Effective January 1st, 2020, the Montana and North Dakota paper and e-app personal worksheets have been updated.

MT LTC13:

• M119106_MT (Potential Premium Increase form) replaces M28370
• M28385_MT (MT LTC13 Outline of Coverage form) updated, same form number

ND LTC13:

• M119106 (Potential Premium Increase form) replaces M28370

Old forms will not be accepted after January 31st, 2020.
 
If you have any questions, please contact Mutual of Omaha’s Sales Support at (800) 693-6083 or email sales.support@mutualofomaha.com.
 

Updated Personal Worksheets for Montana and North Dakota
 

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