCODE_CODFORM953Collect premium on Delivery. COD is Cash On Delivery.
Cognitive EvaluationOLI_REQCODE_LTCCOGEVAL631Assessment of cognitive ability using tools such as Delayed Word Recall and Clock Draw.
Collateral Assignment FormOLI_REQCODE_COLLASSFORM228
Collateral Assignment Release FormOLI_REQCODE_COLLATERALRLSEFORM954
Collect Additional Blood SampleOLI_REQCODE_ADDBLOOD49
Collect Additional Urine SpecimenOLI_REQCODE_URINERECHECK50May also be referred to as Home Office Specimen (HOS) recheck for specimen collection.
Collect Blood SampleOLI_REQCODE_BLOOD2
Collect Blood Sample- Mark for CBCOLI_REQCODE_BLOODCBC31
Collect Dried Blood SpotOLI_REQCODE_DRIEDBLOODSPOT24
Collect Glucose Tolerance TestOLI_REQCODE_GTT91
Collect Hair SampleOLI_REQCODE_COLLHAIR629
Collect Oral Fluid (Saliva)OLI_REQCODE_ORALFLUID17
Collect Urine HIVOLI_REQCODE_URINEHIV327
Collect Urine SpecimenOLI_REQCODE_URINE5Paramedical service provider collects a urine sample from a proposed insured. Specimen is later sent to a lab for testing. May also be referred to as Home Office Specimen (HOS) collection.
Company DisclosureOLI_REQCODE_COMPANYDISCLSURE955
Comparison StatementOLI_REQCODE_COMPSTMT158
Compensation AgreementOLI_REQCODE_COMPAGREEMENT835Special compensation agreement associated with a specific insurance product.
Compensation DisclosureOLI_REQCODE_COMPENSATIONDISC956
Complete electronic interviewOLI_REQCODE_ELECINTERVIEW1022Client is required to complete a digital form of a questionnaire.
Complete QuestionnaireOLI_REQCODE_QUESTIONNAIRE497
Conduct Tele-InterviewOLI_REQCODE_TELEINTERVIEW137
Consent to accept delivery by an electronic methodOLI_REQCODE_EDELIVERYCONSENT1016Consent to accept delivery by an electronic method such as an email attachment, portal download, or other electronic means.
Consent to do Business ElectronicallyOLI_REQCODE_CONSENTBUSELECT957
Consumer Acknowledgement FormOLI_REQCODE_CONSUMACKFORM958
Consumer Disclosure GuideOLI_REQCODE_CONSDISC895
Contact Group AdministratorOLI_REQCODE_GRPADMIN931The policy owner must contact their Group / Plan Administrator. For example, some group pension administrators require the client to contact their plan administrator to initiate a proposed change to the policy (e.g. replacement, surrender, roll-over).
Continuing Education CertificationOLI_REQCODE_EDCERT529
Copy of E&O Declaration PageOLI_REQCODE_EODEC516E&O: Errors & Omissions Insurance
Copy of regulatory jurisdiction license - Non-ResidentOLI_REQCODE_COPYRJLICNONRES512
Copy of regulatory jurisdiction license - ResidentOLI_REQCODE_COPYRJLICRES511
Corporate DisclaimerOLI_REQCODE_CORPDISCLMR230
Corporate Financial StatementOLI_REQCODE_CORPFINSTATE231
Corporate ResolutionOLI_REQCODE_CORPRESOLUTN232A corporate resolution is a legal document defining which individuals are authorized to act on behalf of a corporation. For example, for replacement of funds, the Corporate Resolution is used by the ceding carrier to verify that the person who signed the replacement documents on behalf of the Issuing Carrier is an authorized officer of that organization.
Corporation SearchOLI_REQCODE_CORPSEARCH806Perform a search to verify the existence of a corporation.
Cost BasisOLI_REQCODE_COSTBASIS159Cost basis, also known as "tax basis", is the original monetary amount paid for shares of a security. When you sell or exchange shares of mutual funds or other securities, you may have a capital gain or loss that must be reported to the taxation authority (Internal Revenue Service (IRS) in the U.S.).The original value of an asset for tax purposes (usually the purchase price), adjusted for stock splits, dividends and return of capital distributions. This value is used to determine the capital gain, which is equal to the difference between the asset's cost basis and the current market value or sales price.
Credit/Debit Card AuthorizationOLI_REQCODE_CREDCARDAUTH702This is the authorization needed to allow for premium and other payments to be charged to a credit or debit card. In order to accept credit/debit card payments, it is necessary for the card holder to provide authorization for the card to be charged.
Credit Card Declined or InvalidOLI_REQCODE_CCDECLINE959Credit card was declined or rejected by issuer, producer action is required.
Criminal Records ReportOLI_REQCODE_REPORTCRIMINALRECORDS330This is a report of criminal records provided by a third party service provider.
Criminal Records Report Max coverageOLI_REQCODE_REPORTMAXCRIMINALRECORDS331
Customer Information SupplementOLI_REQCODE_CUSTSUPP1024The customer information supplement is used to collect additional information such as income, liquidity needs, investment objectives and experience, and other suitability-related details used to assess product suitability.
Daily Care NotesOLI_REQCODE_DAILYCARENOTES667A copy of the daily care notes taken on a patient to record the patients' treatment and progress
Data VerificationOLI_REQCODE_DVR564Analyzes applications to determine if the information an individual has given matches the public-access information about that person.
Date of BirthOLI_REQCODE_DATEOFBIRTH233
DBS - A1cOLI_REQCODE_DBSA1C784a test for the level of A1c Hemoglobin in a dried blood spot specimen
DBS CholesterolOLI_REQCODE_DBSCHOLESTEROL584Dried Blood Spot (DBS) Cholesterol
DBS - Cholesterol/HDL RatioOLI_REQCODE_DBSCHOLHDLRATIO782A test for the level of ratio of cholesterol to HDL in a dried blood spot specimen.
DBS CocaineOLI_REQCODE_DBSCOCAINE617A test for the amount of cocaine in a dried blood spot specimen
DBS - CocaineOLI_REQCODE_DBSCOCAINEDEP802A test for the amount of cocaine in a dried blood spot specimen
DBS CotinineOLI_REQCODE_DBSCOTININE619Test measures the amount of cotinine in the dried blood spot (DBS). Cotinine is associated with exposure to tobacco smoke and nicotine.
DBS GGTOLI_REQCODE_DBSGGT583Dried Blood Spot (DBS) Gamma Glutamyltransferase (GGT) test.
DBS - GlucoseOLI_REQCODE_DBSGLUCOSE783A test for the amount of Glucose in a dried blood spot specimen.
DBS - HDL CholesterolOLI_REQCODE_DBSHDLCHOL780a test for the level of High Density Lipoprotein (HDL) in a dried blood spot specimen
DBS HIV ScreenOLI_REQCODE_DBSHIV615DBS HIV Screen
DBS - TriglyceridesOLI_REQCODE_DBSTRIGLYC781a test for the level of Triglycerides in a dried blood spot specimen
Declaration Release Form for non-res applicantsOLI_REQCODE_NONRESFORM811Form used for situations where the owner and/or life insured on a new application are not residents of the country for which they are applying.
Definition of Life Insurance SelectionOLI_REQ_DEFNLIFEINS705Definition of Life Insurance Selection Form required
Details related to other pending applicationsOLI_REQCODE_OTHERPENDINGAPPDETL841Obtain details related to other pending applications. This is different from "Review of cases combined for administration" because there is no requirement that these applications be processed together.
Details to questionsOLI_REQCODE_DETAILS234
DiagnoseOLI_REQCODE_DIAGNOSE535Determine Requirement Services Needed.
Digital signatureOLI_REQCODE_DIGSIG519See Requirement Details for what Signature is required
Direct Deposit AuthorizationOLI_REQCODE_DDAUTH532
DisbursementOLI_REQCODE_DISBURSEMENT960
Disease ManagementOLI_REQCODE_DM917A process by which a Health Insurance Company identifies conditions in an insured person which might lead to substantial claims in the future. The company attempts to forestall these claims by working with the insured person to manage their condition proactively.
Divorce DecreeOLI_REQCODE_DIVORCEDECREE961
Doctor's Name and AddressOLI_REQCODE_DOCTORADDRS235Applies for attending physicians as well as other doctors involved in the process
Doctor's Phone NumberOLI_REQCODE_DOCTORPHONE236Applies for attending physicians as well as other doctors involved in the process
Doctor's Plan of TreatmentOLI_REQCODE_DRPLANTRT666The signed doctor's plan of treatment for a patient.
Dollar Cost Averaging FormOLI_REQCODE_DCAFORM707Dollar Cost Averaging Form Required
Domestic Partner AffidavitOLI_REQCODE_DOMESTICAFFIDAVIT962
Drivers License NumberOLI_REQCODE_DRIVERSLICNUMB237
Drug Urine TestOLI_REQCODE_DRUGURINE319Analyze urine for illegal substances.
E & O InsuranceOLI_REQCODE_EANDOINSUR238
Echocardiogram - RepeatOLI_REQCODE_ECHO288
EKG / ECG - Stress or Treadmill - with ThalliumOLI_REQCODE_EKGTHALLIUM679Perform Stress EKG with injection of a small amount of thallium (a radioactive substance). This is immediately followed by a scan of the heart to visualize areas of the heart that do not receive sufficient blood supply.
Electronically display/present documentOLI_REQCODE_DISPLAYSIG819Electronically present document for viewing to party indicated in AppliesToPartyID. No signature requirement is implied with this code. Use Requirement Code 810 to display and collect signature.
Electronically Sign DocumentsOLI_REQCODE_ESIGNDOCS810Signature is required on the document. Present and collect signature.
Electronic Health RecordOLI_REQCODE_EHR943Electronic Health Record (EHR), also known as an Electronic Medical Record (EMR), is a systematized collection of patient and population health information stored in a digital format. It may contain a broad collection of information such as demographic, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information. It is designed to represent patient health information over time.
