1. What types of insurance plans does NAIFA offer?
NAIFA offers a suite of insurance products including:
A) White-Glove Concierge Service for All Types of Medical Insurance:
- Individual and Family Plans (ACA compliant coverage)
- Short Term Health
- Medicare Solutions
- Small Group Health Plans
- Telemedicine
B) Supplemental Group Health Plans:
- Group Long Term and Short-Term Disability
- Group Term Life Insurance & Accidental Death & Dismemberment
- Group Dental and Vision
- Business Overhead Expense
C) Property & Casualty:
- Auto, Home, and Renters
- Cyber Liability & Data Breach
2. What group insurance plans are offered?
NAIFA, in partnership with Gallagher Affinity, offers group plans for the following products:
- Long Term and Short-Term Disability
- Group Term Life Insurance & Accidental Death & Dismemberment
- Small Employer Group Health Plans
- Group Dental and Vision
3. Why are group plans often better than individual marketplace plans?
- Cost Advantages: Group plans spread risk across a larger population, which can reduce premiums.
- NAIFA Group Plans offer an open enrollment period in which members receive advantageous underwriting concessions
- Richer Plan Design Options
- Stronger Buying Power: Association/Group policy structure gives access to large-group-style pricing and flexibility not typically available in the individual market.
4. Do NAIFA plans require medical underwriting? Who is eligible?
It depends on the plan type:
- ACA-compliant Major Medical plans → Fully insured plans do not require underwriting with less than 50 members employees enrolled.
- Level-funded / alternate funded plans → Yes, medical underwriting is required.
- Supplemental Health Products:
| Applying Outside Open Enrollment Period |
| Product |
Underwriting Standards |
| Long Term Disability |
An applicant is eligible for Guaranteed Issue if their application is received within 60 days of their membership start date and or employment start date. If the application is received outside of that 60-day window, then they will be subject to underwriting. Must be under age 65 to enroll. |
| Short Term Disability |
An applicant is eligible for Guaranteed Issue if their application is received within 60 days of their membership start date and or employment start date. If the application is received outside of that 60-day window, then they will be subject to underwriting. Must be under age 65 to enroll. |
| Term Life Insurance |
You may be eligible to complete a Simplified Issue short application, with 5 medical questions, based on your age and requested coverage amount. If you are not eligible, based on review, a separate application and full medical underwriting may be required. Must be under age 65 to enroll. |
| Business Overhead Expense |
Members under the age of 65 can apply but full underwriting is required. |
|
| Applying During Open Enrollment Period |
| Product |
Underwriting Standards |
| Long Term Disability |
If applicants have not been declined previously by carrier, if application is received within the OE period dates, then they are eligible for Guaranteed Issue. If applicants have been previously declined, then they would be subject to full underwriting. |
| Short Term Disability |
If applicants have not been declined previously by carrier, if application is received within the OE period dates, then they are eligible for Guaranteed Issue. If applicants have been previously declined, then they would be subject to full underwriting. |
| Term Life Insurance |
The below amounts of coverage are Simplified Issue for State Farm Agents specifically, with 1 medical question, have you been hospitalized in last 24 months? If question is answered yes, then applicants are not eligible for the Simplified Issue
| Age of Member |
Coverage Amount (Multiple of $10,000 up to max of: |
| Less than 45 |
Up to $250,000 |
| Less than 45-54 |
Up to $150,000 |
| Less than 55-59 |
Up to $100,000 |
| Age of Spouse |
Coverage Amount (Multiple of $5,000 up to max of: |
| Less than 45 |
Up to $125,000 |
| Less than 45-54 |
Up to $75,000 |
| Less than 55-59 |
Up to $50,000 |
If requesting more than these amounts, a separate application will be required.. |
| Business Overhead Expense |
Guaranteed Issue up to $6,000 in coverage for new members or existing members without BOE Coverage already. Will be asked 1 medical question, have you been hospitalized in last 24 months? If yes, then full underwriting will be required. |
5. How fast is underwriting?
- Simplified issued coverage can take up to 5 business days
- Coverage requiring a Statement of Health can take up to 30 business days
- Turnaround time depends on the complexity of the medical records and response time if more information is required. More simple and straight forward cases can be approved quicker.
6. What if I have pre-existing conditions?
ACA Plans (inside or outside NAIFA)
- Plans do not exclude pre-existing conditions – they are covered.
Group Supplemental Plans:
| Product |
Pre-Existing Condition Limitation |
| Long Term Disability |
6/24-month pre-existing condition limitation meaning any sickness or injury you are receiving medical treatment, consultation, care or services; or took prescription medication or had medication prescribed in the 6 months immediately prior the effective date of the policy, is not eligible for the payment of benefits for the first 24 months of the active policy. |
| Short Term Disability |
6/24-month pre-existing condition limitation meaning any sickness or injury your are receiving medical treatment, consultation, care or services; or took prescription medication or had medication prescribed in the 6 months immediately prior the effective date of the policy, is not eligible for the payment of benefits for the first 24 months of the active policy. |
| Term Life Insurance |
For Group Term Life insurance, in the event of your death by suicide during the first 24 months of coverage (Missouri, North Dakota and Colorado, 12 months) benefits will not be paid. Premiums that have been paid will be refunded to the beneficiary designated. |
| Business Overhead Expense |
No pre-existing condition limitations. |
May involve:
- Health questionnaires
- Potential rate adjustments or group-level decisions
Important: Because these are group-based, one person’s condition does not automatically exclude them—but it can impact overall pricing.
7. Can someone be declined coverage?
- ACA major medical health insurance plans: No (guaranteed issue)
- Underwritten plans: Possibly at the group level, depending on risk profile.
