Contracting Information A - L
AGA Forms
- EFT Changes
- AOC Set Up & Termination
- Hierarchy Changes
- Contracting Status Meanings
- Errors and Omissions
Aetna
- Contracting
- Transfer / Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commissions
Aetna ACA
- Contracting
- Transfer / Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commissions
Aetna Med Supp
Aflac
AIMC – ACE
AIMC – MIAC
AIMC – WoodmenLife
Agewell
Alignment
Allstate Health
Ambetter ACA
American Benefits Life – Liberty Bankers
AmeriHealth – IBC
Ameritas Dental and Vision
- Contracting
- Transfer / Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commissions
Anthem Blue Cross and Amerigroup
- Contracting
- Transfer / Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commission
Anthem ACA
Aspire
Astiva
Asuris Northwest & Regence BlueCross BlueShield
- Contracting
- Transfer / Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commissions
Bankers Fidelity
- Contracting
- Transfer / Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commissions
Banner Health
BCBS AR
BCBS of AZ
BCBS HCSC – IL, MT, NM, OK, & TX
- Contracting
- Transfer / Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commission
BCBS of Kansas City (MO & KS)
BCBS of MN
BCBS of NC
BCBS of NE
BCBS of TN
Blue Shield
Brand New Day
Bright Health
- Contracting
- Transfer / Release Policy
- EFT Changes
- Demographic Changes
- Add Non Resident State
- Assignment of Commissions
CalOptima Health
Care N Care
Carepartners
Centene – Allwell, Ascension Complete, Fidelis Care, Health Net, and WellCare
- Contracting
- Transfer/Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commissions
Central
CIGNA Healthcare
CIGNA Med Supp
CIGNA ACA
Clear Spring Health
Clever Care
Clover Health
Commonwealth Care Alliance
Denver Health Medical Plan
Devoted Health Plans
Elderplan
Emblem
Emblem ACA
Essence Healthcare (Stanford)
eternalHealth AZ
eternalHealth MA
Excellus – Univera
Fallon
Florida Blue
Freedom Health – Optimum Healthcare
Friday Health ACA
Geisinger Health Plan
Gold Kidney
Guarantee Trust Life
Harvard Pilgrim Healthcare – Stride
Hamaspik
HCSC ACA
Health New England
Health First NY
Health First FL
Health First FL ACA
HealthPartners
Heartland National Life
Highmark
Horizon / Braven
- Contracting
- Transfer/Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commission
Humana
- Contracting
- Transfer/Release Policy
- Demographic Changes
- EFT Changes
- Add Non Resident State
- Assignment of Commission
IBC – AmeriHealth
IMG
Imperial Health Plan
Indiana University Health Plans
Innovative Integrated Health Community Plans
Intervalley
Jefferson Health Plans
Kaiser Permanente
KelseyCare
LA Care
Liberty Heatlhcare
Liberty Bankers
Aetna
Thank you for your interest in marketing Aetna Medicare and SilverScript through Applied General Agency. Aetna uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days. Click on the link to begin contracting.
For a full overview please see Aetna Onboarding Guide
You will be asked if you already have access to the Aetna Producer World. If you do not, you will be asked to register. After you are registered for Producer World, click back on the contracting link and log in using your Username and Password.
If you, cannot find your invitation email or are taken to the Producer World home page, navigate to Individual Medicare, Quick Links then Medicare Producer Contracting. If you have multiple invites, you will need to cancel all but one invite to move forward.
Upon login to Producer World, your records will be pulled from the National Insurance Producer Registry. Be sure to update your personal and firm information with the National Insurance Producer Registry https://nipr.com/licensing-center/change-contact-info.
Aetna will then ask if you are contracting as an agency. Select YES if you are the principal of your own corporation. Select NO if you are not the principal of your own corporation.
You will then review and sign your W-9. Complete required fields with and select the blue “Click to Sign” button.
Continue and select invitation.
Now you will work your way through each contracting tab. Fill in all the mandatory fields as requested. The tab will show “incomplete” if information is missing. Note the final “Transfer” tab – this is where you will upload your Aetna transfer form if you are moving from a different upline agency. This is NOT required if you are contracting with Aetna for the first time.
If you are already contracted you will need to complete the Aetna Transfer Release form. If your current upline signs it, you will transfer immediately. If the form is not signed by your upline, upload the form with just your signature and you will be realigned after a 90-day waiting period. No transfers can be made between 10/1 and 12/31.
After all tabs have been completed, submit the contract for processing. You will receive a confirmation of submission. You can immediately begin Aetna certification by using Aetna certification instructions in your AGA back office portal under Sales Tools, My Sales Tools then Certifications.
IMPORTANT – Your contract will finish NOT processing until certification is complete.
Upon completion of your contract and yearly certification, you will be appointed by Aetna for Individual Medicare products in the pre-appointing states where they hold an active license. Just-in-time appointing states will be ordered after a policy is written.
Transfers are not permitted or processed from October 1 – December 31. The last day to submit a notice of intent for the current year’s AEP is June 30th.
If you are currently contracted, have been with your current upline for at least three months AND have no production in the last three months you may submit a new contract. Please follow the instructions above for new contracting.
If you are contracted less than three months or have had production in the last three months, you will need to complete a new contract and upload the Aetna Transfer Release form. Please follow the instructions above for new contracting.
If your upline will not sign the Transfer form, begin a notice of intent by completing all the way to the agent portion of the Transfer form. The completed transfer must be submitted electronically via Medicare Producer Contracting via Producer World. Open Producer World>Medicare Producer Contracting>Open assigned invitation>Add Document>Upload transfer or intent to transfer. Once submitted, you will be transferred to the AGA after a 3-month interim period.
Update your personal and firm information with the National Insurance Producer Registry https://nipr.com/licensing-center/change-contact-info. Your demographics from NIPR will flow into Aetna’s contracting tool.
Log into Producer World https://www.aetna.com/about-us/login.html. Navigate to Manage your personal information > Personal/Firm profile > Firm Access Info/privileges > Personal Profile
If you have questions, just contact the Aetna Medicare Broker Services Department at 1-866-714-9301 or brokersupport@aetna.com. Normal business hours are 8 a.m. to 8 p.m. ET from Monday – Friday.
Log into Producer World https://www.aetna.com/about-us/login.html. Navigate to the Compensation section. Click “Get compensation statement” then select the applicable direct deposit link (individual or firm). Submit the updated form online.
If you have questions, just contact the Aetna Medicare Broker Services Department at 1-866-714-9301 or brokersupport@aetna.com. Normal business hours are 8 a.m. to 8 p.m. ET from Monday – Friday.
You should actively monitor your RTS status before selling in each state where you conduct business. You can begin to monitor your active RTS status now on our new map tool on Aetna’s Individual Medicare Page under Requirements to sell on Producer World, https://www.aetna.com/about-us/login.html. This interactive map will allow an agent or agency principal to determine their own RTS status by product and by state, specific to the selling season.
To add a state email brokersupport@aetna.com, and include your name, NPN, non resident license, and state you would like to be contracted in that state.
Some state appointments are processed just in time, and others need an appointment prior to submitting business. Review Aetna’s Pre-Appointment State List
Aetna ACA
Thank you for your interest in contracting with Aetna ACA . AGA is partnered with our Integrity Partner, Plan Advisors, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your ACA contracting.
Adding Aetna ACA Existing Broker or Aetna ACA New Broker and choose Plan Advisors as your upline.
Thank you for your interest in contracting with Aetna ACA . AGA is partnered with our Integrity Partner, Agent Pipeline, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your ACA contracting.
Adding Aetna ACA Existing Broker or Aetna ACA New Broker and choose Plan Advisors as your upline.
Update your personal and firm information with the National Insurance Producer Registry https://nipr.com/licensing-center/change-contact-info. Your demographics from NIPR will flow into Aetna’s contracting tool.
Log into Producer World https://www.aetna.com/about-us/login.html. Navigate to Manage your personal information > Personal/Firm profile > Firm Access Info/privileges > Personal Profile
If you have questions, just contact the Aetna Medicare Broker Services Department at 1-866-714-9301 or brokersupport@aetna.com. Normal business hours are 8 a.m. to 8 p.m. ET from Monday – Friday.
Log into Producer World https://www.aetna.com/about-us/login.html. Click on ‘Compensation Services‘ which is located on the left side of the screen then click on ‘EFT & forms’.
If you have questions, just contact the Aetna Medicare Broker Services Department at 1-866-714-9301 or brokersupport@aetna.com. Normal business hours are 8 a.m. to 8 p.m. ET from Monday – Friday.
To do an add state email Aetna at Laau@aetna.com with a license copy and your NPN in subject line.
Commission can be assigned to agent/agency of your choosing.
Aetna Med Supp
Thank you for your interest in marketing Aetna Med Supp through Applied General Agency. Begin your Aetna Med Supp contracting today via DocuSign Aetna Med Supp Contracting
To begin a transfer for Aetna Med Supp you will need to complete the Aetna Med Supp Contracting and submit the form via DocuSign.