Electronic Inspection ReportOLI_REQCODE_ELECINSPECTIONRPT1027Electronic Inspection report is a background report used by an Underwriting department to gain access to publicly available information about an applicant, such as criminal record, real property owned, bankruptcies, etc. Information provided in this report is often found on social media and other internet sources.
Electronic Package DeliveryOLI_REQCODE_ELECPKGDEL1015This code is used to track the overall status of a package of electronic delivery requirements such as electronic signatures. Delivery of the package is considered complete when all components have been completed.
Employee Benefit ReviewOLI_REQCODE_EMPBENREV877
Employer's StatementOLI_REQCODE_EMPLOYERSTMENT658A statement from the Employer regarding the insured's period of disability.
Employment InformationOLI_REQCODE_EMPLOYER964Provide information regarding party's employer and status
Enrollment CardsOLI_REQCODE_ENROLLCARDS239
E-Paramedical ExamOLI_REQCODE_EPARAMEDICAL944Paramed done on an electronic support device such as a tablet for capturing and transmitting results.
Evidence of AgeOLI_REQCODE_EVIDOFAGE240
Evidence of InsurabilityOLI_REQCODE_EVIDOFINSUR241
Examiner's Name and AddressOLI_REQCODE_EXAMINERNAMEADD906
Exchange Delivery ReceiptOLI_REQCODE_EXCHGDELRECPT242
ExclusionOLI_REQCODE_EXCLUSION879If the requirement is to clearly communicate an exclusion, use this code. Use amendment when the policy is being amended but it is unclear whether or not it is an exclusion.
Expensecomp SupplementOLI_REQCODE_EXPSUPP878
Experience Letter to another company (used in cases of 'churning', etc. as a notification).OLI_REQCODE_EXPLTR149
Extended Care Facility StatementOLI_REQCODE_EXTFACSTMENT661The statement from an extended care facility attesting to the dates of confinement.
FAA Records ReportOLI_REQCODE_REPORTFAA335
Face Amount RequestedOLI_REQCODE_FACEAMOUNT243
Face to Face Assessment for Long Term CareOLI_REQCODE_FACETOFACEASSESM495Includes Medical History but not a cognitive evaluation. Includes activities of daily living.To include a CE request LTC Cognitive Exam
Face to Face Cognitive AssessmentOLI_REQCODE_FACETOFACE795Face to face assessment of cognitive ability using tools such as Delayed Word Recall and Clock Draw.Usually performed on a senior citizen and sometimes referred to as a Senior Exam.
Face to Face Cognitive Assessment RecheckOLI_REQCODE_FACETOFACERECHECK913This is a recheck of the Face to Face Cognitive Assessment. This involves another assessment rather than reviewing the original assessment.
Face to Face Frailty AssessmentOLI_REQCODE_FRAILTY912Face to face assessment used to assess a person's frailty. It consists of a series of questions relating to ADLs (Activities of Daily Living), IADLs (Instrumental Activities of Daily Living), and/or AADLs (Advanced Activities of Daily Living). Usually performed on a senior citizen.
Face to Face Frailty Assessment RecheckOLI_REQCODE_FRAILTYRECHECK915Face to Face Frailty Assessment Recheck. This involves another assessment rather than reviewing the original assessment.
Face to Face Inspection plus Credit & Financial Report (billed hourly) - 10 year historyOLI_REQCODE_INSPECTION350Applicant is interviewed via telephone to collect information regarding the applicant's health, employment, finances, duties and habits. Also includes a credit report and an in-depth financial breakdown. Applicant is billed hourly.
Face to Face Mobility AssessmentOLI_REQCODE_MOBILITY911Assessment of a person's mobility using tools such as the The "get-up and go test". This test typically requires patients to stand up from a chair, walk a short distance, turn around, return, and sit down again. It is usually performed on a senior citizen.
Face to Face Mobility Assessment RecheckOLI_REQCODE_MOBILITYRECHECK914Face to Face Mobility Assessment Recheck. This involves another assessment rather than reviewing the original assessment.
Farmer's SupplementOLI_REQCODE_FARMER880
FATCA&CRS Decl of Tax Res / genericOLI_REQCODE_FATCACRSGEN1012FATCA & CRS Declaration of Tax Residency; Generic request for either individual or entity
FATCA US Person Exclusion ReasonOLI_REQCODE_FATCAREASON926Reason entity is not a specified U.S. person based on FATCA requirements.Asked if US Indicia, as defined by FATCA, is discovered during review.
Fees to be paidOLI_REQCODE_FEES898
Financial / Credit CheckOLI_REQCODE_CREDITCHECK334This is the requirement code to request the actual credit report. The authorization needed to perform the credit check may be requested separately using type code 142, Authorization - Credit Check.
Financial Report - Audited Business (accountant statements)OLI_REQCODE_FINRPTAUDBUS145
Financial Report - PersonalOLI_REQCODE_FINRPTPERS144
Financial Report - Unaudited Business (profit and loss statements)OLI_REQCODE_FINRPTUNAUDBUS146
Fingerprint cardOLI_REQCODE_FINGERCARD525
FINRA Registration RequiredOLI_REQCODE_NASDREGIST261
FINRA U4 (Reg Prods Only) App for Sec RegOLI_REQCODE_SECREG520FINRA U4 (Registered Products Only) Application for Securities Registration
FINRA U4 Sts Rpt (from CRD rpt) Sts curr Sec RegOLI_REQCODE_SECREGSTAT521FINRA U4 Status Report (from CRD report) Status of current Securities Registrations
FINRA U5 (Reg Prods Only) Term of prior Sec RegOLI_REQCODE_SECREGTERM522FINRA U5 (Registered Products Only) Termination of prior Securities Registration
Forced Expiratory Volume TestOLI_REQCODE_FEV89
Forced Expiry Volume Test - RepeatOLI_REQCODE_FEV290
Foreign Death AffidavitOLI_REQCODE_FOREIGNDTH652A official Report of the Death prepared by the foreign consul. A document which is prepared when a person dies outside of their Country. This is an official report that is prepared by the foreign consul and is sent to the official state department for permanent filing.
Formal PapersOLI_REQCODE_FORMLPAPERS244
Form ClarificationOLI_REQCODE_FORMCLAR903
Fund LiquidationOLI_REQCODE_FUNDLIQUIDATION929Owner must liquidate the funds. Some custodians required funds to be liquidated and available prior to the Transfer of Assets (TOA) paperwork being received and funds being transferred.
Gas chromatography-mass spectrometry (GC/MS)OLI_REQCODE_GCMS808Gas chromatography-mass spectrometry (GC/MS) is a method that combines the features of gas-liquid chromatography and mass spectrometry to identify different substances within a test sample such as drug detection. The GC-MS has been widely heralded as a "gold standard for forensic substance identification because it is used to perform a specific test.
Generate 1099-R formOLI_REQCODE_1099R928Generate a Form 1099-R to show distribution from retirement accounts.
Global intermediary identification number (GIIN)OLI_REQCODE_FATCAGIIN925Global intermediary identification number assigned for FATCA reporting purposes.
Glomerular Filtration Rate (GFR)OLI_REQCODE_GFR813Used to test kidney function; the GFR is a calculated estimate of the actual glomerular filtration rate and is based on serum creatinine concentration, which requires a blood sample. The calculation uses a formula that may include age, gender, height, weight, and sometimes race. Also known as eGFR (estimated GFR) or cGFR (calculated GFR).
Government Allotment FormOLI_REQCODE_GOVALLTFORM160
Government Issued Certificate of good standingOLI_REQCODE_GOVTCERT665This is a government issued document that certifies that the organization is valid and functioning properly.
Government Registration PapersOLI_REQCODE_GOVREG697Request for copies of the Company Registration papers filed with the government.
Group CensusOLI_REQCODE_GROUPCENSUS245
Guarantor AgreementOLI_REQCODE_GUARANTOR867
HCV PCR (polymerase chain reaction)OLI_REQCODE_HEPCPCR809The basic PCR viral detection tests are used to confirm the actual presence of HCV. This is especially useful in the case of people who have an inconclusive (unclear) HCV antibody test, or with people who have signs they may have previously cleared their hep C (i.e. their liver function tests are consistently normal and they experience no symptoms of hep C illness).
HeightOLI_REQCODE_HEIGHT96
Hepatitis RIBA-3 InterpretationOLI_REQCODE_HEPR3INT764A test for the presence of Hepatitis RIBA-3 in a blood specimen.
High School DiplomaOLI_REQCODE_HSDIPLOMA526
HIPAA AuthorizationOLI_REQCODE_HIPAAAUTH822A form required by the USA Health Insurance Portability and Accountability Act in which an individual provides his/her signed permission to allow a covered entity to use or disclose the individual's protected health information (PHI) that is described in the authorization for the purpose(s) and to the recipient(s) stated in the authorization.
HIV ConsentOLI_REQCODE_CONSENTAIDS6
Identify Applicable Product PageOLI_REQCODE_IDPRODPAGE850
Identify Attending PhysicianOLI_REQCODE_IDATTPHYS851Identify the name of the attending physician
Identify UnderwriterOLI_REQCODE_IDUNDERWRIT849Assign an underwriter to this case
Identity Verification FormOLI_REQCODE_IDENTITYVERIFY683Form to verify an owner's identity.
Illustration / Carrier Quote as quotedOLI_REQCODE_ILLUSQUOTE940Provide illustration or quote as run; no signature required.
Illustration - as issuedOLI_REQCODE_ISSUEDILL965
Illustration - BasicOLI_REQCODE_BASICILL966The basic illustration for this product. For products regulated by NAIC this will consist of a narrative summary, a numeric summary, and a tabular detail.
Illustration Certificate signed (waiving illustration)OLI_REQCODE_ILLUSTCERT246
Illustration DisclosureOLI_REQCODE_ILLDISC968
Illustration - Inforce IllustrationOLI_REQCODE_ILLUSTINFRC247
Illustration - reissuedOLI_REQCODE_REISSUEDILL967
Illustration - RevisedOLI_REQCODE_ILLUSTREVISED248
Immigration DocumentsOLI_REQCODE_IMMDOC1018
Important Notice about Information PracticesOLI_REQCODE_INFOPRACTICES647This notice tells about the information practices that are employed in evaluating the application for insurance.
