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Life InsuranceWorksheet

Life Insurance Needs Worksheet

A quiet way to think through what your family would need if your income stopped. You fill it in on paper, keep it, and bring your questions — nothing is submitted to us, and there are no formulas pretending to know your life.

Download the PDF (PDF)

Format: PDF. Free to download. No email address, no form, no follow-up unless you ask for one. Last reviewed September 4, 2026. Prepared by Bleu Sky's Insurance Solutions.

Who this is for

  • Parents and guardians
  • Couples planning together
  • Anyone whose income or care others rely on
  • People reviewing coverage they already have

What's included

  • Who depends on you
  • What you would want covered
  • Coverage you may already have
  • How long protection may be needed
  • Questions to bring to a conversation

How to use this worksheet

Work through it in whatever order feels natural. There are no right answers and no scoring. The goal is to arrive at a conversation already knowing what matters to you, so an advisor can explain options in terms of your actual life.

Anything you write on this worksheet stays with you. Please do not email or upload Social Security numbers, Medicare numbers, medical records, account numbers or banking details.

1. Who depends on you

People who rely on my income or my care
Their ages today
Anyone with long-term or special care needs
Who would care for them day to day

2. What you would want taken care of

  • Everyday living costs for the household
  • Housing — rent or the mortgage
  • Childcare or care for an older relative
  • Education you hope to make possible
  • Debts you would not want to leave behind
  • Final expenses
  • Time — so family are not rushed back to work

3. What is already in place

Coverage through work (and whether it would follow me if I left)
Coverage I bought myself
Savings the household could rely on
Income my household would still have

4. How long protection may matter

Years until the youngest child is independent
Years left on the mortgage or other major commitments
Anything I want covered for life rather than for a period

5. What matters to you

My monthly budget for protection is realistically…
I would rather have more coverage for a set period / lifelong coverage, because…
Health or lifestyle details an advisor should know about
Who should be my beneficiary, and who should be a back-up

6. Questions to bring

  • What is the practical difference between term and permanent coverage for someone in my situation?
  • What happens to my coverage if I change or leave my job?
  • What would make an application take longer, or cost more?
  • How and when should I review this again?
  • What should my family do, and who should they call, if they ever need to make a claim?

This resource is general educational information only. It is not insurance, financial, tax, medical or legal advice, and it does not recommend a specific plan or company. Your own situation may be different — talk with a licensed advisor, and confirm details with the plan or with the official government source before you decide.

This worksheet does not calculate a coverage amount and is not a recommendation. Availability, eligibility and pricing depend on the insurer's underwriting.

Source: Bleu Sky's Insurance Solutions. Last reviewed September 4, 2026.

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