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Disability Insurance
Disability Insurance
The Big 6
State By State
2022 Guide to Disability Insurance
Frequently Asked Questions
Life Insurance
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Career
Health
Basics
What is your occupation status currently?
Select
Medical student
Resident
Fellowship
Attending
Non-physician
Medical School Program Sponsor/Institution
Medical School End Date
current annual income
Are you starting residency soon?
Yes
No
Resident Program Sponsor Institution
resident program sponsor institution
Residency end date
current annual income
Are you starting fellowship soon?
Yes
No
Fellowship Program Sponsor Institution
have you signed an employment contract yet?
Yes
No
New employers name
expected start date
expected annual income
new employer state
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
This will help us get you the more accurate and affordable quotes from the big 6 companies
will you be covered by employer group disability insurance?
Yes
Not Sure
No
What is the maximum monthly benefit amount?
What percentage of your income does it cover?
Select
40%
45%
50%
55%
60%
Does your employer pay the premiums?
Yes
No
Fellowship Program/Institution
fellowship end date
current annual income
have you signed an employment contract yet?
Yes
No
New employers name
expected start date
expected annual income
new employer state
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
This will help us get you the more accurate and affordable quotes from the big 6 companies
will you be covered by employer group disability insurance?
Yes
Not Sure
No
What is the maximum monthly benefit amount?
What percentage of your income does it cover?
Select
40%
45%
50%
55%
60%
Does your employer pay the premiums?
Yes
No
employer name
current annual income
Did you finish training in the last 12 months?
Yes
No
Training program graduation date
what was the name of your program or institution?
Please Provide Your Primary Occupational Duties
Duty
Percentage of Time Spent
Select
10
20
30
40
50
60
70
80
90
100
Select
10
20
30
40
50
60
70
80
90
100
- Remove duty
+ Add another duty
Are you covered by employer group disability insurance?
Yes
Not Sure
No
What is the maximum monthly benefit amount?
What percentage of your income does it cover?
Select
40%
45%
50%
55%
60%
Does your employer pay the premiums?
Yes
No
Are you changing employers soon?
Yes
No
New employers name
expected start date
expected annual income
new employer state
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
This will help us get you the more accurate and affordable quotes from the big 6 companies
will you be covered by employer group disability insurance?
Yes
Not Sure
No
What is the maximum monthly benefit amount?
What percentage of your income does it cover?
Select
40%
45%
50%
55%
60%
Does your employer pay the premiums?
Yes
No
Next
Height
Select
4ft 0in
4ft 1in
4ft 2in
4ft 3in
4ft 4in
4ft 5in
4ft 6in
4ft 7in
4ft 8in
4ft 9in
4ft 10in
4ft 11in
5ft 0in
5ft 1in
5ft 2in
5ft 3in
5ft 4in
5ft 5in
5ft 6in
5ft 7in
5ft 8in
5ft 9in
5ft 10in
5ft 11in
6ft 0in
6ft 1in
6ft 2in
6ft 3in
6ft 4in
6ft 5in
6ft 6in
6ft 7in
6ft 8in
6ft 9in
6ft 10in
6ft 11in
7ft 0in
7ft 1in
7ft 2in
7ft 3in
7ft 4in
7ft 5in
7ft 6in
7ft 7in
7ft 8in
7ft 9in
7ft 10in
7ft 11in
Weight
do you currently have any medical conditions?
Yes
No
List all medical conditions with dates and treatments
do you currently take any medication?
Yes
No
please provide the name, dosage, and purpose
Any recent hospitalizations or surgeries?