A letter of release is needed if you have written business within the past 6 months or have been contracted with your current upline for less than 6 months.
If you are unable to obtain a release, you may begin a delayed 6 month release.
To change your EFT, complete the EFT form. Either fax 855-571-3847 or electronically send to Aetna Med Supp. To electronically submit log into https://www.aetnaseniorproducts.com/ssi/index.html, select My Tools, Agent Maintenance. Request type is Agent Maintenance, Select Agent Number, upload EFT form, and submit.
AGA
To set up, change or cancel your EFT for AGA commissions please complete the EFT Form via DocuSign. The name on check must match the payee name we have on file. If you are changing your payee name please complete the corresponding AOC change forms.
Assignor = the party (individual/entity) that is assigning its commission
Assignee = the party (individual/entity) that is receiving the commission
Please contact contracting@appliedga.com with questions.
If you would like to set up and assign commissions to a corporation you own, please complete the AOC Principal Owned via DocuSign. Be prepared to upload a copy of the corporation license, E&O, and void check. Completing these forms will only change how AGA pays out your agent commissions. AGA will send out contracting links for direct-pay carriers these need to be completed to allow to be paid to your corporation. Each direct pay carrier has a unique process for updating how commissions are paid.
If you would like to set up and assign commissions to a corporation you do not own, please complete the AOC Non-Principal Owned via Docusign. Assignor will need to enter the contact information for the Assignee. The Assignee must be a signing principal of the corporation, and will need to be prepared to upload a corporation license, E&O and void check. The forms are completed once the Assignor and Assignee complete their portions of the forms. Completing these forms will only change how AGA pays out your agent commissions. AGA will send out contracting links for direct-pay carriers these need to be completed to allow to be paid to the corporation. In instances where the carrier does not allow agent-to-agent AOC or the corporation is not contracted agent commissions can be directed to AGA for distribution.
To terminate an assignment of commission and have your new and past business paid to you, complete the AOC Termination Form. This will require approval from the Assignor and Assignee. Assignor will need to enter the contact information for the Assignee. The Assignee must be a signing principal of the corporation. The forms are completed once the Assignor and Assignee complete their portions of the forms.
To terminate an assignment of commission and have new business paid to you, complete the AOC Termination Form Future Business. Be prepared to upload a copy of a void check. This does not require approval from your previous Assignee to terminate.
Changes within AGA’s hierarchy can be requested by using AGA Hierarchy Transfer Form via DocuSign. This form has a signing order and will need to be completed by all parties before a hierarchy change is made in AGA’s system.
- The releasing principal will click on the link above. The releasing principal will need the agent’s name, the agent’s email on the landing page. On the DocuSign the releasing principal will need to complete the form and list name of the agency the agent is transferring to.
- The form will be sent to the agent to complete and sign
- The form will be approved by AGA Sales, Jason Bronston
- AGA Contracting will then process the hierarchy change
To leave AGA contact help@appliedga.com
Base Status | In AGA downline / Not in downline | Meaning |
In Process | Not in downline | AGA will soon send contracting or temporarily waiting for more information |
Approved | In downline | Agent RTS with carrier for current year |
Submitted | Not in downline | AGA sent contracting paperwork and waiting for a carrier response |
Denied | Not in downline | Denied per carrier |
Closed | Not in downline | Inactivated due to a variety of reasons |
Missing Document(s) | Not in downline | Paperwork is missing for us to send contracting |
Out-of-Area | Not in downline | Carrier not available in agent’s state |
Opted Out | Not in downline | Agent does not want to contract with carrier |
Pending Business | Not in downline | Contracting can be sent in at the same time as the first piece of business
|
Pending Documents from Agent | In downline | Need paperwork or information agent in downline |
Pending Certifications | In downline | Agent needs to complete certifications |
Pending Carrier Approval | Not in downline | Paperwork submitted waiting for carrier |
Pending Agent Action – Contract | Not in downline | Agent needs to complete carrier contracting/requirements |
Pending Agent Action – Certifications | Not in downline | Agent needs to complete certifications |
Delayed Release – In Process | Not in downline | Carrier offers delayed release. Necessary docs have been submitted to carrier |
Delayed Release – Pending Agent Action | Not in downline | Carrier offers delayed release. Agent has not completed necessary docs |
Pending Documents from Agent – Release | Not in downline | Need release from agent to move forward |
Suggested E&O provider https://www.napa-benefits.org/aga/errors-and-omissions
Aflac
Thank you for your interest in marketing Aflac through Applied General Agency. Aflac uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days. Click on the link to begin contracting.
The email will be from DoNotReply@aetna.com with “Your application for Aflac” as the subject. Note: A reference number will be generated after you access the link. Please keep this number for your record in order to return to this application if needed.
Contracting:
Click the link in the email
Click the “Start” button or enter your reference number if you are returning to a previously started application.
IMPORTANT – Be sure to save your reference number in case you need to come back to contracting application
Scroll through the screens and complete all the requested information
You will be able to upload any documents that may be needed, such as release letters or explanations for special circumstances
Review your information at the at the “Acknowledgment” page – prior to submission
Click the “Submit” button
Please see Onboarding Guide for a step-by-step guide.
You will receive an email letting you know that your contracting application has been received for processing. Processing will take approximately 7-10 business days. An email will be sent to you with your new Aflac writing number when the approval process is complete.
If you are licensed to sell Final Expense individual whole life insurance plans, you are required to complete an annual anti-money laundering course and provide Aflac proof of completion. Upload your AML training on https://www.suppinsadmin.com/ssitpa/tpaSecure/afl/aflHome.html under My Business then My Profile.
AML training can be completed on www.limra.com.
A letter of release is needed if you have written business within the past 6 months or have been contracted with your current upline for less than 6 months.
To transfer immediately a letter of release is needed from your current upline.
If you are unable to obtain a release, you may begin a delayed 6 month release. To begin you will need to contact the Regional Sales Specialist at Aetna to let them know you would like to change hierarchies. You will be able to switch hierarchies 6 months after making this request and can continue to write business during this waiting period.
When the 6 month waiting period is over, you will need to submit a new contract with the requested upline hierarchy.
To review your state appointments with Aflac log onto https://www.suppinsadmin.com/ssitpa/tpaSecure/afl/aflHome.html. Go to My Business, then my Profile to review your state appointments.
In regard to states, all states are JIT except AK, PA, UT, and WY. Those 4 are pre-appointment. If needed, those can be sent to the Tier One at information@aflac.aetna.com and other various licensing questions as well.
Aflac EFT changes can be made on https://www.suppinsadmin.com/ssitpa/tpaSecure/afl/aflHome.html.
AIMC – ACE, MIAC, Woodmen Life
Thank you for your interest in marketing AIMC – ACE, MIAC, Woodmen Life through Applied General Agency. AIMC uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days. Click on the link to begin contracting.
No release is required if the agent has now written in the past 6 months and has been contracted for less than 6 months.
To begin a transfer please email the intent statement to contracting@appliedga.com and licensing@aimc.net. The letter of intent is a statement in the body of your email. Please state your name, NPN, your request to transfer to AGA, indicate where commissions are to be paid (self or your corporation), indicate if you have a downline, indicate if you would like an advance (6 or 9 months), and list the states you are contracting in. For example, Hello my name is John Smith, NPN 123123. Please process my hierarchy change to Applied General Agency. I would like my commissions to be paid to my corporation JS Insurance. I do not have any agents in my current downline. I would like to advance my commissions to 9 months. Please contact me in the states that I am licensed in, CA OR, WA, and TX. Thank you,
Email licensing@aimc.net and indicate what states you want to be contracted with. Include your name, NPN and indicate what carrier(s) the change is for.
All states are pre-appointment – meaning for any state the agent must see it on the ACE E-app portal before writing an application. (Any state is all the states available whether the state has an appointment process or not!)
ACE requires that all individuals hold a valid license in any state they want to conduct business. This includes their resident state although that state may not be available with product at this time. If contracting as an agency, please make all agents aware that ACE requires the agency to hold a valid license in any state they want to conduct business and receive commission of any type. This includes states that may not require an insurance agency license (IA, RI, TN & WI). Please encourage all agents to choose all the states they will be doing business in when completing the online contract. This will speed up the process when they need to write an application as an agent cannot write for ACE if the state has not been activated on their contract/writing#.
Email licensing@aimc.net and indicate what the changes are. Include your name, NPN and indicate the carrier(s) you are making the change for.
Agewell
As of 11/1/2023 Agewell no longer marketing MAPD Plans
Thank you for your interest in contracting with AgeWell New York through AGA. Please have your NY license, E&O and AHIP ready to upload. When completed your contracting will be sent to AgeWell by AGA, and then you set instructions to complete your certifications. Please contact contracting@appliedga.com with questions.
