On an application for individual health insurance, all of the following are typically included on the agent's report EXCEPT:

The agent's report, also known as the producer's statement, is a confidential section of the insurance application completed by the agent for the underwriter. It contains the agent's personal observations about the applicant's financial stability, character, and any existing relationship. Because this report is a private communication between the agent and the insurer and is not seen by the applicant, the applicant's signature is not required on it. The applicant's signature is required on the main application form to attest that the information they provided is true and complete.

A. Agent's relationship to the applicant: This is included to help the underwriter assess potential moral hazard or anti-selection if a close personal or business relationship exists.

B. Applicant's financial status: The agent's assessment of the applicant's finances helps the underwriter determine the suitability of the proposed coverage and the likelihood of premium persistency.

C. Applicant's general character: The agent's observations on the applicant's character and lifestyle are crucial for the underwriter to evaluate moral risk.

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1. Rejda, G. E., & McNamara, M. J. (2017). Principles of Risk Management and Insurance (13th ed.). Pearson. In Chapter 11, "Life Insurance," the text describes the life insurance application process, which is analogous to health insurance applications. It specifies that the application consists of multiple parts, including the Agent's Report, which is a "confidential report" and "is not seen by the applicant." (pp. 230-231).

2. Vaughan, E. J., & Vaughan, T. (2013). Fundamentals of Risk and Insurance (11th ed.). Wiley. Chapter 18, "The Insurance Contract," explains the components of the application, noting the distinction between the information provided by the applicant (which they sign) and the separate, confidential report completed by the agent for the insurer.

3. Code of Virginia, Title 38.2. Insurance. § 38.2-1812, "Reporting and accounting for premiums and funds," establishes the fiduciary duty of the agent to the insurer, which includes providing complete and accurate information relevant to underwriting, as contained within the agent's report. The statute does not require the applicant to be a party to this specific reporting.