Income VerificationOLI_REQCODE_INCVERIF860Proof of income
Independent Legal Opinion (Borrower)OLI_REQCODE_INDLEGLOP868
Indeterminate Premium FormOLI_REQCODE_INDETERMINATEPREM641State and Product specific form requiring the Applicant's signature for applications for a specific Term policy written in Texas and Montana. The form that states that the applicant understands the premium provisions of the Indeterminate Premium contract that was applied for. The form sets forth the premium payment pattern, that non-guaranteed elements are subject to change, that the carrier reserves the right to charge the maximum premium and the carrier will not exercise its right to change premium more often than once per year.
Indexed Product Acknowledgement FormOLI_REQCODE_INDEXACK812Indexed products afford clients the opportunity to link policy cash value growth to the performance of one or more specific external financial indices.A client purchasing an indexed product must acknowledge understanding that the product being applied for is indexed. Certain states require an additional form for the acknowledgement.
Info Request - affiliates outside issuing countryOLI_REQCODE_AFFLFOREIGN892Request for information about affiliates outside of issuing country
Informal QuoteOLI_REQCODE_INFRMLQUOTE249
Information from confidential sourceOLI_REQCODE_CONFSOURCE875
Initial Nursing Home AssessmentOLI_REQCODE_INNHASSESS672A copy of the initial Nursing Home assessment of a patient.
Initial Underwriting ReviewOLI_REQCODE_INITIALUWREVIEW847This requirement indicates that the application has been received and there is a need to have it reviewed by an underwriter. Routine requirements are needed and potentially additional requirements may be required.
Inspection Report - Business BeneficiaryOLI_REQCODE_INSPRPTBUSBENE138
Insurance Company ContractOLI_REQCODE_CONTRACT229
Insurance History SupplementOLI_REQCODE_INSURHISTORY250
Insurance SupplementOLI_REQCODE_INSSUPP121
Insured/Owner AddressOLI_REQCODE_INSADDR863
Insured/Owner Email AddressOLI_REQCODE_INSEMAIL1002
Insured/Owner Telephone NumberOLI_REQCODE_INSTELE864
Interpret ECGOLI_REQCODE_INTERPECG821Request for service to interpret or analyze an ECG (Electro Cardio Gram).
Interview coworkersOLI_REQCODE_INTERVIEWWORKCENTERINSPECTION196
Interview neighborsOLI_REQCODE_INTERVIEWSTREETINSPECTION197
Investment Account Application & ProfileOLI_REQCODE_INVESTPROFILE969
IRA Disclosure FormOLI_REQCODE_IRADISCLFORM251
IRS Request for Individual Tax Return TranscriptOLI_REQCODE_TAXRETURNREQFORM907Internal Revenue Service - Request for Individual Tax Return Transcript. IRS form used to request from the US Internal Revenue Service a copy of an individual's tax return.
Itemized Hospital BillOLI_REQCODE_ITHOSPBILL671A line itemized bill from a hospital for a patient for all charges incurred during an admission and discharge period.
Itemized Nursing Home BillOLI_REQCODE_ITNHBILL673A line itemized bill from a Nursing Home for a patient for all charges incurred during an admission and discharge period.
Juvenile FormOLI_REQCODE_JUVNFORM313
Lab ReportOLI_REQCODE_LABRPT933Provide lab testing results in a report format.
Lab Slip DocumentOLI_REQCODE_LABSLIPDOC833This is an administrative requirement for the actual lab slip document that accompanies a lab kit.
Lab slip missingOLI_REQCODE_LABSLIP252This requirement related to paramedical services is used to document that a lab kit was received by an underwriting vendor without its lab slip.
Language DeclarationOLI_REQCODE_LANGUAGEDECL1006Language Declaration so that the client can declare their preferred language.
Letter Of AuthorityOLI_REQCODE_LTRAUTH899
Letter of ConsentOLI_REQCODE_LTRCONSENT888
Letter to Doctor (used for explanation of findings during application process).OLI_REQCODE_LTRTODR150Letter from Insurance Company Underwriter to the Applicant's Doctor explaining the reason for an adverse UW decision.
License of AgencyOLI_REQCODE_LICAGENCY669A copy of the license of an agency that is providing services, care and/or treatment to a patient.
License of FacilityOLI_REQCODE_LICFACILITY668A copy of the license of a facility to which the patient is confined.
License of Provider of CareOLI_REQCODE_LICPROVIDER670A copy of the license of an individual person that is providing services, care and /or treatment to a patient.
Licensing - Agent Multiple ContractingOLI_REQCODE_LICAGTMULTCON253
Licensing - Agent Requirement Form (ARF comment)OLI_REQCODE_ARF623This is used when the Carrier sees licensing issues with an Agent and needs certain actions to be completed for the agent to be properly appointed.
Licensing - Agents Current State License (State License Form)OLI_REQCODE_LICAGTSTATE254
Licensing - Agents Personal Data FormOLI_REQCODE_LICAGTPERSDATA255
Licensing - License RenewalOLI_REQCODE_LICRENEWAL836License has expired and a copy of the renewed license is needed.
Licensing - Licensing FeeOLI_REQCODE_LICENSEFEE256
Licensing - Producer Info & AgreementOLI_REQCODE_LICENSEINFO257
Licensing - State AppointmentOLI_REQCODE_LICENSEAPPT258
LLC Operating AgreementOLI_REQCODE_LLC663This is the document that outlines the agreement under which the LLC (Limited Liability Corporation) is functioning.
Loan Carry-Forward InformationOLI_REQCODE_LOANCFINFO676During the processing of the replacement of a policy where an outstanding loan balance exists, the replacing carrier may agree to establish the new policy with a carry-forward of the existing loan. In this case, a requirement for the issue of the new policy is to obtain the accurate loan balance figures from the surrendering carrier.
Location application was signedOLI_REQCODE_SIGNLOC861
Lost Policy FormOLI_REQCODE_LOSTPOLFORM123Lost Policy Affidavit signed by the contract owner stating that they affirm that the policy or contract has been destroyed or lost and that no other person has any right, title or interest in the contract, nor has it been assigned, pledged or encumbered unless the replacement is a life insurance policy with a loan to carry forward.
LTC Older Age SupplementOLI_REQCODE_LTCOLDERAGESUPP797Face to Face Assessment for a Long Term Care policy. Used to assess a person's cognitive ability specifically for an LTC policy.
LTC Personal WorksheetOLI_REQCODE_LTCWKSHEET942Long Term Care (LTC) Insurance Personal Information Worksheet
Marketing Center ReplyOLI_REQCODE_MKTCTRREP884
Maryland Acknowledgement FormOLI_REQCODE_MARYLANDFORM530
MEC Election FormOLI_REQCODE_MECELECTIONFORM970MEC is Modified Endowment Contract.
Medallion Signature GuaranteeOLI_REQCODE_MSG682A Medallion imprint or stamp indicates that the financial institution is a member of a Medallion signature guarantee program and is an acceptable signature guarantor. By participating in the program, financial institutions can guarantee customer signatures with the assurance that their guarantees will be immediately accepted for processing by transfer agents. Furthermore, the guarantor of the seal assumes any financial responsibility associated with the endorsement. Medallion Signature Guarantees must cover the amount of the requested transaction.If a Medallion Signature Guarantee is required, the stamp will be placed on a 3-1/2' wide by 2" high white space that is located on the TOA and or LOA Forms near the Authorized Account Owner's Signature. The color of the seal (stamp) is GREEN.
Medical Details Release FormOLI_REQCODE_AUTHMEDRELEASE649Provides authorization for the release of medical details
Medical Exam by CardiologistOLI_REQCODE_MEDEXAMCD72
Medical Exam by InternistOLI_REQCODE_MEDEXAMINT74
Medical Exam By Pediatrician (Juvenile Medical)OLI_REQCODE_MEDEXAMPED75
Medical Examination by Senior DoctorOLI_REQCODE_MEDEXAMSENDR9Historically there was a requirement that a more 'senior' or experienced doctor would provide the exam.
Medical Exam with Cardiovascular sectionOLI_REQCODE_MEDEXAMCV73
Medical recordsOLI_REQCODE_MEDRECORDS876
Medical section of applicationOLI_REQCODE_MEDSECT894
Medical Test - OtherOLI_REQCODE_MEDTEST18
MIB AuthorizationOLI_REQCODE_MIBAUTH23
MIB InquiryOLI_REQCODE_MIBCHECK21This requirement includes any need for submitting an inquiry against any MIB database service.
MIB PrenoticeOLI_REQCODE_MIBPRENOTE340
MIB Request for DetailsOLI_REQCODE_MIBDET22
MIB UpdateOLI_REQCODE_MIBUPDATE648This requirement includes any need to submit reports for any MIB database service.This includes corrections as well as original reports
Mini Mental State Exam FormOLI_REQCODE_MMNTALSTEX695A form that is completed by a trained clinician in evaluating a patient and providing such information as orientation, immediate recall, attention, delayed verbal recall, naming, stage command, reading, writing and sentence language.
Modified Data Verification reportOLI_REQCODE_MODDVR817An abbreviated version of the data verification that analyzes applications to determine if the information an individual has given matches the public-access information about that person.
Motor Vehicle Authorization FormOLI_REQCODE_MOTORVEHICLEAUTH840Authorization from the policy owner/insured to enable the carrier to request a Motor Vehicle Report from the appropriate transportation authority within the province issuing the current driver's license.
Motor Vehicle Report - General Agent orderedOLI_REQCODE_MVRGA259
Motor Vehicle Report RecheckOLI_REQCODE_MVRRECHECK853This is a recheck of the Motor Vehicle report. Recheck involves requesting another report rather than re-examining the original report.