To get started complete the Docusign AgeWell New York Contract.
Agents can request a 6 month delayed release with completing part 1 of the Transfer Release Form. Or can complete part 1 & 2 of Transfer Release Form (where FMO signs) for an immediate transfer. Send the completed transfer form to medicarebrokerintake@agewellnewyork.com & contracting@appliedga.com.
Alignment
Thank you for your interest in marketing Alignment through Applied General Agency. Alignment uses an online contracting system, and will require you to complete your own contracting. Please allow about two hours to complete this process. You will be contracting and certifying in one sitting, when complete you should be sent a ready to sell letter. Please have your license, E&O and AHIP ready to upload.
Navigate to https://www.alignmenthealthcare.com/Partners/Brokers; click on Certify+, and select New Agent. Enter your NPN and submit.
Complete General Information. Select Applied General Agency as your contracted affiliation. Just start typing Applied and a drop down will appear for you to select Applied General Agency. Select NEXT.
Upload Documents: Upload your current license, E&O and AHIP.
AOC Agreement: Fill your full name in Agent Signature and ensure Contracted Agency Name is Applied General Agency.
Training: Please note the following about our certification training and exam.
You need to watch the entire training video before taking the exam. The certification exam must be completed within 2 hours, or you will have to restart the training. All questions must be answered and you must achieve a score of 85% or greater. You need to pass the certification exam within 3 attempts
If you choose to come back later, to get to the training navigate to https://www.alignmenthealthcare.com/Partners/Brokers; click on Agent tab, and select New Agent. Enter your license, NPN and selling market. You will be taken to where you left off.
Policy: Active Agents in good standing will be granted a (1) time per year hierarchy change with no release required from FMO/Agency hierarchy. Requests need to be submitted by 15th of the month, to be effective the following month with a blackout period from October – December. Moves requested during the 4th quarter will require a letter of release in order to be honored.
To begin the transfer please complete the Alignment Transfer Form. Be prepared to upload a letter of release If you are submitting the request in October – December.
Contracted Agency = Applied General Agency LLC
Log into Alignment portal, and complete state specific certifications. https://agents.alignmenthealthcare.com/
Alignment offers direct pay to agents. Agents will be opted into direct pay or opted out of direct pay based on AGA’s data.
An agent who opted out of direct pay will continue receiving commissions paid by AGA. If an agent is marked as an AOC will not be added to direct pay. To change an AOC agent’s Alignment pay the principal will need to email contracting@appliedga.com and confirm the change that is needed. It is very important to note Alignment’s direct pay will be for new business AND renewals. ALL commissions will be paid to a single location. If a captive agent moved to direct pay, the agent would receive renewals that are not contractually due to them.
An agent who is opted in for direct pay will be sent additional requirements by Alignment, including providing bank account information, submitting a W9 form, and signing Direct Pay Agent Joinder. Failure to complete these steps will result in payments continuing to be directed to AGA, for disbursement. Multiple agents can assign their commissions to a corporation/person. Agents will still be broker of record no matter where they point their commissions. (LOAs are not available, just AOC). Also, direct pay is unique to the agency through which the business was written. Therefore, if an agent moves from AGA to a different agency and opts for direct pay, it will only apply to the business written under the new agency.
Set up Alignment Health EFT by navigating to the My Commission tab in your Alignment Broker Portal, and then click on “Connect to e123” to sign up.
In the e123/Unified TPA Agent Payment portal, follow these steps:
Download, complete, and sign your W-9. Upload it to the Documents section.
- Add your bank account for ACH Direct Payment of Commissions.
- Go to the Documents section on the agent portal, and then click the ‘Generate Agent Joinder’ agreement.
After completing these steps, expect an email from agent@unifiedtpa.com confirming your Opt-in Status or addressing any missing or incomplete information. If you have any questions, please reach out to PartnerExperience@ahcusa.com.
Allstate Health
Begin contracting by using the following contracting link: AGA/Allstate Health Landing Page
Releases are handled on a case-by-case basis. If you are unable to complete your online contracting link contact NatGenAHagentserv@ngic.com, state that you are contracting under AGA, and you will be advised on how to move forward.
Ambetter ACA
Thank you for your interest in contracting with Ambetter ACA . AGA is partnered with our Integrity Partner, Plan Advisors, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your ACA contracting.
All agents must complete the Ambetter Broker Release Form and submit to Ambetter for review and approval. Forms should be submitted to Ambetterbrokers@centene.com. Please Cc contracting@appliedga.com & info@myplanadvisors.com on the email request.
NOTE: Agents that are currently direct with Ambetter: only the Sub-Producer signature is required (not the Principal & Agency).
Transfer Timeframe: Requests are generally processed within 15 business days.
Ambetter reserves the right to deny this request. Ambetter does not under any circumstance transfer membership or commissions.
Any commissions and membership that the sub-producer earned while under the contracted agency & principle noted on this form will not be transferred to sub-producers new requested contracting entity. All commissions and membership earned by the sub-producer listed on this form while contracted under agency and principle listed on this form will remain. No exceptions will be granted.
Upon completion agent needs to recontract
No delayed release process
Blackout period varies year to year. Determined by Ambetter
Email changes to info@myplanadvisors.com & contracting@appliedga.com
Changes can be made by contacting info@myplanadvisors.com
Email changes to info@myplanadvisors.com & contracting@appliedga.com
American Benefits Life – Liberty Bankers
Thank you for your interest in marketing American Benefits Life – Liberty Bankers through Applied General Agency. Aflac uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days. Click on the link to begin contracting.
TRANSFER RULES
No transfer will be allowed in the first 12 months of an agent’s contract. Transfer without production in the last 12 months does not require a release.
When an agent requests a transfer from their hierarchy and is declined, after 31 days of non- production the agent can request a direct transfer from the Company or the applicable rules of engagement promulgated by the Company will apply.
Cannot transfer for a higher-level contract in first 12 months following release.
Same transfer rules apply to everyone.
Changes can be made on www.lbig.com, at the top right where it says myLBIG Portal, under the AGENTS Header, click Med Sup American Benefit.
Changes can be made on www.lbig.com, at the top right where it says myLBIG Portal, under the AGENTS Header, click Med Sup American Benefit.
Changes can be made on www.lbig.com, at the top right where it says myLBIG Portal, under the AGENTS Header, click Med Sup American Benefit.
NM and PA are our only pre-appointment states. All other states are set up with the agent submits an app in the state.
AmeriHealth – IBC
Thank you for your interest in contracting with AmeriHealth – IBC. To get started complete the contracting link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer AmeriHealth – IBC to our agents. Be prepared to upload a copy of a void check. After the DocuSign submission, you will receive a contracting link to begin contracting in a few days. Click on the link to begin contracting.
AmeriHealth – IBC Direct Pay Contracting Link: Agents are paid directly by Ritter.
(Not Common) AmeriHealth – IBC Indirect Pay Contracting Link: AGA pays you for your enrollments
Thank you for your interest in contracting with AmeriHealth – IBC. To get begin your transfer complete the contracting link via DocuSign, and indicate you are transferring your appointment. AGA is partnered with our Integrity Partner, Ritter, for us to offer AmeriHealth – IBC to our agents. Be prepared to upload a copy of a void check. After the DocuSign submission, you will receive a contracting link to begin contracting in a few days. Click on the link to begin contracting.
AmeriHealth – IBC Direct Pay Contracting Link: Agents are paid directly by Ritter.
(Not Common) AmeriHealth – IBC Indirect Pay Contracting Link: AGA pays you for your enrollments
Important transfer notes:
• Sales with coverage effective dates on or after the hierarchy switch date will be credited to the new FMO/MGA.
• Hierarchy switch dates or level changes may only be effective on the first day of a calendar month.
• Requests for an agent switch to a new FMO/MGA for an October 1 effective date must be received no later than September 15.
• Hierarchy switches will not be approved for November 1 or December 1 effective dates, herein referred to as the blackout period.
• For an agent switch to a new FMO/MGA to commence on January 1, agent must be certified with the new FMO/MGA by September 30 of the prior calendar year. An Agent who does not meet the September 30 certification completion date will not become effective with the new FMO/MGA until March 31 or later, pending completion of all required steps.
• New Agents must complete all steps of the Independence/AmeriHealth- certification process within 30 days of receiving the IBC/AmeriHealth certification link. If agent doesn’t complete the Independence /AmeriHealth certification within 30 days the agent will not be aligned to the new FMO/MGA.
• Requests for an Agent change to a General Agent level, or for an increase to a General Agent’s level, must be submitted using the Hierarchy Switch request with the requested level notated. The proposed GA’s downline must also submit Hierarchy Switch requests at that time. GA level requests will be denied if the FMO-GA contractual requirements are not met at time of submission.
Email license@ritterim.com with the requested changes.