Yes
No
list all including dates, treatments, and outcomes
Next
first name
last name
Date of Birth
Email
Phone number
gender
Male
Female
State of Residence
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
specialty
Select
Other
Allergy
Allergy: Immunology
Anesthesiology
Anesthesiology: Critical Care
Anesthesiology: Pain Management
Anesthesiology: Pediatric
Cardiology: Electrophysiology
Cardiology: Invasive
Cardiology: Invasive-Interventional
Cardiology: Noninvasive
Chiropractor
Critical Care: Intensivist
CRNA
Dentistry: General
Dentistry: Endodontics
Dentistry: Pediatric
Dentistry: Prosthodontics
Dentistry: Periodontics
Dentistry: Orthodontics
Dermatology
Dermatology: Dermatopathology
Dermatology: Mohs Surgery
Emergency Medicine
Endocrinology/Metabolism
Family Medicine (with OB)
Family Medicine (without OB)
Family Medicine: Ambulatory Only (No Inpatient Work)
Family Medicine: Sports Medicine
Gastroenterology
Gastroenterology: Hepatology
Geriatrics
Hematology/Oncology
Hematology/Oncology: Oncology (Only)
Hospice/Palliative Care
Hospitalist: Family Medicine
Hospitalist: Internal Medicine
Hospitalist: IM-Pediatric
Hospitalist: OB/GYN
Hospitalist: Pediatric
Infectious Disease
Internal Medicine: General
Internal Medicine: Ambulatory Only (No Inpatient Work)
Internal Medicine: Pediatric
Neonatology
Nephrology
Neurology
Nurse
Nurse Practitioner
Obstetrics/Gynecology: General
OB/GYN: Critical Care
OB/GYN: Gynecology (Only)
OB/GYN: Gynecological Oncology
OB/GYN: Maternal & Fetal Med
OB/GYN: Reproductive Endocrinology
OB/GYN: Urogynecology
Occupational Medicine
Ophthalmology
Ophthalmology: Corneal & Ref Surgery
Ophthalmology: Pediatric
Ophthalmology: Retina
Orthopedic (Nonsurgical)
Orthopedic Surgery: General
Orthopedic Surgery: Foot & Ankle
Orthopedic Surgery: Hand
Orthopedic Surgery: Hip & Joint
Orthopedic Surgery: Pediatric
Orthopedic Surgery: Spine
Orthopedic Surgery: Trauma
Orthopedic Surgery: Sports Medicine
Otolaryngology
Otorhinolaryngology
Otorhinolaryngology: Pediatric
Pain Management: Nonanesthesia
Pathology: Anatomic & Clinical
Pathology: Anatomic
Pathology: Clinical
Pediatrics: General
Pediatrics: Adolescent Medicine
Pediatrics: Allergy/Immunology
Pediatrics: Cardiology
Pediatrics: Child Development
Pediatrics: Critical Care/Intensivist
Pediatrics: Emergency Medicine
Pediatrics: Endocrinology
Pediatrics: Gastroenterology
Pediatrics: Genetics
Pediatrics: Hematology/Oncology
Pediatrics: Infectious Disease
Pediatrics: Neonatal Medicine
Pediatrics: Nephrology
Pediatrics: Neurology
Pediatrics: Pulmonology
Pediatrics: Radiology
Pediatrics: Urgent Care
Pharmacist
Physician Assistant
Physiatry (Physical Medicine & Rehabilitation)
Physical Therapy
Podiatry: General
Podiatry: Surgery-Foot & Ankle
Psychiatry: General
Psychiatry: Child & Adolescent
Psychiatry: Geriatric
Pulmonary Medicine: General
Pulmonary Medicine: Critical Care
Pulmonary Medicine: General & Critical Care
Radiation Oncology
Radiology: Interventional
Radiology: Diagnostic
Radiology: Neurological
Radiology: Nuclear Medicine
Rheumatology
Sleep Medicine
Surgery: General
Surgery: Bariatric
Surgery: Breast
Surgery: Cardiovascular
Surgery: Cardiovascular-Pediatric
Surgery: Colon & Rectal
Surgery: Critical Care
Surgery: Neurological
Surgery: Neurological-Pediatric
Surgery: Oncology
Surgery: Oral
Surgery: Pediatric
Surgery: Plastic & Reconstruction
Surgery: Thoracic (Primary)
Surgery: Transplant
Surgery: Trauma
Surgery: Vascular (Primary)
Urgent Care
Urology
Urology: Pediatric
Please provide other specialty
citizenship status
US Citizen
Permanent US Resident
Foreign Citizen
in which country are you a citizen?
Select
Afghanistan
Akrotiri
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Ashmore and Cartier Islands
Australia
Austria
Azerbaijan
Bahamas, The
Bahrain
Bangladesh
Barbados
Bassas da India
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Clipperton Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Coral Sea Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dhekelia
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Europa Island
Falkland Islands (Islas Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia, The
Gaza Strip
Georgia
Germany
Ghana
Gibraltar
Glorioso Islands
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Jan Mayen
Japan
Jersey
Jordan
Juan de Nova Island
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Namibia
Nauru
Navassa Island
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paracel Islands
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Spratly Islands
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tromelin Island
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands
Wake Island
Wallis and Futuna
West Bank
Western Sahara
Yemen
Zambia
Zimbabwe
What type of Visa/Green card do you have?
J-1
H-1B
O-1
F-1
L-1
Are you active duty military?
Yes
No
current discharge date
how did you hear about us?
What is their name?
Are you interested in life insurance?
Yes
No
any additional comments or questions?
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