NAIC DisclosureOLI_REQCODE_NAICDISCL260
New Front Page to medical examinationOLI_REQCODE_FRONTPG891
Non English Speaking FormOLI_REQCODE_NONENGSPEAKINGFORM136
Non-Medical - Details of AnswersOLI_REQCODE_NONMEDDETAIL262
Non-Medical - Part IOLI_REQCODE_NONMEDPART1264
Non-Medical - Part IIOLI_REQCODE_NONMEDPART2265
Non-Medical - Signature RequiredOLI_REQCODE_SIGNNONMED266
Non-Medical - Unanswered QuestionOLI_REQCODE_NONMEDUNANSQ263
Notarized SignatureOLI_REQCODE_NOTARSIG674A Notary Public is a public servant appointed by state government to witness the signing of important documents and administer oaths. Documents are notarized to deter fraud and to ensure they are properly executed. An impartial witness (the Notary) identifies signers to screen out impostors and to make sure they have entered into agreements knowingly and willingly. A notarized signature is not a Signature Guarantee. Refer to Signature Guarantee or Medallion Signature Guarantee.
Notice Regarding MECs RequiredOLI_REQCODE_MODENDOWNOTICE704Notice Regarding Modified Endowment Contracts Required
Notice to Consult Tax AdvisorOLI_REQCODE_NOTETAXADVISOR971
Notify agent of activityOLI_REQCODE_AGTCOMM854Notify agent of activity pertinent to this case
Obtain Attending Physician Statement (APS)OLI_REQCODE_ATTPHYSTATEMENT11
Obtain Company Producer IdentifierOLI_REQCODE_PRODUCERID848Confirm the company producer identifier to be used for this producer for this case
Obtain Information on FileOLI_REQCODE_PFILE804Request information already on file. This could be from an existing policy or if they were previously underwritten.
Obtain Medical Evidence from other companyOLI_REQCODE_MEDEV803This is when they are requesting medical evidence from another company.
Obtain Motor Vehicle ReportOLI_REQCODE_MOTORVEHICLERPT147
Obtain Payor DetailsOLI_REQCODE_PAYORDETAILS976Identify who the payor is and include details such as name and contact information.
Obtain ReferralOLI_REQCODE_REFERRAL852Obtain details pertaining to a referral. The type of referral may be specified in RequirementDetails when applicable.
Obtain Required SignatureOLI_REQCODE_REQSIG130
Obtain Social Insurance NumberOLI_REQCODE_SIN805Social insurance number is missing. For certain types of policies the SIN is required. It is very common for them to request it, so they created a requirement code for it.
Obtain the opinion of the reinsurerOLI_REQCODE_REINSUROPINION681Obtain the opinion of the reinsurer about an insured
Oral Fluid Antibody Screen InterpretationOLI_REQCODE_ORALASI785a test for HIV-1 antibodies in an oral fluid specimen
Oral Fluid Antibody Screen Interpretation (U.S.)OLI_REQCODE_ORALASIUS787a test for HIV-1 antibodies in an oral fluid specimen
Oral Fluid ConfirmationOLI_REQCODE_ORALCONFIRM786A test to determine if an oral fluid specimen consists of human oral fluid.
Oral Fluid Hepatitis B Surface InterpretationOLI_REQCODE_ORALHEPBSURFI788A test for the Hepatitis B Surface Antibody in an oral fluid specimen.
Oral HGAOLI_REQCODE_ORALHGA790A test for oral hypoglycemic agents (HGA) in urine.
Order Medical RequirementsOLI_REQCODE_ORDERMEDS934Order medical requirements, per the carrier age/amount table requirements.
Original ApplicationOLI_REQCODE_ORIGINALAPP972
Original PolicyOLI_REQCODE_ORIGPOL124The original contract/policy or copies of the original policy.
OSJ Compliance ApprovalOLI_REQCODE_COMPLIANCEAPPROVAL678Suitability review and approval of the order by OSJ (Office of Supervisory Jurisdiction).
OtherOLI_OTHER2147483647
Other Administrative RequirementOLI_REQCODE_OTHADMIN168
Other Company's AddressOLI_REQCODE_CORRADDROTHERCOMP973
Other Company's Lab ResultsOLI_REQCODE_OTHERCOMPLABRSLTS974Obtain lab results collected by a different insurer
Other Company's PapersOLI_REQCODE_OTHERPAPERS268
Other Delivery RequirementOLI_REQCODE_OTHDEL169
Outsourced UnderwritingOLI_REQCODE_OUTSOURCEDUNDERWRITING508
Outstanding Licensing Fee Money (non resident)OLI_REQCODE_LICENSEFEENR523
Outstanding Loan BalanceOLI_REQCODE_LOANBAL820During the processing of the replacement of a policy where an outstanding loan balance exists, it is required that the loan balance be paid before the contract is surrendered.
Overhead Expense StatementOLI_REQCODE_OVERHEADEXPSTATE975
Owner - Change of OwnershipOLI_REQCODE_OWNERCHANGE269
Owner ClarificationOLI_REQCODE_OWNERCLARIF344
Owner Must Cancel PolicyOLI_REQCODE_OWNERCANCELPOL930Owner must cancel their policy directly with the ceding carrier. This requirement is often for policies that have no surrender value but need to be cancelled in order for the owner/applicant to use premiums to fund a new policy.
Partnership AgreementOLI_REQCODE_PARTNERSHIP664This is the document that outlines the agreement under which the partnership is functioning.
PassportOLI_REQCODE_PASSPORT270
Pathology ReportOLI_REQCODE_PATHRPT20Request for a Pathology Report typically associated with an Attending Physician Statement (APS). The preferred method for ordering this is to order the APS w/Comment requesting a Pathology Report.
Payment SourceOLI_REQCODE_PAYSOURCE807Obtain necessary details regarding the payment source for the contract.
Pension Plan AgreementOLI_REQCODE_PENSNPLANAGR271
Perform 1 View X-Ray (Frontal)OLI_REQCODE_1VIEWXRAY16This is a single view X-ray, specifically a frontal view (as opposed to a lateral or side view)
Perform 2 View X-Ray (Frontal & Lateral) OR Hair AnalysisOLI_REQCODE_2VIEWXRAY92Prior to version 2.9, this code represented Hair Analysis. In versions 2.9 and later, it was changed to the current definition.
Perform Blood Pressure Readings - Different DaysOLI_REQCODE_BPRECHK97This is a blood pressure reading performed over separate/unique days or appointments. Use type code 71 (OLI_REQCODE_BPRECHECK) for recheck at a single visit/appointment. Number of actual readings should be specified in RequirementDetails and also specify the interval of time between readings (e.g. days). Note - This can be used as either an initial reading -or- as a request for a subsequent recheck performed over multiple days.
Perform Blood Pressure Recheck - Single VisitOLI_REQCODE_BPRECHECK71Request to recollect blood pressure information, performed at a single appointment/session. Use type code 97 (OLI_REQCODE_BPRECHK) for recheck over multiple visits/appointments. Number of actual readings should be specified in RequirementDetails.
Perform Carrier Suitability ReviewOLI_REQCODE_CARRSUITREVIEW1023Carrier to perform a suitability review to ensure that the product meets the customer's financial wellness needs.
Perform CAT ScanOLI_REQCODE_CATSCAN85
Perform EchocardiogramOLI_REQCODE_ECHOCARDIOGRAM87
Perform Echocardiogram - Regular StressOLI_REQCODE_ECHOSTRESS796An Echocardiogram performed under stress - typically while on a treadmill
Perform EKG / ECG (Electrocardiograph)- RestingOLI_REQCODE_EKGREST13
Perform EKG / ECG -Stress or TreadmillOLI_REQCODE_EKGTREADMILL14
Perform Examination By Medical Doctor (MD)OLI_REQCODE_MEDEXAMMD7
Perform Examination By ParamedOLI_REQCODE_MEDEXAMPARA10
Perform Examination By SpecialistOLI_REQCODE_MEDEXAMSPEC8
Perform Heart Chart ExamOLI_REQCODE_HEARTCHART342
Perform Persantine Stress testOLI_REQCODE_PERSANTINE680A persantine stress test is similar to the graded exercise stress test except that a medication called persantine is used to elevate the heart rate instead of exercise. Note that nuclear imaging, such as that requested in requirement code OLI_REQCODE_EKGTHALLIUM, will be performed with this test.
Perform Physical MeasurementsOLI_REQCODE_PHYMEASUREMENTS496
Perform Pulmonary Function Test (TVC)OLI_REQCODE_PULMONARY15Perform a Timed Vital Capacity Test (TVC) Pulmonary Function Test
Perform Short Form Exam By ParamedOLI_REQCODE_MEDEXAMSHORTFORM26Short Form Exam includes height, weight, and blood pressure. Also known as Abbreviated Paramed.
Personal History InterviewOLI_REQCODE_PERSNLHISTRY272
Pharmaceutical Profile Consent FormOLI_REQCODE_PPCONSENT318
Pharmaceutical Profile RequestOLI_REQCODE_PPR348Request for a Pharmaceutical Profile Report, specifically a report that includes individual prescription drug histories.
Physical Measurements Re-checkOLI_REQCODE_PHYMEASURERECHECK798Examiner visits the applicant a second time to re-obtain physical measurements
Physician Medical Facility InformationOLI_REQCODE_MEDFACINFO977
Placement of initial businessOLI_REQCODE_PLACEMENTINITBUS936This applies to appointment processes. A carrier appointment cannot be completed until there is an initial sale to coincide with it.
Place of BirthOLI_REQCODE_BIRTHPLC904
Plan of InsuranceOLI_REQCODE_PLANOFINSUR273
Pledge of ProfessionalismOLI_REQCODE_PROFPLEDGE533AKA "Code of Conduct"
Police ReportOLI_REQCODE_POLICERPT653A report completed by a police officer who is in charge of an accident or crime scene.
Policy Change FormOLI_REQCODE_PLCYCHGFORM282
Policy Change SupplementOLI_REQCODE_POLCHGSUPP816A supplement form used to document certain types of policy changes. Examples of this type of policy change would include rating reductions or reclassifications, face amount changes, etc. A policy change supplement may also be used in conjunction with a policy conversion.