Complete EFT Change Form Via Docusign
To add a state please complete new contracting to add your requested state.
AmeriHealth – IBC Direct Pay Contracting Link: Agents are paid directly by Ritter.
(Not Common) AmeriHealth – IBC Indirect Pay Contracting Link: AGA pays you for your enrollments
Ameritas Dental and Vision
Thank you for your interest in contracting with Ameritas. To get started please complete the Ameritas AGA Agent Contract via DocuSign. Be prepared to upload a void check and a letter of explanation if needed. Your contract will be sent to AGA and Ameritas immediately after submission for processing. After processing Ameritas will send a welcome letter that includes your writing number and custom URL.
Important: Enter your full name as it appears on your license after clicking the contracting link.
Agents are free to transfer their Ameritas appointment without a release after 6 months of no production under their current GA. To begin the transfer please complete the Ameritas AGA Agent Contract via DocuSign. Be prepared to upload a void check and a letter of explanation if needed. Your contract will be sent to AGA and Ameritas immediately after submission for processing. After processing Ameritas will send a welcome letter that includes your writing number and custom URL.
Important: Enter your full name as it appears on your license after clicking the contracting link.
Email LC@ameritas.com with your demographic changes
Complete EFT changes on www.producerportal.ameritas.com
Anthem Blue Cross and Amerigroup
Thank you for your interest in marketing Anthem Blue Cross & Amerigroup through Applied General Agency. Anthem uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days.
The Anthem email will be from software.support@anthem.com with the subject of “Action Required: Your agency has asked us to appoint you”. The body of the email will indicate that the invite was sent to you by ‘APPLIED GENERAL AGENCY, INC’.
Anthem Walkthrough: Anthem submission guide
If logging in using the link in the email notification received from SoftwareSupport@anthem.com, once logged in you will land directly in the appointment request. If logging in by going to https://brokerportal.anthem.com/apps/ptb/login, Click the ‘Complete Appointment’ button
Basic Information: If Contracting as a Corporation: The agency information section will only appear if you select ‘yes’ to indicate you are the Principal of an Agency or General Agency. If you are a not the principal of the agency, please select ‘no’ and you will not be prompted to enter any agency information.
Appointment Section: Select the state/brand combinations you would like to be appointment/contracted in. Select “Line of Business” – most states will have the options of Individual, Large Group, Small Group and Senior. You will select one option and then select Add another Line of Business to add additional options. Select who your Medicare commissions should be paid to. When contracting as a corporation both you and your corporation need to be licensed in all states being requested.
To sell Medicare with AGA it is very important to select to sell the Senior line of business.
- Commission selection – State selection needs to be complete to view all options
- Broker – Direct pay to agent
- Parent Agency – Commissions are paid to AGA, and AGA will pay you
- 3 Tier Broker Owned Agency – Commission paid to the corporation you own
- 3 Tier Agency – Not Common – You are assigning your Anthem/Amerigroup commissions to a third party that is currently contracted with Anthem.
If a release is required due to an existing agency relationship, you will see the release information message. If a release is not required, you will not see any release information.
Complete business survey, forms, EFT, and payment. Payment of state appointment fees is required if you are contracting for the first time in this state. Fees are determined by each state’s Department of Insurance.
When completed you will see a submission confirmation. You can then check the status of your request on your dashboard
You may now begin the certification process. You can complete the certification while your contract is being processed, Instructions are in your back office portal. After the contract is processed and certification has been completed successfully, you will receive an Anthem “Welcome” letter with agent number.
If you are currently contracted with Anthem through another agency you will need to submit a new agent contract under AGA using the above instructions.
In addition to the paperwork, there are two ways to transfer to AGA.
Immediate transfer: Submit your AGA/Anthem contract and upload your letter of release from your previous agency. Please reach out to your current upline to see if they will issue a letter of release. If the release is not uploaded you will default to the three month delayed release.
Three month delayed release: Submit your AGA/Anthem contract. After three months you will need to send a new AGA/Anthem contract. You will be sent an email from Anthem notifying your three months has passed. Email that email to contracting@appliedga.com and we will send you a new contracting link. Agents submitting for a delayed release from 7/1 to 9/1 can submit their second contract after 1/1.
Agents can continue to sell Anthem whether their Upline Agency honors their request for immediate release or requires a waiting period.
Elevance Health Agent Release Policy
Agents currently associated to an FMO/EMO/MGA partner must be released in order to change their relationship. When an onboarding request is received for a new relationship and the agent is identified as having an active affiliation with one of our FMO/EMO/MGA partners, a release request will be generated online via the Broker Portal to the current Partner.
IF the release is approved, the new onboarding request will move forward and complete processing. No waiting or black out period applies.
IF the release request is denied, the current onboarding request is closed and a waiting period is required for the agent to re-apply to move to a new relationship.
Blackout Period for Agent Release:
- Upline Agency denial of agent release requests that are submitted between January 2 and June 30 will have a waiting period of 90 days.
- Upline Agency denial of agent release requests that are submitted between July 1 and September 30 will be subject to a black out period during AEP. Agents will be able to re-apply for relationship change beginning January 2.
- A limit of one release every 12 months will be accepted for all agents without an approval from the current Upline Agency (subject to waiting periods).
Why do we have a Blackout Period and a 90 day Release Option for Downline Agents?
This change protects our Agency partners during the most critical months before and during the annual Medicare open enrollment period. Offering a faster 90 day release option gives agents more flexibility. Downline agents can continue to sell Anthem whether their Upline Agency honors their request for immediate release or requires a waiting period.
Agent Release Timeline | |||
Release Request Received | If Not approved, Release Waiting Period | If approved, Immediate Release | |
1/2 through 6/30 | Agents can re-apply after 90 day waiting period | *Processed upon receipt | |
Blackout Period – 7/1 through 9/30 | Agents can re-apply beginning 1/2/2025 | *Processed upon receipt | |
10/1 through 1/1 | Agents can re-apply after 90 day waiting period | *Processed upon receipt | |
1/2 through 6/30 | Agents can re-apply after 90 day waiting period | *Processed upon receipt | |
*upon validation by our Licensing & Credentialing Team |
See Anthem Demographic-EFT-Commission Pay Structure.
Updating contact/demographic information page 15
Log into Producer Toolbox https://brokerportal.anthem.com/apps/ptb/login. Click the profile icon and ‘Account Details’, click ‘Contact’, click ‘Edit’. Update desired information (address, phone number, and/or email address) and click ‘Save’. If updates are accepted, a successfully message will appear.
See Anthem Demographic-EFT-Commission Pay Structure.
Existing Brokers Changing Commission Payment Structure page 12 – 13
Existing Agents Adding or Updating Electronic Fund Transfer (EFT) page 14
Log into Producer Toolbox https://brokerportal.anthem.com/apps/ptb/login. Click the profile icons, ‘Account Details’
Select ‘EFT info’. Add, Edit, or Remove EFT information.
See Anthem Demographic-EFT-Commission Pay Structure.
Existing Brokers Changing Commission Payment Structure page 12 – 13
At this time existing agents are only able to request this type of change during the communicated opt in period.
Log into Producer Toolbox https://brokerportal.anthem.com/apps/ptb/login. Click the profile icon and ‘Account Details’. Scroll down to a state with a senior relationship under your upline/parent agency. Click ‘Update Commission’ to change the commission payment setup. Note: When changing your commission payment structure, you only have to complete this process for one state. Based on that request, the updates will be made for ALL state under that upline/parent agency.
Select desired commission payment setup type from the dropdown list. Enter the required agency information if requesting a 3 Tier setup. Click ‘Save Changes’. Complete all required forms. Click ‘I Acknowledge’ and then click ‘Back to Overview’ once all forms show completed. Click ‘Submit’. A confirmation screen will appear with a button to return to ‘Account Details’.
Anthem ACA
Thank you for your interest in contracting with Anthem ACA . AGA is partnered with our Integrity Partner, Plan Advisors & New Health Partners, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your ACA contracting.
Email info@myplanadvisors.com with changes
Complete the ACA EFT form via DocuSign
Email info@myplanadvisors.com with changes
Aspire
There are a limited number of agent contracts available for Aspire. To be considered for contracting Aspire you will need to conduct the majority of your business in Monterey county, and provide a marketing plan or an estimate of the business you expect to write. Please detail your qualifications in an email to contracting@appliedga.com.
Astiva
Thank you for your interest in marketing Astiva through Applied General Agency. Astiva uses an online contracting system, and will require you to complete your own contracting.
Certification Link: http://brokerportal.astivahealth.com/
Contracted Agency Affiliation: Applied General Agency NPN 6187022
Please be prepared to provide the following information:
- National Producer Number (NPN)
- AHIP for current year
- CA Department of Insurance License
- E&O Coverage
For an immediate transfer please send a copy of your letter of release to contracting@appliedga.com and let us know you need to transfer your Astiva contract.
