Guidelines for NON-USA Citizens

If the applicant resides in the United States, but is not a U.S. Citizen, he or she must meet and provide the following documentation and resident information:

1. Provide ITIN* (Individual Tax Identification Number) and a Copy of Permanent Residence Card (Green Card) or Copy of Visa (Non-Immigrant Work Visa or Immigrant Visa)
   NOTE: Not acceptable – Mexican Consular cards, Foreign Driver’s License or Passport, Temporary Work Visas
2. Provide Copy of United States Driver’s License**
3. Current physician that practices in the United States***
4. Lived in the United States for a minimum of 1 year
5. No current plans to move outside of the United States
6. If Non-Resident Alien (Non-USA Citizen without a Green Card) – Owner must submit W-8BEN****
7. If Resident Alien (Non-USA Citizen with a Green Card) – Owner must submit W-9****
8. If premiums paid by ACH, must be a United States bank
9. Complete Telephone Interview*****

* If ITIN (Individual Tax Identification Number), provide:

Occupation, Employer Name, Address, Nature of the business and How long employed.

NOTE: If not employed, provide source of income and annual income.

** If NO Driver’s License, provide: Legal or Medical reason details.

*** Current Physician, provide:

Name, Address, Phone number, Date last seen, Reason last seen and Medications prescribed.

**** W-8BEN and W-9 Forms are available on the United States IRS website

***** Complete the Telephone Interview with APPTICAL
APPTICAL: 877-351-1773
7:30am-1:00am Monday through Friday CST
9:00am-9:00pm Saturday & Sunday CST

NOTE: Non-USA Citizens cannot be the payor or owner of an Insured’s policy even if they meet all of our Non-USA Citizen requirements. (Okay for parent/guardian to be payor/owner for minor children). DACA participants or individuals in the country on temporary VISAs are not accepted.

Revised 10/2020