Policy Custody Agreement / ReceiptOLI_REQCODE_POLICYCUSTAGREE978
Policy DeclarationOLI_REQCODE_POLDECL887
Policy Delivery ExtensionOLI_REQCODE_DELIVERYEXTENSION343
Policy Delivery InstructionsOLI_REQCODE_DELINST885
Policy Delivery ReceiptOLI_REQCODE_POLDELRECEIPT132
Policy Issue Date Change (Endorsement)OLI_REQCODE_POLICYISSUEDATE337This form is part of the "Policy Pages" sent to the policy owner. This will be a requirement of only those policies that need to receive this endorsement.
Policy Re-issue RequestOLI_REQCODE_POLICYREISSUE845Conduct internal processing for Policy Re-issue Request
Policy Returned Not TakenOLI_REQCODE_PLCYNTO283
Policy SummaryOLI_REQCODE_POLSUM699A policy summary describes the basic features of a contract. This can include the conditions, coverage limitations, premiums, cost of the contract such as the premium amounts, and information on the benefit, including the amount to be paid upon death.
Politically Exposed Person FormOLI_REQCODE_PEFPFORM842Disclosure of information for related persons and relationships of the owner(s) to politically exposed individuals.
Postal Zipcode RequiredOLI_REQCODE_POSTALZIP865
Power of AttorneyOLI_REQCODE_POWATTY675Power of Attorney (POA) allows a party, typically the contract owner, to give legal permission to someone else to act on his or her behalf.
Preliminary Statement of Policy CostOLI_REQCODE_PRELIMCOSTSTATEMENT643State regulatory requirement. Must be completed for all Term/PGL, policies presented to clients in MA at the time of application.
Premium Allocation FormOLI_REQCODE_PREMALLOCFORM844Allocation of payments/deposits across investment product coverages.
Premium Deposit Agreement (PDA) FormOLI_REQCODE_PDAFORM1014A form that is used to establish consent for and use of a Premium Deposit Account in order to pay policy premiums. May also be known as Premium Deposit Fund (PDF).
Premium DiscrepancyOLI_REQCODE_PREMDISC889
Premium Due CarrierOLI_REQCODE_PREMDUE125
Premium RefundOLI_REQCODE_PREMREFUND161
Premium - Verify ModeOLI_REQCODE_PREMVERFYMODE284
Prepare Inspection ReportOLI_REQCODE_INSPECTNRPT139
Producer Appointment Data SheetOLI_REQCODE_PRODUCERFORM509
Product Feature Comparison FormOLI_REQCODE_PRODFEATURECOMP1025A Product Feature Comparison form is used to collect summary information about the policies being replaced and the proposed policy, for suitability analysis purposes.
Provide Best Time to CallOLI_REQCODE_BESTTIMECALL873
Provide Death CertificateOLI_REQCODE_DEATHCERT834Provide a certificate signed by a doctor, giving pertinent identifying of the deceased person.
Public Records ReportOLI_REQCODE_REPORTPUBLICRECORDS332
Public Records Report Max CoverageOLI_REQCODE_REPORTPUBLICRECORDSMAX333
Pulmonary Function TestOLI_REQCODE_PFT93
PVT CSC Used in an inquiry to request allOLI_REQCODE_ALL999
PVT INGOLI_REQCODE_ING362362
PVT INGOLI_REQCODE_ING363363
PVT INGOLI_REQCODE_ING364364
PVT INGOLI_REQCODE_ING365365
PVT INGOLI_REQCODE_ING366366
PVT INGOLI_REQCODE_ING367367
PVT INGOLI_REQCODE_ING368368
PVT INGOLI_REQCODE_ING369369
PVT INGOLI_REQCODE_ING370370
PVT INGOLI_REQCODE_ING371371
PVT INGOLI_REQCODE_ING372372
PVT INGOLI_REQCODE_ING373373
PVT INGOLI_REQCODE_ING374374
PVT INGOLI_REQCODE_ING375375
PVT INGOLI_REQCODE_ING376376
PVT INGOLI_REQCODE_ING377377
PVT INGOLI_REQCODE_ING378378
PVT INGOLI_REQCODE_ING379379
PVT INGOLI_REQCODE_ING380380
PVT INGOLI_REQCODE_ING381381
PVT INGOLI_REQCODE_ING382382
PVT INGOLI_REQCODE_ING383383
PVT INGOLI_REQCODE_ING384384
PVT INGOLI_REQCODE_ING385385
PVT INGOLI_REQCODE_ING386386
PVT INGOLI_REQCODE_ING387387
PVT INGOLI_REQCODE_ING388388
PVT INGOLI_REQCODE_ING389389
PVT INGOLI_REQCODE_ING390390
PVT INGOLI_REQCODE_ING391391
PVT INGOLI_REQCODE_ING392392
PVT INGOLI_REQCODE_ING393393
PVT INGOLI_REQCODE_ING394394
PVT INGOLI_REQCODE_ING395395
PVT INGOLI_REQCODE_ING396396
PVT INGOLI_REQCODE_ING397397
PVT INGOLI_REQCODE_ING398398
PVT INGOLI_REQCODE_ING399399
PVT INGOLI_REQCODE_ING400400
PVT INGOLI_REQCODE_ING401401
PVT INGOLI_REQCODE_ING402402
PVT INGOLI_REQCODE_ING403403
PVT INGOLI_REQCODE_ING404404
PVT INGOLI_REQCODE_ING405405
PVT INGOLI_REQCODE_ING406406
PVT INGOLI_REQCODE_ING407407
PVT INGOLI_REQCODE_ING408408
PVT INGOLI_REQCODE_ING409409
PVT INGOLI_REQCODE_ING410410
PVT INGOLI_REQCODE_ING411411
PVT INGOLI_REQCODE_ING412412
PVT INGOLI_REQCODE_ING413413
PVT INGOLI_REQCODE_ING414414
PVT INGOLI_REQCODE_ING415415
PVT INGOLI_REQCODE_ING416416
PVT INGOLI_REQCODE_ING417417
PVT INGOLI_REQCODE_ING418418
PVT INGOLI_REQCODE_ING419419
PVT INGOLI_REQCODE_ING420420
PVT INGOLI_REQCODE_ING421421
PVT INGOLI_REQCODE_ING422422
PVT INGOLI_REQCODE_ING423423
PVT INGOLI_REQCODE_ING424424
PVT INGOLI_REQCODE_ING425425
PVT INGOLI_REQCODE_ING426426
PVT INGOLI_REQCODE_ING427427
PVT INGOLI_REQCODE_ING428428
PVT INGOLI_REQCODE_ING429429
PVT INGOLI_REQCODE_ING430430
PVT INGOLI_REQCODE_ING431431
PVT INGOLI_REQCODE_ING432432
PVT INGOLI_REQCODE_ING433433
PVT INGOLI_REQCODE_ING434434
PVT INGOLI_REQCODE_ING435435
PVT INGOLI_REQCODE_ING436436
PVT INGOLI_REQCODE_ING437437
PVT INGOLI_REQCODE_ING438438
PVT INGOLI_REQCODE_ING439439
PVT INGOLI_REQCODE_ING440440
PVT INGOLI_REQCODE_ING441441
PVT INGOLI_REQCODE_ING442442
PVT INGOLI_REQCODE_ING443443
PVT INGOLI_REQCODE_ING444444
PVT INGOLI_REQCODE_ING445445
PVT INGOLI_REQCODE_ING446446
PVT INGOLI_REQCODE_ING447447
PVT INGOLI_REQCODE_ING448448
PVT INGOLI_REQCODE_ING449449
PVT INGOLI_REQCODE_ING450450
PVT INGOLI_REQCODE_ING451451
PVT INGOLI_REQCODE_ING452452
PVT INGOLI_REQCODE_ING453453
PVT INGOLI_REQCODE_ING454454
PVT INGOLI_REQCODE_ING455455
PVT INGOLI_REQCODE_ING456456
PVT INGOLI_REQCODE_ING457457
PVT INGOLI_REQCODE_ING458458
PVT INGOLI_REQCODE_ING459459
PVT INGOLI_REQCODE_ING460460
PVT INGOLI_REQCODE_ING461461
PVT INGOLI_REQCODE_ING462462
PVT INGOLI_REQCODE_ING463463
PVT INGOLI_REQCODE_ING464464
PVT INGOLI_REQCODE_ING465465
PVT INGOLI_REQCODE_ING466466
PVT INGOLI_REQCODE_ING467467
PVT INGOLI_REQCODE_ING468468
PVT INGOLI_REQCODE_ING469469
PVT INGOLI_REQCODE_ING470470
PVT INGOLI_REQCODE_ING471471
PVT INGOLI_REQCODE_ING472472
PVT INGOLI_REQCODE_ING473473
PVT INGOLI_REQCODE_ING474474
PVT INGOLI_REQCODE_ING475475
PVT INGOLI_REQCODE_ING476476
PVT INGOLI_REQCODE_ING477477
PVT INGOLI_REQCODE_ING478478
PVT INGOLI_REQCODE_ING479479
PVT INGOLI_REQCODE_ING480480
PVT INGOLI_REQCODE_ING481481
PVT INGOLI_REQCODE_ING482482
PVT INGOLI_REQCODE_ING483483
PVT INGOLI_REQCODE_ING484484
PVT INGOLI_REQCODE_ING485485
PVT INGOLI_REQCODE_ING486486
PVT INGOLI_REQCODE_ING487487
PVT INGOLI_REQCODE_ING488488
PVT INGOLI_REQCODE_ING489489
PVT INGOLI_REQCODE_ING490490
PVT INGOLI_REQCODE_ING491491
PVT INGOLI_REQCODE_ING492492
PVT INGOLI_REQCODE_ING493493
PVT INGOLI_REQCODE_ING494494
PVT Met Initial informationOLI_REQCODE_INITINFO171
Questionnaire - Alcohol UsageOLI_REQCODE_QALCOHOLUSE114
Questionnaire - AsthmaOLI_REQCODE_QASTHMA107
Questionnaire - AviationOLI_REQCODE_QAVIATION102
Questionnaire - AvocationOLI_REQCODE_QAVOCATION103
Questionnaire - Avocation/Hobby/AviationOLI_REQCODE_QAVOCATIONAVIATION692A questionnaire covering avocations, hobbies and aviation activities.