If you are unable to obtain a letter of release from your current upline, Astiva can review transfers on a case by case basis. Please reach out to brokersupport@astivahealth.com and contracting@appliedga.com, to discuss your situation.
Complete your Astiva EFT Changes via DocuSign
Complete your Astiva AOC via DocuSign
Regence BlueCross BlueShield and Asuris Northwest
Thank you for your interest in contracting with Asuris/Regence. To get started please complete the Request link via DocuSign Regence – Asuris Contracting Request. AGA is partnered with our Integrity Partner, My Plan Advisors, for us to offer Asuris to our agents.
When submitting a Producer Affiliation request as an Agency appointment, the corporation and agent must be both licensed in the states requested. Be prepared to upload a copy of your license, E&O, and void check, if applicable corporation license and corporation E&O.
Allow 10-14 business days for the request to be processed (can take longer during times of increased activity). The Asuris Agent Onboarding team will send the producer/agency agreement to the email provided. Review, sign, complete, and return the agreement to agentdesk@regence.com. Once the request is complete, you will receive a welcome email with your writing number. If a Medicare appointment to sell MA/PDP Plans was requested, agents will automatically receive an email with a link to the certification training found at Pinpoint.
Immediate Realignment – Release letter
To secure a release, please obtain a letter from your current FMO. The letter should be on the FMO’s letterhead, list your name and agency name (if applicable), and the date of the release. The letter should be signed by the principle of the FMO.
Send a copy of the release, Asuris Contracting Request Form with supporting documents to contracting@appliedga.com.
If you are an affiliated producer in an agency (one who assigns commissions to an agency), you will also need a release from the agency.
90 Day Delayed Release – Cannot Obtain Release Letter
If you are unable to secure a Release letter from your current upline, send an email to the current upline requesting to be released. Ensure the email contains the name of your current upline agency and shows the date it was requested.
Send a copy of the email request, Asuris Contracting Request Form with supporting documents to contracting@appliedga.com.
If you are an affiliated producer in an agency (one who assigns commissions to an agency), you will also need to request a release from the agency.
Your contract and appointment will be realigned under Plan Advisors 90 days from the date of the release request once your paperwork is completed
Email changes to AgentDesk@regence.com.
Email changes to AgentDesk@regence.com.
Send the, Asuris Contracting Request Form with supporting documents to contracting@appliedga.com and agentdesk@regence.com
Allow 10-14 business days for the request to be processed (can take longer during times of increased activity). The Asuris Agent Onboarding team will send the producer/agency agreement to the email provided. Review, sign and complete and return agreement to agentdesk@regence.com.
Once the request is complete, you will receive a welcome email with your writing number. If a Medicare appointment to sell MA/PDP Plans was requested, agents will automatically receive an email with a link to the certification training found at Pinpoint.
Bankers Fidelity
Thank you for your interest in contracting with Bankers Fidelity with Applied General Agency! To get started you will complete online contracting through SuranceBay.
Below is the link that AGA downlines will use to contract with Bankers:
If you are new to SuranceBay here is a SuranceBay User Guide.
To transfer your Bankers Fidelity appointment to AGA you will need to complete a new contract through SuranceBay. In addition to completing the contract if you have written business in the past six months or have contracted with a new upline in the past six months a letter of release is needed to transfer your contract.
Below is the link that AGA downlines will use to contract with Bankers:
Bankers direct deposit form completed and emailed to licensing@premiersmi.com and contracting@appliedga.com with agent name, writing number
Email contracting@appliedga.com and licensing@premiersmi.com with agent name, writing number, and states to add.
Bankers Assignment of Commissions form completed and emailed to licensing@premiersmi.com and contracting@appliedga.com with agent name, writing number
Thank you for your interest in marketing Banner Health through Applied General Agency. Banner Health uses an online contracting system and we will need some information to get the process started.
To get started complete the Banner Background Form via DocuSign. After completion, AGA will send you a Banner contracting invitation to begin contracting in a few days. You will receive an email from bannermedicarecommunications@bannerhealth.com with username information and a link to reset your password.
See Banner MA Onboarding User Guide
If you have completed your background form and have not received your email from Banner, you can go to the broker portal link and click reset password. This will prompt you to set up the authenticator and log in. https://mybannerhealthinsurance.my.site.com/BrokerPortal/s/login/
BCBS AR
Thank you for your interest in contracting with BCBS AR. To get started please complete the Request link via DocuSign. AGA is partnered with our Integrity Partner, Premier, for us to offer BCBS AR to our agents. After the DocuSign submission, you will receive an invitation with a link to begin contracting in a few days. Click on the link to begin contracting.
Important: Enter your full name as it appears on your license after clicking the contracting link.
If you are currently contracted with another upline please complete the BCBS AR Hierarchy Form, and return it to contracting@appliedga.com. For an immediate release, you will need a signature from your current FMO. If you are unable to obtain your FMO’s signature you may begin a delayed 90-day release.
Please complete the BCBS AR Hierarchy Form, and return it to contracting@appliedga.com. New online carrier contracting paperwork will be emailed to you for completion.
Blackout period from 9/1 through 12/1 – don’t accept releases but will let agent transfer with 90-day intent.
Changes can be made on https://bpa.arkansasbluecross.com/s/login/
Changes can be made on https://bpa.arkansasbluecross.com/s/login/
BCBS of AZ
Thank you for your interest in marketing BCBS AZ through Applied General Agency. BCBS AZ uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting.
New added users will receive a welcome email containing: Contracting Guide
- Registration ID – User’s National Producer Number
- Access code – BCBSAZ24
- Link to registration page – https://bcbsarizona.pinpointglobal.com/Apps/Medicare/default.aspx
See BCBS AZ User Guide & BCBS AZ Contracting Guide to completing contracting
To complete the registration the user can follow the link provided in the welcome or click on the (1) ‘Register’ button on the homepage. Enter your ‘Registration ID’ and ‘Access Code’ and click ‘Continue’. Select the (1) ‘Lookup NPN using NIPR’ button. Search for your NPN and confirm. Your NPN number is now confirmed. Click the ‘Submit’ button on the Registration page to continue and complete your registration information. All required fields are marked with a *red asterisk and need to be filled out before the registration can be successfully submitted. The first and last name is pre-filled based on the pre-registration information and can’t be altered during the registration process.
Users that have completed their registration can login directly on the homepage https://bcbsarizona.pinpointglobal.com/Apps/Medicare/default.aspx
Steps to transfer your BCBS AZ appointment
- Send contracting@appliedga.com a copy of an email and/or a letter that was sent to their current FMO, requesting to be released. (Response from FMO not required). The Producer will need to have a current AZ resident license and be current with all mandatory certifications.
- AGA will submit the following to MedSalesCon@azblue.com for processing.
- Email stating “This is an FMO transfer request”
- New Producer Upload Spreadsheet (completed by AGA)
- Copy of your release request
- BCBSAZ will add a new contract to our training site, Pinpoint Global, for the Producer to complete a new contract(s) under the requested FMO.
- Only complete contract(s) will be submitted to our Contracting Team for processing.
- Please allow 7-10 business days for processing.
- Once the contract(s) have been processed, the Producer will receive a Ready to Sell email.
**Important Notes**
Incomplete contracts or missing documents will delay processing times. Please make sure all re-quired documents are included to avoid delays. If the contract(s) is not completed within 30 days, then the transfer request will be voided.
Former FMO: The Producer’s book of business will stay with the former FMO. The FMO is expected to continue commission payout to the Producer as long as the Producer of record has not changed, and the policy is still active.
FMO Transfer Blackout Period: October 1 – December 31 (Annually) Producers will not be able to complete an FMO transfer from October 1 to December 31. If the FMO receives a Producer request to change FMOs during this time, the FMO may send these requests to medsalescon@azblue.com beginning January, 1 of the following calendar year.
BCBS HCSC – IL, MT, NM, OK, & TX
Thank you for your interest in contracting with BCBS IL,TX,NM,OK,MT. To get started please complete the BCBS IL,TX,NM,OK,MT Request Form via DocuSign. AGA is partnered with our Integrity Partner, Premier, for us to offer BCBS IL,TX,NM,OK,MT to our agents. After the DocuSign submission, you will receive an invitation with a link from Producer_Service_Center@hcsc.net with the subject line of “Onboarding Invitation” to begin contracting in a few days. The body of the email includes a Login link that launches the Producer Pro application. This is a link that is intended only for the recipient. It cannot be transferred, forwarded to another email account or used by another Producer individual.
Contracting Request Form: BCBS IL,TX,NM,OK,MT
Please see BCBS Onboarding Instructions for Individual or BCBS Onboarding Instructions for Corporation
Important: Enter your full name as it appears on your license after clicking the contracting link.