NAIFA typically provides multiple plan options, so groups can still access coverage even if one path is not ideal.
8. Are benefits better than individual plans?
Often, yes-depending on design:
NAIFA Group Plan Advantages:
- No lifetime maximums on group plans
- Deductible credit (same calendar year)
- Broader networks (Aetna, UHC, etc.)
- Ability to tailor benefits to employee needs
Individual Plans:
9.Are employees of NAIFA member businesses eligible for coverage?
Yes—employees of NAIFA members are eligible. Please see edibility grid below.
| Product |
Employee Eligibility |
| Long Term Disability |
New Employees: You can enroll in the LTD with no medical underwriting, during your eligibility period. Your eligibility period is within the first 60 days from your date of hire or the date your employer becomes a member of NAIFA, whichever is later. The pre-existing limitation will apply during your first 24 months of coverage.
Existing Employees: For employees beyond their 60-day eligibility period, you can enroll at any time subject to medical underwriting. You can also enroll during any approved national open enrollment period. If previously declined for medical underwriting by MetLife or Standard insurance company, you will need to complete medical underwriting and be approved by MetLife. |
| Short Term Disability |
| Term Life Insurance |
All eligible members and their employees working at least 20 hours per week, under the age of 65 at the time of application. |
| Business Overhead Expense |
Not Applicable to Employees |
| Dental |
All active members of the NAIFA association and their employees, working 20 hours per week. |
| Vision |
Employees and dependents in multiple states can be included in the same plan.
10. Are HSA-compatible plans available?
Yes—NAIFA offers HSA-qualified options, depending on underwriting and plan selection.
11. What’s the biggest difference vs. buying your own plan?
| Feature |
NAIFA Group Plan |
Individual Market Plan |
| Pricing |
Lower through risk pooling |
Based on individual or standardized ACA rates |
| Employer Contribution |
Yes |
No |
| Underwriting |
Sometimes (group-based) |
None (ACA plans) |
| Pre-existing Conditions |
Covered (varies by plan type) |
Always covered (ACA) |
| Customization |
High |
Moderate |
| Network Access |
National PPO options |
Varies by plan |
| Tax Advantages |
Employer & pre-tax benefits |
Limited |
Disclaimer:
Applications for coverage are subject to review and approval by MetLife. Increased coverage may be subject to underwriting. MetLife will evaluate your request for coverage based upon your answers to the health questions, MetLife’s underwriting rules and other information you authorize us to review. MetLife may request additional information to evaluate your coverage request. Coverage will be effective in accordance with the applicable policy and certificate after approval by MetLife. Only applicants who reside in a US state, the District of Columbia, or Guam, Northern Mariana Islands, Puerto Rico or US Virgin Islands are allowed to complete their SOH form online (where available). Otherwise, applicants will be provided with a paper SOH form. Individuals residing outside of the US or in certain US territories must be on US payroll and be approved by MetLife before being provided with an SOH form.
If you work in a state with state-mandated disability or paid medical leave benefits (“State Benefits”)*, you should carefully consider whether to enroll for this coverage. If you are eligible for State Benefits, you must apply if required by state law. If permitted, your STD benefit will be reduced by State Benefits or other government benefits that apply. Depending on your compensation, the amount of the State Benefit, and other factors, you may only receive the minimum weekly benefit. You should consider, based on your individual circumstances, whether you need additional coverage beyond the State Benefit.
* These jurisdictions include, but may not be limited to, California, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Maine, Massachusetts, Minnesota, New Jersey, New York, Oregon, Puerto Rico, Rhode Island, Washington (and Maryland as of 1/3/28, Virginia as of 12/1/28).
Any discussion of taxes is for general informational purposes only, does not purport to be complete or cover every situation, and should not be construed as legal, tax or accounting advice. You should confer with your qualified legal, tax and accounting advisors as appropriate.
Like most group disability insurance policies, MetLife policies contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Ask your MetLife group representative for complete costs and details.
MetLife Group Disability Income Insurance is issued by Metropolitan Life Insurance Company, 200 Park Avenue, New York, NY 10166, under Policy Form GPNP23-2T DI.
AD&D insurance does not include payment for certain losses as described in more detail in your certificate. Specific information pertaining to your insurance can be obtained by contacting your benefits administrator or MetLife.
Nothing in these materials is intended to be advice for any particular situation or individual. Please consult with your own advisors for such advice. Like most group insurance policies, insurance policies offered by MetLife contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact your benefits administrator or MetLife for costs and complete details.
MetLife Group Term Life insurance and AD&D is issued by Metropolitan Life Insurance Company, 200 Park Avenue, New York, NY 10166 under Policy Form GPN99/G2130-S.
Vision benefits are underwritten by Metropolitan Life Insurance Company, New York, NY. Certain claims and network administration services are provided through: Davis Vision, Inc. (“Davis Vision”), a New York corporation; Superior Vision Services, Inc. (“Superior Vision”), a Delaware corporation; or Vision Service Plan (VSP), Rancho Cordova, CA. Davis Vision and Superior Vision are part of the MetLife family of companies. VSP is not affiliated with Metropolitan Life Insurance Company or its affiliates. Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, reductions, limitations, waiting periods and terms for keeping them in force. Please contact MetLife or your plan administrator for costs and complete details.
Like most group benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. You may be financially responsible for copayments, deductibles, or any other amounts in excess of those MetLife is required to pay for covered services as described in your dental certificate and/or policy. Ask your MetLife representative for costs and complete details.
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MetLife and the M logo are registered marks of Metropolitan Life Insurance Company.
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