Questionnaire - Back or Neck DisorderOLI_REQCODE_QBACKNECK108
Questionnaire - BallooningOLI_REQCODE_BALLOONING909
Questionnaire - Blood or Lymph Gland DisorderOLI_REQCODE_QBLOODLYMPH361Requirement to fill out more details on a Blood or Lymph Gland Disorder questionnaire.
Questionnaire - Blood PressureOLI_REQCODE_BLOODPRESSQ856
Questionnaire - Bone or Joint DisorderOLI_REQCODE_QBONEJOINT360Requirement to fill out more details on a Bone or Joint Disorder questionnaire.
Questionnaire - Business InsuranceOLI_REQCODE_QBUSINESSINS209
Questionnaire - Cancer HistoryOLI_REQCODE_CANCERHISTORY951
Questionnaire - Chest PainOLI_REQCODE_QCHESTPAIN109
Questionnaire - ColitisOLI_REQCODE_QCOLITIS203
Questionnaire - Confidential Personal HistoryOLI_REQCODE_QCONFPERSHIST119
Questionnaire - ConvulsionOLI_REQCODE_QCONVULSION204
Questionnaire - Coronary Artery DiseaseOLI_REQCODE_QCORNART153
Questionnaire - COVIDOLI_REQCODE_QCOVID1028
Questionnaire - Criminal HistoryOLI_REQCODE_CRIMHISTORY916This is a client completed questionnaire related to criminal history.
Questionnaire - Critical IllnessOLI_REQCODE_CRITILL871
Questionnaire - CRS Decl of Tax Res of IndOLI_REQCODE_CRSIND1010CRS Only Declaration of Tax Residency of Individual. In Canada, CRA Form RC520 can be used.
Questionnaire - CRS Decl of Tax Res of OrgOLI_REQCODE_CRSENT1011CRS Only Declaration of Tax Residency of Entity. In Canada, CRA Form RC521 can be used.
Questionnaire - DiabeticOLI_REQCODE_QDIABETES111
Questionnaire - Diagnostic TestsOLI_REQCODE_QDIAGNOSTIC922Questionnaire used for querying proposed insured on diagnostic tests he/she may have received.
Questionnaire - DigestiveOLI_REQCODE_QDIGESTIVE686A questionnaire covering digestive medical conditions.
Questionnaire - DivingOLI_REQCODE_QDVING104
Questionnaire - Driving HistoryOLI_REQCODE_DRIVINGHIST855
Questionnaire - Drug UsageOLI_REQCODE_QDRUGUSE115
Questionnaire - Ears/Eyes/Nose InformationOLI_REQCODE_EENINFO963
Questionnaire - EpilepsyOLI_REQCODE_QEPILEPSY110
Questionnaire - Fainting or Loss Of ConsciousnessOLI_REQCODE_QFAINTING687A questionnaire covering fainting or loss of consciousness incidents.
Questionnaire - Family HistoryOLI_REQCODE_QFAMILYHISTORY689A questionnaire for family members' medical history.
Questionnaire - FATCA&CRS Decl of Tax Res of IndOLI_REQCODE_FATCACRSIND1008Combined (FATCA & CRS) Declaration of Tax Residency of Individual. In Canada, CRA Form RC518 can be used.
Questionnaire - FATCA&CRS Decl of Tax Res of OrgOLI_REQCODE_FATCACRSENT1009Questionnaire - Combined (FATCA & CRS) Declaration of Tax Residency of Entity.In Canada, CRA Form RC519 can be used.
Questionnaire - FATCA Entity Classification Decl.OLI_REQCODE_FATCAENTITY924Questionnaire - Declaration of (FATCA) Classification for an Entity. This Questionnaire is used to capture an entity classification type to certify their USA tax status.
Questionnaire - FATCA Self-CertificationOLI_REQCODE_FATCASELF923Questionnaire used for applicants to certify their USA tax status
Questionnaire - Financial SupplementOLI_REQCODE_QFINSUPP117
Questionnaire - FishingOLI_REQCODE_QUESFISH883
Questionnaire - Foreign NationalOLI_REQCODE_FOREIGNNATLQUEST984
Questionnaire - Foreign Residence/TravelOLI_REQCODE_QFOREIGN688A questionnaire for travel outside the country or if living outside the country.
Questionnaire- Foreign TravelOLI_REQCODE_QFOREIGNTRAV210
Questionnaire - Gastric DiseaseOLI_REQCODE_QGASTRIC205
Questionnaire - Gynecologic DisordersOLI_REQCODE_GYNECOL937
Questionnaire - Hang GlidingOLI_REQCODE_QUESHANGGLID881
Questionnaire - Hazardous ActivitiesOLI_REQCODE_QHAZARDACT101
Questionnaire - Heart Murmur/Valve DiseaseOLI_REQCODE_HEARTMURMURQUEST979
Questionnaire - HepatitisOLI_REQCODE_HEPATITISQUEST980
Questionnaire - HIVOLI_REQCODE_QHIV113
Questionnaire - Indigestion / UlcerOLI_REQCODE_QULCER112
Questionnaire - Key Person SupplementOLI_REQCODE_KEYPERSSUP874
Questionnaire - Liver DisorderOLI_REQCODE_LIVERDISQ869
Questionnaire - Mature Age FocusOLI_REQCODE_QMATUREAGE698This questionnaire is requested to find out how older people spend their time. Also known as Daily Activities Questionnaire.
Questionnaire - MedicalOLI_REQCODE_QMED106
Questionnaire - MilitaryOLI_REQCODE_QMILITARY118
Questionnaire - Motor Boat RacingOLI_REQCODE_MOTORBOATRACE910
Questionnaire - Motor SportsOLI_REQCODE_QMOTORSPORTS200
Questionnaire - Mountain ClimbingOLI_REQCODE_QMOUNTAINCLIMBING690A questionnaire covering mountain climbing activities.
Questionnaire - Nervous DiseaseOLI_REQCODE_QNERVOUS206
Questionnaire - NeurologicalOLI_REQCODE_NEURQUES870
Questionnaire - Occupational DutiesOLI_REQCODE_QOCCUPDUTIES201
Questionnaire - OtherOLI_REQCODE_QOTHER120
Questionnaire - Politically Exposed PersonOLI_REQCODE_QPEFP843Initial questions used to determine if a Politically Exposed Person Form is required.
Questionnaire - Preferred RiskOLI_REQCODE_QPREFERREDRISK691A lifestyle & medical questionnaire requested when a preferred risk class has been applied for.
Questionnaire- PsychiatricOLI_REQCODE_QPSYCHIATRIC207
Questionnaire - Resident AlienOLI_REQCODE_QRESDNTALIEN211
Questionnaire - Respiratory DisordersOLI_REQCODE_QRESP920Questionnaire used for querying proposed insured on issues related to respiratory disorders.
Questionnaire - Risk ClassificationOLI_REQCODE_QUESRISKCLASS886
Questionnaire - SeasonalOLI_REQCODE_QUESSEASONAL882
Questionnaire - SeizureOLI_REQCODE_QSEIZURE208
Questionnaire - Sky DivingOLI_REQCODE_QSKYDIVING202
Questionnaire - Sleep ApneaOLI_REQCODE_QSLPAPNEA921Questionnaire used for querying proposed insured on issues relating to the condition of sleep apnea.
Questionnaire - SportsOLI_REQCODE_SPORTSQUEST981
Questionnaire - Stroke / TIAOLI_REQCODE_STROKEQUEST982TIA is Transient Ischemic Attack
Questionnaire - Suicide And IncontestabilityOLI_REQCODE_SUICIDEL872
Questionnaire - Tobacco UsageOLI_REQCODE_QTOBACCOUSE116
Questionnaire - Truck DriversOLI_REQCODE_QTRUCKDVR105
Questionnaire - Universal LifeOLI_REQCODE_UNIVLIFE154
Questionnaire - Urinary or Kidney DisorderOLI_REQCODE_QURINARY359Requirement to fill out more details on a urinary system/kidney disorder questionnaire.
Questionnaire - Vehicle RacingOLI_REQCODE_RACINGQUEST983
Questionnaire - ViolationOLI_REQCODE_QVIOLATION358Requirement to fill out more details on a violation questionnaire. Used especially for DUI, DWI, driver's license suspension or revocation or moving violations.
Rate ReductionOLI_REQCODE_RATEREDUCTN285
Refer to Home OfficeOLI_REQCODE_REFERTOHO286
Reinsurance - AutomaticOLI_REQCODE_REINSURCMP1288
Reinsurance - FacultativeOLI_REQCODE_REINSURFACUL287
Release of Assignee's Interest FormOLI_REQCODE_RELASSIGNEE685Consent of the assignee to reduce/terminate a policy or a form releasing interest in the assigned policy.
Release of Bankruptcy FormOLI_REQCODE_RELBANKRUPTCY684Consent of the bankruptcy trustee to reduce/terminate a policy or a discharge to release the policy from bankruptcy.
Release of Liability FormOLI_REQCODE_RELLIABFORM294
Replaced Policy FundsOLI_REQCODE_REPLFUNDS655Requirement for funds from the policy being replacedThis would originally be passed on message 126 or 127 by the Receiving Carrier on the"Applied For" Holding. The Delivering Carrier would pass the requirement back on the associated Inforce/Active Holding on the 126/127 response or the 1128 with the appropriate status.
Replacement Consent FormOLI_REQCODE_REPCONSENT694Authorization by the client to disclose the information on the Replacement form to the Insurance Co.
Replacement Disclosure StatementOLI_REQCODE_REPLACEDISC985
Replacement FormOLI_REQCODE_REPFORM127This form is used to accomplish full or partial exchange of policies / contracts pursuant to Internal Revenue Code (IRC) Section 1035. This form can also be used for Transfers of Funds and Rollovers. Examples include: The ACORD 951 - 1035 Exchange / Rollover / Transfer Form, State Replacement Forms, or the Issuing Carrier's proprietary Replacement / 1035 Exchange / Rollover or Transfer of Assets Form.