Agents are responsible for submitting a transfer request by email during one transfer period per year determined by HCSC. Outside of the transfer period agents can terminate their appointment. To terminate agents have to contact the carrier to have their current appointment terminated, once the termination is approved re-contracting will be needed. There is no waiting period to re-contract once an appointment is termed.
By terminating to transfer all previous business and renewals are lost.
If you would like to continue to transfer your appointment to AGA email either the below individual or corporate termination template to Producer_Licensing@bcbstx.com and contracting@appliedga.com. BCBS will confirm your termination, and AGA will send you a BCBS contracting link. Please see BCBS Onboarding Instructions for Individual or BCBS Onboarding Instructions for Corporation
Individual Termination Template: Please term my, (NAME), Medicare appointment (PRODUCER ID#) in order for me to recontract as a direct pay under Premier Senior Marketing.
Corporation Termination Template: Please terminate my current Medicare appointment (PRODUCER ID#) in order for me to re-contract my agency (NAME) and as an LOA sub-producer under it.
Changes can be made on https://producers.hcsc.net/producers/login
Changes can be made on https://producers.hcsc.net/producers/login
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After you return the 5.6 Add Carrier Request you will receive an invitation with a link from Producer_Service_Center@hcsc.net with the subject line of “Onboarding Invitation” to begin contracting in a few days. The body of the email includes a Login link that launches the Producer Pro application. This is a link that is intended only for the recipient. It cannot be transferred, forwarded to another email account or used by another Producer individual.
Please see BCBS Onboarding Instructions for Individual or BCBS Onboarding Instructions for Corporation
BCBS of Kansas City (MO & KS)
As of 09/17/2024 Carrier no longer contracting new agents. Blue Cross of Kansas City will be exiting the MA Marketplace at the end of the year. For this reason, we are not accepting new agents for MA specific line of business.
Thank you for your interest in marketing BCBS of Kansas City (MO & KS) through Applied General Agency.
New agents email contracting@appliedga.com & PRODUCERINFO@BlueKC.COM include agent name, email, NPN indicate contracting with MA under AGA.
Example: BCBS KC, My name is Toby Stark, NPN 1213, please send me a Medicare Advantage appointment under AGA-BCBS KC contracting link to tstark@appliedga.com.
*MA appointments with us requires the completion of the Medicare + Fraud, Waste, & Abuse (MFWA) through AHIP as well as active insurance licenses in both KS & MO.
If you are not sure who you are currently contracted with log into https://agents.bluekc.com/login And select My Profile. The listed company name is your current upline.
An agent can request a change in upline by:
1. A written request to BCBS of KC (maproducerinfo@bluekc.com & PRODUCERINFO@BlueKC.COM & contracting@appliedga.com)
2. If an agent is already with an agency then the agent will request a release from the current agency or wait 6 months from the written request date to BCBS of KC.
Producer Support: 1-877-259-8657
BCBS of MN
Thank you for your interest in contracting with BCBS of MN. AGA is partnered with our Integrity Partner, IFC National Marketing, for us to offer this carrier to our agents. To get started complete the AGA BCBS of MN Request Form
BCBS MN requires agents to either have a MN resident license, or a resident license of a bordering state (the address must also be within a bordering county).
Once this request form is completed, IFC will provide you with the instructions to pay their appointment fee(s) to BCBS MN. Individual agents must pay $138.50. If an agent has an agency they would like to contract the fee is $75.00 on top of any individual agent fees.
IFC will also send you a DocuSign to complete. It includes banking information, demographic information, license copies, E&O and some other questions regarding the agent’s specific agency orientation.
Thank you for your interest in contracting with BCBS of MN. AGA is partnered with our Integrity Partner, IFC National Marketing, for us to offer this carrier to our agents. To get started complete the AGA BCBS of MN Request Form
BCBS MN requires agents to either have a MN resident license, or a resident license of a bordering state (the address must also be within a bordering county).
BCBS of NC
Thank you for your interest in marketing BCBS of NC through Applied General Agency. AGA is partnered with our Integrity Partner, Carolina Senior Marketing (CMS), for us to offer BCBS NC to our agents.
You must be a resident of NC.
To get started please complete the CSM BCBS NC O65 Appointment Intake Form.
Agency Affiliation = Applied General Agency
Once the intake form is completed, CSM will submit the information to BCBS NC within 24-48 hours of receipt. From there the Regional Service Executive (RSE) assigned to you will reach out directly with the next steps including additional interview questions if necessary and training instructions.
It is important you be on the lookout for an email from their RSE, as we do not have line of sight on this communication, if you are not responsive to the RSE you will not get appointed. Please reach out to contracting@appliedga.com if you have not heard from your BCBS NC RSE after 10 business days, and we will reach out to BCBS NC for an update.
Since Blue Cross Blue Shield NC pays all agent commissions to their affiliated TMO, if an agent decides to transfer away from their current TMO their commissions would stay with the TMO. The agent would need to make sure they have an agreement with their TMO that the agent would still receive their Blue NC commissions after transferring away from the TMO or that the agent was okay giving up their current Blue NC commissions.
The agent would then need to get a written release from their current TMO releasing their appointment. Please send your letter of release to your Regional Sales Executive (RSE), contracting@appliedga.com and contracts@carolinaseniormarketing.com. In the email you will need let the RSE of your intent to transfer to Carolina Senior Marketing and then you will need to complete a new appointment application under CSM. Example: RSE, Please see my attached letter of release from XY Agency. I would like to transfer my appointmetn to Carolina Senior Marketing. Thank you, John Smith
Email changes to email to Producer.operations@bcbsnc.com, include their P# and copy contracts@carolinaseniormarketing.com
BCBS of NE
Thank you for your interest in contracting with BCBS NE. To get started complete the BCBS NE Contracting via DocuSign. AGA is partnered with our Integrity Partner, Premier, for us to offer BCBS NE to our agents. After the DocuSign submission, you will receive certification instructions from the carrier within in a few days.
Contracting Request Form: BCBS NE Contracting
Thank you for your interest in contracting with BCBS NE. AGA is partnered with our Integrity Partner, Premier, for us to offer BCBS NE to our agents. To get transfer your appointment complete the BCBS NE Contracting via DocuSign, and you will need to email Broker_Appointment@NebraskaBlue.com, and state you are transferring your appointment to Premier Marketing.
Email changes to email Broker_Appointment@NebraskaBlue.com
Changes are made on Contracting Request Form: BCBS NE Contracting
BCBS of TN
Thank you for your interest in contracting with BCBS TN . AGA is partnered with our Integrity Partner, Agent Pipeline, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your contracting.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your contracting.
Release is not required – Agent can transfer at anytime, carrier allows agents to be contracted with more than one FMO at a time – FMO Assentation Form is required to transfer
Email your changes to contracting@appliedga.com and state your updates for BCBS TN.
Email your changes to contracting@appliedga.com and state your updates for BCBS TN.
Blue Shield
Thank you for your interest in Blue Shield. To complete your appointment, please click on the link to get started. https://www.blueshieldca.com/bwa/auth/home
You will need to create an account, once completed you will log in. It will prompt you to reset your password prior entering the portal. After resetting your password you will then you will be able to gain access. Once in the portal, a tab will appear, “ What you need to apply”, it will show the documents that are required for your application. Once you have the necessary documents, you will be able to begin your application. See Blue Shield Appointment User Guide for step by step instructions
IMPORTANT: You must complete your Blue Shield certifications and align yourself to AGA. To align to AGA, you must first transfer your AHIP to Blue Shield and then log in to Blue Shield Learns. Click the Agency/Profile Update link, update your Primary Agency to Applied General Agency, TIN 330961867, and SAVE.
To change your upline to AGA by making changes on Blue Shield Learns. To align to AGA, you must first transfer your AHIP to Blue Shield and then log in to Blue Shield Learns. Update link, update your Primary Agency to Applied General Agency, TIN 330961867, and SAVE.
Complete Blue Shield EFT form then email forms to producerdepositforms@blueshieldca.com
Assignment of Commission Form and submitted to ProducerDepositForms@blueshieldca.com
The Broker Assignment of Commission (AOC) form is intended for use by an agent to assign their individual commission to a company owned by the individual or their spouse. The assignment must meet the requirements of the Blue Shield Producer Agreement. The company must be appointed and maintain a current license issued by the California Department of Insurance and hold a Blue Shield of California appointment. If the corporation is not appointed, follow the online appointment process using the agency information only. Broker Registration – Producer Connection (blueshieldca.com).
If assigning commissions to a third party there are two options. One, agent can terminate their Blue Shield appointment. uncontracted agents will have their commissions paid to AGA as long as AGA’s ID is on the application. AGA can then pay the third party. This does disrupt the agent’s ability to reach out to the carrier to check on client statuses. Two, update the agent’s EFT to pay the third party. The agent will get the 1099 at the end of the year, but the third party’s accountant can change that to to the third party with a form.
NOTES
• Please continue to submit your applications just as you do today, listing the Agent Section with your Individual NPN and/or SSN, and FMO Section with AGA #330961867E
• The Assignment of Commissions Form is an all or nothing form. It will assign future and past commissions for all lines of business, individual, Medicare, and Med Supp, to the one location of your choosing.
• You may revoke or change your payee information at any time and as often as you want by notifying Blue Shield in writing.
• If both your corporation and individual appointments exist, then only the Assignment of Commission Form needs to be completed and submitted to ProducerDepositForms@blueshieldca.com to expedite the process.
• To check your Blue Shield appointment, search for Blue Shield in your corporate and individual appointments at this CA DOI link.
• If you do not complete the appointment paperwork for your corporation, your commissions will be deposited into the account of your choosing, but your Blue Shield 1099 will be issued to you individually. This can be changed after the fact by working with your tax professional and submitting an additional IRS form.
Bright Health, Central and Brand New Day
Thank you for your interest in marketing Central, Brand New Day, and Molina through Applied General Agency. Molina uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days. Click on the link to begin contracting.
- Website https://social.webcomserver.com/wpm/userHome.do?tenantName=molinahealthcareinc
- Username = NPN
- Domain molinahealthcareinc
Complete online carrier contracting, see Molina Agent Appointment Guide & Molina Producer Guide
The Full Contract must be completed within 60 days, otherwise the invite is deleted.
Workflow Case Status:
Retrieve NPN – Case Created, not yet started.
Producer Application – Case has been started, but not yet completed.
Review Application – Case has been submitted to Molina for processing.
Awaiting Training Completion – Case has been approved and waiting for agent to complete certification. If agent has completed certification, notify Molina of completion date.
Review & Submit – Certification completed, final review by Molina. Background is ordered.
Appointment Pending – Appointments have been processed. This usually takes 2 business to proceed to active status.
Onboarded – Case is now active. Agent will show RTS. Welcome Letter with Writing Number is sent both to the agent and agency.
Ready to Sell (RTS) requirements that must be me in order to SELL and BE COMPENSATED for any Molina Medicare Policy:
Contracting Completed for Current Year
Certification Completed for Current Year
Agent must have a current Errors and Omissions on file with us at the time a policy is written.
Agent must have a current license and applicable Molina appointments in the state(s) they are contracted with us.
To transfer your Molina appointment to AGA there are 2 options for this transfer. For an immediate transfer complete the Molina immediate release form. It will need to be signed by the agent and their current upline. Once release is completed, please email it to MCRBrokercontracting@molinahealthcare.com
If you are unable to get the immediate release you can begin a delayed release. For a delayed release you will complete a constructive release in the Molina contracting. Request a Molina contract by emailing a 5.6 to contracting@appliedga.com. This release will go in effect the 1st of the month, 90 days from when it was received.
Example – Release is received 02/10/2024, 90 days out will fall on 05/10/2024 and transfer will be effective 06/01/2024. Not available during AEP(10/1 to 12/15). If a constructive or delayed release should have been effective from 10/1 to 12/15, it will be effective for 1/1.
Email your updated information to MCRBrokerContracting@MolinaHealthcare.com and contracting@appliedga.com, include your name and NPN.
Email your updated information to MCRBrokerContracting@MolinaHealthcare.com and contracting@appliedga.com, include your name and NPN.
Complete Molina Supplier Form to have your commissions paid to a corporation, send the completed form to mcrbrokercontracting@molinahealthcare.com
Per CMS Communication and Marketing Guidelines (110.1), compliance with state licensure and/or appointment laws is required. Producers have the responsibility to maintain state licenses, continuing education and all other state requirements. Uplines must be contracted and have the proper licenses and appointments required by applicable law.
To add state(s):
Send an email to: MCRBrokerContracting@MolinaHealthcare.com
Subject Line: Add Additional States
Include copy of licenses for requested states. Broker Support will respond back to you and cc your upline
once you have been appointed and are ready to sell in additional state(s).
Lines of Authority:
• CA – Accident & Health
• FL – Health
• ID – Disability
• MI – Accident & Health
• NM – Accident and Health or Sickness
• OH – Accident & Health
• SC – Accident Health or Sickness
• TX – Life, Accident, Health and HMO
• UT – Accident and Health or Sickness
• WA – Disability
• WI – Accident & Health
Email MCRBrokerContracting@MolinaHealthcare.com to make changes
CalOptima Health
Thank you for your interest in marketing CalOptima through Applied General Agency. CalOptima uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days.
The CalOptima email will be from DoNotReply@caloptima.org. Please have your valid government ID, CA DOI license, E&O certificate, and Current AHIP ready for upload.
You may access the portal using the following credentials. Please use this log in to upload any missing documents.
Website: https://agents.caloptima.org/
UserID: Your Email Address
If you cannot find your CalOptima email, navigate to the CalOptima website and reset your password.
Release Letters from currently appointed OneCare FMO Agencies are NOT required. Begin your transfer by completing the CalOptima Transfer Form. This form can only be submited once a year from January 1st and July 14th.
Complete the CalOptima Transfer Form via DocuSign, have your license, E&O and AHIP ready to upload. CalOptima Health processes current FMO/Broker Agency “Release” and updates FMO’s CalOptima Health OneCare Ready to Sell roster “Release Approved effective (date)”. CalOptima Health provides new FMO/Broker Agency confirmation of reassignment effective date.
CalOptima Health Annual Election Period (AEP) Blackout Period is from August 1st to January 1st. Blackout period transfer request is not permitted from July 15th to December 31st. An agent will only be allowed to transfer FMO/Broker Agency once a year between January 1st and July 14th. Any request to transfer outside the time frame above will be declined. Agents will be asked to re-submit transfer requests after January 1st.
CalOptima Health allows agents with a currently active status to change their Field Marketing Organization (FMO)/Broker Agency once a calendar year. Agent transfer requests must be submitted by the 15th of the month, to be effective on the 1st of the following month. Only ONE change is permitted within a 12-month period.
If an agent terminates the subcontract with CalOptima Health’s contracted Field Marketing Agency (FMO) after July 15th, the agent will not be able to re-contract with a new FMO until the following calendar year.
Commissions:Commissions associated with enrollment applications received prior to the effective date of release remain unchanged and will continue to be paid according to prior commission assignment. The release ONLY affects enrollments that occur after the date of the release.
AGA will pay commissions for CalOptima Health. To set up or update your EFT with AGA complete our EFT Form, attach a void check, and send it to contracting@appliedga.com.
Website: https://agents.caloptima.org/
UserID: Your Email Address
Care N Care
As of 7/11/2024 New Agent Contracting has been suspended indefinitely.
Thank you for your interest in contracting with Care N Care. To get started please complete the Request link via DocuSign. AGA is partnered with our Integrity Partner, Premier, for us to offer Care N Care to our agents. After the DocuSign submission, you will receive an invitation with a link to begin contracting in a few days. Click on the link to begin contracting.
Care N Care Direct Pay (Carrier Pays Commission)
(Not common AGA will pay commissions) Care N Care Indirect Pay
Important: Enter your full name as it appears on your license after clicking the contracting link.
Begin your Care N Care transfer today! You will need a clean balance. Transfers are allowed after 6 months of non production, or 3 month wait after CNC Transfer Release Form signed. Or immediate release after CNC Transfer Release Form signed. Send the completed transfer form to contracting@appliedga.com
Updates can be made on https://www.cnchealthplan.com/
Updates can be made on https://www.cnchealthplan.com/
Carepartners
To get started please request the carrier by completing our Request Form then we will email you the contracting instructions.
Centene – Allwell, Ascension Complete, Fidelis Care, Health Net, and WellCare
Thank you for your interest in contracting to represent Centene – Allwell, Ascension Complete, Fidelis Care, Health Net, and WellCare plans through the AGA. You will be completing contracting through Centene’s online contracting system Ping One.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link from Centene@evolvenxt.com with the subject line as Onboarding Invitation. The email will include the contracting link, username, and password. Click on the link to begin contracting. The contracting link will always be https://desktop.pingone.com/cnc-workbench-brk, and your username is your NPN.
Review Centene’s Guide to Onboarding Brokers
After logging in, select the Centene Workbench icon, and you will see the pending contract to complete. Select “Start”.
When beginning the contract, you will need to validate your Social Security Number (SSN)/Tax Identification Number (TIN) against the NPN provided in your initiation. The NPN will be pre-populated. Enter in your SSN/TIN and select Validate. After validating, you will view a dashboard with tabs to enter Demographics, Payment, and State Licenses information before selecting the Submit tab.
Once you have completed all demographic information, please review your Upline and Sub Type information. Your upline should show as Applied General Agency NPN 6187022.
Sub-type descriptions: Downline Only – Broker has an upline, the broker receives their own commissions. Broker owns book of business. Licensed Only Agent – Broker has an upline, commissions are assigned to this upline. Broker does not own the book of business. Dual Assignment – The broker has an upline, commissions are assigned to this upline.