Replacement form clarificationOLI_REQCODE_REPLFORMCLAR893
Replacement Letter (LOA)OLI_REQCODE_REPLETTER128Replacement Letter or Letter of Acceptance (LOA)A LOA is a document that states that a policy holder requests to release funds, from their existing insurance policy or mutual fund, to a carrier who will be issuing a new policy / fund on behalf of the policy holder. Assignment by a policy owner of all control of and rights in the policy to a third party.
Reply to a 1035 Exchange OfferOLI_REQCODE_REPLY1035OFFER986
Reply To an Offer on a Modified ApplicationOLI_REQ_REPLYMODIFIEDOFFER703Reply required on a policy offer that was modified and differs from the original submitted application.
Reply to memoOLI_REQCODE_REPMEMO155agent response required to insurance company memo
Reply To Phone CallOLI_REQCODE_REPLYTOPHONECALL987
Reply to Tentative OfferOLI_REQCODE_REPLYOFFER267
Report from Motor Vehicle records Max CoverageOLI_REQCODE_REPORTMOTORVEHICLEMAX336
Request for 'Consent for General Blood Testing' FormOLI_REQCODE_CONSENTBLOOD25Normally would use a specific consent form: HIV Consent Form, State Specific Consent Form, Carrier Specific Consent Form, Lab Consent Form
Return Alternate PolicyOLI_REQCODE_RETALTPOL162
Return Conditional ReceiptOLI_REQCODE_RETCONDREC163
Returned CheckOLI_REQCODE_RETCHK164Check refused by bank, producer action is required.
Review by Carrier's Medical Director or CMOOLI_REQCODE_MEDRVW598This is sometimes a step in the Carrier workflow, where the underwriter refers a case to the Carrier's internal Medical Director or Chief Medical Officer (CMO) for review and next steps. The Medical Director or CMO then provides feedback to the underwriter on what tests if any need to be ordered.This is used internally by the Carrier to help track case progress and location. Could be viewed as an "internal" and "administrative" requirement.
Review of cases combined for administrationOLI_REQCODE_ADDLCASES838Review of additional cases that have been identified for combined administrative processing to make a determination regarding those cases. For example, this may be used between the policy issue and the underwriting teams and the agent, to keep insureds/participants and/or applications together.
Risk AdjustmentOLI_REQCODE_RA918A process by which a Health Insurance Company which has insured an above average number of individuals with HCC (Hierarchical Condition Category) conditions may be compensated by Health Insurance Companies that have insured less than the average number of individuals expected with these HCC codes.
Rollover Amount DueOLI_REQCODE_ROLLOVERDUE295
Sales Material ChecklistOLI_REQCODE_SALESMATERIAL644State regulatory requirement. For states that have replacement regulations requiring any sales material used during a sales presentation must be submitted to the Home Office
Saliva Cocaine MetabolitesOLI_REQCODE_SALIVACOCAINE585Saliva Cocaine Metabolites
Saliva Hepatitis C AbOLI_REQCODE_SALIVAHEPC591Saliva Hepatitis C Antibodies
Saliva NicotineOLI_REQCODE_SALIVANICOTINE547Test measures the amount of nicotine in saliva. Nicotine is associated with exposure to tobacco smoke and cotinine.
Saliva test with HIVOLI_REQCODE_SALIVAHIV328
Scheduled Date for AppointmentOLI_REQCODE_APPTDT897Date visit is scheduled
S Corp - 1120SOLI_REQCODE_SCORP1120S988
Secondary Addressee InformationOLI_REQCODE_2NDRYADDRESSEE1017A Secondary Addressee is an additional contact for communications regarding a policy such as copies of notices and letters regarding potential lapses in coverage.
Second Medical ExaminationOLI_REQCODE_MEDEXAM270
Serum AppearanceOLI_REQCODE_BLOODSERUMAPPEAR791A test for the presence of lipemia and hemolysis in a blood serum specimen.
Shared MedicalsOLI_REQCODE_SHAREDMEDICALS939Original medical reports shared with other organizations. For example, the original request for medical examination that is shared within a 6 month time period rather than requesting a second medical examination. Additional information such as the the specific examiner or examination date may be specified using RequirementDetails.
Short Portable Mental Status QuestionnaireOLI_REQCODE_SPMSQ696A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. This is commonly known as SPMSQ.
Side Account Transfer NeededOLI_REQCODE_SIDEACCTTRANS890
Signature GuaranteeOLI_REQCODE_SIGGUAR677The authentication of a signature in the form of a stamp, seal, or written confirmation by a bank or member of a domestic stock exchange (or other acceptable guarantor). A notary public cannot provide a signature guarantee. A signature guarantee is a common requirement when transferring or redeeming shares or changing the ownership of an account. The color of the seal (stamp) is BLACK.
Signature On Agent's ReportOLI_REQCODE_SIGAGTREP316
Signed Application - (applicants signature)OLI_REQCODE_SIGNEDAPP165
Signed EndorsementOLI_REQCODE_SIGNEDENDORSE989
Signed IllustrationOLI_REQCODE_SIGNILLUS133
Single Case AgreementOLI_REQCODE_SINGLCASEAGR296
Source Of Funds SupplementOLI_REQCODE_SOURCEOFFUNDSFORM1007A questionnaire used to assess whether the transaction meets the standard for fiduciary responsibility and is in the client's best interest.
Special Class LetterOLI_REQCODE_SPECLCLSLTR297
Special HandlingOLI_REQCODE_SPECIALHANDLING990To notify the agent that special handling is needed, often for confidentiality or privacy reasons. Use RequirementDetails to include the specifics.
Special RequirementOLI_REQCODE_SPECIALREQ300
Specific Carrier ContractOLI_REQCODE_CARRIERCONTRACT513
Split Dollar AgreementOLI_REQCODE_SPLITDOLLAGR301
State DisclosureOLI_REQCODE_STATEDISC148
Statement / Documentation of Good HealthOLI_REQCODE_STMTGOODHEALTH19
Statement from ClientOLI_REQCODE_CLIENTSTMT227
Substitution of InsuredOLI_REQCODE_SUBINSURED991
Suitability InformationOLI_REQCODE_SUITABILITYINFO992
Suitability InterviewOLI_REQCODE_SUITABILITYINTER993
Superannuation - application for membershipOLI_REQCODE_SUPERAPP135
Supplementary ApplicationOLI_REQCODE_SUPPAPP866
Support Document to FollowOLI_REQCODE_SUPPORTDOCTOFOLLOW832Support document will be sent to the recipient following the submission of this transaction.
Surr Chg Acknowledgement FormOLI_REQCODE_SURRACK700The ceding carrier's surrender charge acknowledgement form, which requires the policy owner's signature, outlines surrender charges the policy owner will incur when they transfer / cancel certain types of investments or insurance policies.
Surrender Comparison Index CertificationOLI_REQCODE_SURRCOMPINDEX645A surrender form specific to the state of PA.
Surrendered Policy FormOLI_REQCODE_SURRPOL651A form which includes the owner and insured information, tax withholding election, and signatures. This information is needed by the carrier in order to surrender a policy.
Surrender FormOLI_REQCODE_SURRENDFORM302The generic name "Surrender Form" refers to an existing (ceding) carrier's proprietary form/paperwork, required by the existing carrier, to be filled out by the policy holder in order to complete a: 1035 exchange, replacement, transfer, withdrawal or surrender of funds. Confirmation, conservation, disbursement or company forms that are tied to fund withdrawals are also referred to as a Surrender Form.The proprietary form name used by a ceding carrier, if different from "Surrender Form", may be stated in the requirement notes.
Swab Test Oral Fluid SpecimenOLI_REQCODE_SWABTEST320This requirement is needed for paramedical service providers. Paramedical service provider collects an oral fluid sample from a proposed insured. Specimen is later sent to a lab for testing.
Tax DisclosureOLI_REQCODE_TAXDISCLOSURE994
Tax FormOLI_REQCODE_MISCTAXFORMS995Miscellaneous tax form
Tax Identification Number Request (TIN)OLI_REQCODE_TINREQUEST129A TIN is an identification number used in the administration of tax laws. In the U.S, the TIN is issued either by the Social Security Administration (SSA) or by the Internal Revenue Service (IRS).
Tax Return - CopyOLI_REQCODE_TAXRETURN303
Tax Return - Schedule AOLI_REQCODE_SCHEDULEA304
Tele-Inspection report - 1 year historyOLI_REQCODE_TELE1351This is one of several different types of inspection reports offered to assist in underwriting a proposed insurance applicant. Applicant is interviewed via telephone to collect information regarding the applicant's health, employment, finances, duties and habits.
Tele-Inspection report plus Credit & Financial Report (billed hourly) - 10 year historyOLI_REQCODE_TELE10CREDITFIN354This is one of several different types of inspection reports offered to assist in underwriting a proposed insurance applicant.Applicant is interviewed in person to collect information regarding the applicant's health, employment, finances, duties and habits. Also includes a credit report and an in-depth financial breakdown. Applicant is billed hourly.
Tele-Inspection report plus Credit & Financial report - 5 year historyOLI_REQCODE_TELE5CREDITFIN353This is one of several different types of inspection reports offered to assist in underwriting a proposed insurance applicant.Applicant is interviewed via telephone to collect information regarding the applicant's health, employment, finances, duties and habits. Also includes a credit report and an in-depth financial breakdown.
Tele-Inspection report plus Credit report - 3 year historyOLI_REQCODE_TELE3CREDIT352This is one of several different types of inspection reports offered to assist in underwriting a proposed insurance applicant.Applicant is interviewed via telephone to collect information regarding the applicant's health, employment, finances, duties and habits. Also includes a credit report.
Temporary Insurance AgreementOLI_REQCODE_TEMPINSAGMT122
Tenants in Common Ownership FormOLI_REQCODE_TENINCOMMOWNERFORM896
Third Party Financial InformationOLI_REQCODE_FININFO3RDPARTY846Obtain financial information on a Party who is associated to a policy but is not an owner, insured, or beneficiary identified on the policy. This financial information is gathered for compliance purposes and may be used to assess any association with Proceeds of Crime (i.e. Money Laundering, Illegal Enterprise, etc.) and Terrorist Financing.
Third Party Sources of Financial InformationOLI_REQCODE_FININFOSOURCE908Obtain financial information on the "applies to Party", typically an owner or primary insured, from third party source(s). This information is required to support the amount of insurance requested. This documentation may include personal or business financial statements such as W-2s or tax returns, employment contracts, loan or trust agreements, buy-sell agreements, etc. - all of which are considered third party sources of information. This information may be provided by the proposed insured, his or her advisors, attorneys, or accountants.
Third Urine SpecimenOLI_REQCODE_URINE351
Tobacco UseOLI_REQCODE_TU919One of the factors that Health Companies will be able to use in setting the premiums for Health Insurance plans under the Patient Protection and Affordable Care Act of 2010 (PPACA).
Total CholesterolOLI_REQCODE_TOTALCHOL932Blood Analysis - Total Cholesterol
Total insurance with all carriersOLI_REQCODE_TOTINSPLACE996Includes total to be placed and currently inforce
Transaction Analysis ( overall analysis of each requirement).OLI_REQCODE_TRANANAL355Requirement to request analysis/review/evaluation of Requirement Results
Transfer of AssetsOLI_REQCODE_TRANSFERASSETS997
Translation CertificateOLI_REQCODE_TRANSCERT1019Document validating that the translation was done by a certified source
Trust Agreement Tax ID #OLI_REQCODE_TRUSTTAXID310
Trust CertificationOLI_REQCODE_TRUSTCERT311
Trust - Date OfOLI_REQCODE_TRUSTDATE309
Trustee ClarificationOLI_REQCODE_TRUSTEECLARIF346
Trustee FormOLI_REQCODE_TRUSTFORM312
Underwriters WorksheetOLI_REQCODE_UNWRITWORKSHEET341
Unisex Acceptance WaiverOLI_REQCODE_UNISEXACCEPTWVR998
UnknownOLI_UNKNOWN0
UrinalysisOLI_REQCODE_URINALYSIS357
Urine AdulterantOLI_REQCODE_URINEADULTERANT829Identify Adulterants in human urine. Adulterants are used to alter a specimen as a means of passing a drug test.
Urine AmphetamineOLI_REQCODE_URINEAMPH773A test for Amphetamine in a urine specimen.
Urine BABOLI_REQCODE_URINEBAB768a test for Beta Adrenergic Blockers (BAB) in a urine specimen
Urine BenzodiazepineOLI_REQCODE_URINEBENZODIAZEPINE758A test for Benzodiazepine in a urine specimen.
Urine Blood ContentOLI_REQCODE_URINEBLOOD606Urine Blood Content
Urine Cocaine MetaboliteOLI_REQCODE_URINECOCAINE769a test for cocaine in a urine specimen.
Urine CodeineOLI_REQCODE_URINECODEINE774A test for Codeine in a urine specimen.
Urine CotinineOLI_REQCODE_URINENICOTINE561Test measures the amount of cotinine in the urine. Cotinine is associated with exposure to tobacco smoke and nicotine.
Urine CreatinineOLI_REQCODE_URINECREATININE607Urine Creatinine
Urine DIUOLI_REQCODE_URINEDIU767a test for diuretics in a urine specimen
Urine Fasting GlucoseOLI_REQCODE_URINEFASTINGGLUCOSE604Urine Fasting Glucose
Urine GlucoseOLI_REQCODE_URINEGLUCOSE601Urine Glucose
Urine Glucose - 1/2 HourOLI_REQCODE_URINEGLUCOSEHALFHOUR603Urine Glucose - 1/2 Hour
Urine Glucose - 2 HourOLI_REQCODE_URINEGLUCOSE2HOUR602Urine Glucose - 2 Hour
Urine Granular CastsOLI_REQCODE_URINEGRANCASTS574Urine Granular Casts
Urine GTT - 1.0 hour drawOLI_REQCODE_URINEGTT1HRDRAW727A GTT where urine is voided at 1.0 hour intervals
Urine GTT - 1.5 hour drawOLI_REQCODE_URINEGTT1P5HRDRAW728A GTT where urine is voided at 1.5 hour intervals
Urine GTT - 2.5 hour drawOLI_REQCODE_URINEGTT2P5HRDRAW729A GTT where urine is voided at 2.5 hour intervals
Urine GTT - 3.0 hour drawOLI_REQCODE_URINEGTT3HRDRAW730A GTT where urine is voided at 3 hour intervals
Urine HCGOLI_REQCODE_URINEHCG771A test to detect HCG in a urine specimen. Used to determine pregnancy.
Urine Hyaline CastsOLI_REQCODE_URINEHYALINECASTS562Urine Hyaline Casts
Urine Leukocyte EsteraseOLI_REQCODE_URINELEUKEST563Urine Leukocyte Esterase
Urine MarijuanaOLI_REQCODE_URINEMARIJUANA770A test for Marijuana (THC) in a urine specimen.
Urine MC RatioOLI_REQCODE_URINEMCRATIO605Urine Microglobulin/Creatinine Ratio
Urine Meperidine ScreenOLI_REQCODE_URINEMEPSCREEN792A test for Meperidine in a urine specimen.
Urine Methadone QualitativeOLI_REQCODE_URINEMETHQUALCLS760A test for the presence of Methadone in a urine specimen. Methadone is a synthetic opioid. Present in analgesics and cough depressants. It is also commonly used for detoxification and maintenance of heroin addiction. Long term side effects include excessive sweating, lymphocytosis, insomnia and increased prolactin, albumin and globulins.
Urine Methadone ScreenOLI_REQCODE_URINEMETHSCREEN793A test for Methadone in a urine specimen.
Urine MethamphetamineOLI_REQCODE_URINEMETH779A test for Methamphetamine in a urine specimen.
Urine MethaqualoneOLI_REQCODE_URINEMQL776A test for Methaqualone in a urine specimen.
Urine MicroalbuminOLI_REQCODE_URINEMCA772A test to determine the amount of Microalbumin in a urine specimen.
Urine MorphineOLI_REQCODE_URINEMORPH775A test for Morphine in a urine specimen.
Urine Oxycodone ScreenOLI_REQCODE_URINEOXYSCREEN794A test for Oxycodone in a urine specimen.
Urine PC RatioOLI_REQCODE_URINEPCRATIO599Urine Protein/Creatinine Ratio
Urine PHOLI_REQCODE_URINEPH578Urine PH
Urine PhencyclidineOLI_REQCODE_URINEPCC777A test for Phencyclidine (PCP) in a urine specimen.
Urine PropoxypheneOLI_REQCODE_URINEPPP778A test for Propoxyphene in a urine specimen.
Urine Random OpiatesOLI_REQCODE_URINEOPIATES830Test for drug (Opiates) abuse. Use this code when the test is for a variety of opiates rather than a specific opiate such as codeine or morphine.
Urine RBCOLI_REQCODE_URINERBC576Urine Red Blood Count
Urine Specific GravityOLI_REQCODE_URINESPECGRAV579Urine Specific Gravity
Urine Specimen (for Prostate Specific Antigen)OLI_REQCODE_URINEPSA52
Urine Total ProteinOLI_REQCODE_URINETOTALPROTEIN587Urine Total Protein
Urine Toxicology - BarbiturateOLI_REQCODE_URINEBARBITURATE759A test for Barbiturate in a urine specimen.
Urine WBCOLI_REQCODE_URINEWBC577Urine White Blood Count
Urine with Full Drug ScreenOLI_REQCODE_URINEDRUG326
Urine with MicroalbuminOLI_REQCODE_URINEMICROALBUMIN325
Verification Form of Govt Tax ID for businessesOLI_REQCODE_GOVIDVERIFY528Verification Form of Government Tax ID for businesses
Verify Commission OptionOLI_REQCODE_VERIFYCOMMOPTION1000
Verify Payment Information - Ongoing PaymentsOLI_REQCODE_ONGOINGPAYMTINFO1005Verify payment information for ongoing premiums, which may include the method of payment, the mode or frequency of the payment, account information, and/or the payment amount.
Verify Payment Information - Premium Balance DueOLI_REQCODE_PREMDUEPAYMTINFO1004Verify payment information for the premium balance due, which may include the method of payment, the mode or frequency of the payment, account information, and/or the payment amount.
Visa InformationOLI_REQCODE_VISAINFO1001Includes visa number, type of visa, etc.
Vitals: BP Readings / Pulse OnlyOLI_REQCODE_VITALSBPPULSE799Blood pressure and pulse only
Vitals: BP Readings / Pulse Only 2OLI_REQCODE_VITALSBPPULSE2831Pulse Reading second time point
Vitals: Height and Weight OnlyOLI_REQCODE_VITALSHTWT800Height and weight only
Vitals / Physical MeasurementsOLI_REQCODE_VITALS349Vitals / Physical Measurements - Height & Weight, Blood Pressure and Pulse. Specify in the RequirementDetails where to record (Carrier form or Lab Ticket).
Voice RecordingOLI_REQCODE_VOICEREC1020Used for the transmission of voice recording, often recorded during a tele-interview or similar.
Void Check - (need voided check from client).OLI_REQCODE_VOIDCHK166
W-2 CopyOLI_REQCODE_TAXW2FORM305
W-4P Withholding FormOLI_REQCODE_TAXW4FORM306
W-8OLI_REQCODE_W8646Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding
W-9 IRS FormOLI_REQCODE_TAXW9FORM307Request for Taxpayer Identification Number and Certification.
WD Tax Form - Permanent InsuranceOLI_REQCODE_TAXWDFORM308
WeightOLI_REQCODE_WEIGHT95
Wet signatureOLI_REQCODE_WETSIG518See Requirement Details for what Signature is required
Witness Declaration FormOLI_REQCODE_WITNESSDEC858
Witness Signature on applicationOLI_REQCODE_WITNESSSIGN857
Work HistoryOLI_REQCODE_WORKHIST524
Work Permit DocumentOLI_REQCODE_WORKPERMIT935Document to identify authorization to work in a particular jurisdiction.