When you have confirmed this information is correct, please check the box acknowledging you understand, and then select Continue. Please email contracting@appliedga.com if this is not correct.
Select the Payment tab under My Certification Cases. Select Yes if you have a private company that you would like to assign as the Payee. Select No if you do not wish to declare a private company to be the Payee. Complete your W-9 and EFT according to how you will be paid. If you are contracted as an LOA or Dual Assignment you will not be asked to complete EFT information.
Select the State Licenses tab under My Certification Cases. Your Resident state license is automatically selected for you. You can also select all licenses that you wish to market and sell Wellcare products in.
Before submitting this onboarding case, you will be able to review the TPME document and your W9. You can save or print these documents at this time. The documents will also load into your broker profile within the portal. To submit your onboarding case, review and acknowledge the statements below. Use the open space to complete your signature, and then select Submit.
If you are already appointed with Centene and would like to align under AGA, please log into your Ping One account.
Note: Agents must be contracted AND certified to initiate a transfer. If you are contracted as an LOA or Tele Digital agent you will not be able to transfer with the below instructions. LOA agents will need to terminate their existing contracts, notify contracting@appliedga.com after the termination has been completed, then we will send you a new contract. In Ping One the terminate button is under My Credentials then My Status and Credentials. Tele Digital agents will need to have their upline terminate their contract, notify contracting@appliedga.com after the termination has been completed, then we will send you a new contract.
- Contracting Link https://desktop.pingone.com/cnc-workbench-brk
- Username: NPN
- Password: If you do not have your password select Forgot Password. Detailed User Guide to Sign In
Once you are logged into PingOne, select “Centene Workbench”. Click My Account then My Hierarchy Info.
Sub Type Options: Preform an upline or payment change
Upline Options: Request to Leave My Current Upline
Choose to have your commissions paid directly to you or to have AGA pay your commissions.
Search for upline: Enter Applied General Agency or NPN 6187022
Select Update
Hierarchy requests will not be approved between September 15th and December 8th.
- Contracting Link https://desktop.pingone.com/cnc-workbench-brk
- Username: NPN
- Password: If you do not have your password select Forgot Password. Detailed User Guide to Sign In
Once you are logged into PingOne, select “Centene Workbench”. Click My Account then Account Info or Payee Info.
An agent can add a corporation by emailing contracting@appliedga.com. We will then send you a new contracting link to contract your agency. Review Centene’s Guide to Onboarding Brokers
- Contracting Link https://desktop.pingone.com/cnc-workbench-brk
- Username: NPN
- Password: If you do not have your password select Forgot Password. Detailed User Guide to Sign In
Once you are logged into PingOne, select “Centene Workbench”. Click My Account then Account Info or Payee Info.
- Contracting Link https://desktop.pingone.com/cnc-workbench-brk
- Username: NPN
- Password: If you do not have your password select Forgot Password. Detailed User Guide to Sign In
Once you are logged into PingOne, select “Centene Workbench”. Click My Credentials then Manage My Licenses.
Active States displays which states you are currently approved to market/sell Wellcare plans.
Available States displays additional states that are available for you to add to your profile. This is based off the NIPR. It may take a few days to see a new license appear in your Available States. Before writing business you must see the state added to your Active States.
After completing selecting a state(s), select the Add Selected State button to save your changes.
Wellcare will then process any necessary appointments based on the state rules.
- Contracting Link https://desktop.pingone.com/cnc-workbench-brk
- Username: NPN
- Password: If you do not have your password select Forgot Password. Detailed User Guide to Sign In
Note: When you declare a private company to be your payee, your 1099 will be in the name of this entity. A Tax ID can only be used once as a Payee. Two brokers cannot share a Payee Profile.
Once you are logged into PingOne, select “Centene Workbench” then “My Account”. The Payee Info tab captures the name and address on file for payment. Select the Edit Payee Info tab to update your name or address. The 1099 that will generate will match the information on this screen.
To declare a private company as your payee, select the Edit Payee Info button and update the information to reflect that of your company. Name = Name of the business / private company. Address = Shipping Address. SSN / TIN = the TIN of the business / private company. Then select Save
A prompt will display to complete a new W9. The Business Entity Information will be prefilled from what was entered under the Edit Payee Info button. To make any adjustments, edit these fields.
Once the Business Entity Information is accurate, scroll down to the W-9 Information. Assign the appropriate taxation type for your private company. It is required to check the box, acknowledging that you are legally authorized to execute contracts and agreements on behalf of the company. Proceed to the Banking Information and complete all required ACH fields. Select Continue.
The final steps are to acknowledge the W9 is accurate and complete your signature. Select the Submit button. The workflow will be completed, and your Payee Info will be updated.
Cigna Healthcare
Thank you for your interest in marketing CIGNA through Applied General Agency. CIGNA uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days.
The email will be from producerexpress@sircon.com, with a subject of Cigna-HealthSpring Producer Onboarding Invitation. Please be sure to check through your junk and spam folders. Click on the link to begin contracting.
Login to Producer Express: If you do not already have an account with Producer Express, you will need to select“Get My Password” under Need a Password? Once selected, you should receive an email with a temporary password. Once logged in, you will be prompted to create a new password. If you do, enter your existing password and login under Already have a password?
Review the Getting Started page and hit Next. Read the User Agreement and check the box next to “I Agree”. Confirm your upline. You should see you are being aligned to Applied General Agency. Select No to proceed.
Complete the Producer Information section. If you have already completed your Federally-Facilitated Individual Marketplace (FFM) certification, select Yes and provide your FFM user ID. If you have not, please select No. Please keep in mind you must complete the FFM and any applicable state-based certifications prior to being considered Ready-to-Sell.
Review your Requested Appointment States. You will also see a list of any applicable New Business in Hand States. Answer the questions on the Background Information page and provide any corresponding documentation to any questions that are answered Yes. Review and Sign Documents. You will be asked to add your eSignature to the list of documents. Select I Agree to proceed. This will bring up the electronic packet for signature. Click the Click to Sign button to complete your contract. You will have the option to print a copy for your records on the next page.
You can transfer your CIGNA Healthcare appointment in two ways:
- If you have a letter of release from your previous upline, you qualify for an immediate transfer. If you’re unsure who your current upline is, you can confirm this with Carl at Carl@cigna.com.
- If you do not have a release or are in the process of obtaining one, you can start a delayed 90-day release
To begin an immediate transfer, complete a new contract under AGA by submitting a carrier request form and submit a letter of release to contracting@appliedga.com and Carl@cigna.com. The letter of release must be signed by your top hierarchy and dated within the last 60 days. There is an immediate transfer blackout period from September 15 to December 31.
To start a 90-day release, complete the CIGNA Self-Release from Topline Form via DocuSign. This form serves as your notice of intent to change to a new sales hierarchy and initiates a 90-day waiting period. Once the waiting period is over, you must complete a new contract with AGA within 60 days. If you miss this deadline, you will need to submit a new request, undergo a qualification check, and start a new waiting period. The 90-day period officially begins when the CARL email box receives your form. You can continue to sell during this waiting time.To ensure your changes are effective for the Annual Enrollment Period (AEP), submit your delayed release by July 15 and complete your new contract before October 15.
Agents are allowed to change their topline agency once per calendar year.
Complete the CIGNA EFT Form and email to ProducerEFTSet-up@cigna.com
Email a copy of your license to carl@cigna.com. Please include your name and NPN in the body of the email.
The only states that are pre-appoint for MAPD are AL, OK, OR, PA, and WA. All other states are Just in Time (JIT) states so appointments for those states will not be placed until after the agent has submitted their first enrollment. As a reminder, the agent must be contracted, certified, and licensed prior to making a sale in any JIT state.
Cigna Med Supp
Thank you for your interest in marketing CIGNA Med Supp through Applied General Agency. This appointment is for Med Supp and does not include PDP. For PDP contract with CIGNA Healthcare.
Complete the CIGNA Med Supp Contract via DocuSign. Please have your license(s), E&O, and void check ready to upload. State appointment fees are required when the agent is appointed with the insurance company. Separate fees are required for each insurance company you will represent. Payment of the appointment fees will be debited from your commission account. If appointments requested in MT, OK, PA or TX, you will be appointed immediately. See Pre Appointment states for CIGNA Med Supp
CIGNA Med Supp Contract Direct Pay – Carrier will pay commissions to you or to a corporation you own.
(Not Common) CIGNA Med Supp Contract In direct Pay – Your commissions will be paid by a third party designated by you. The third party must be currently contracted with CIGNA Med Supp and under AGA. On the DocuSign landing page complete the Assignee section. You will need the Full Name and Email of the person/entity you are assigning commissions to. The Assignee will be emailed the CIGNA LOA contract and it will be sent to CIGNA. Incomplete submissions will be voided.
To begin a transfer complete a CIGNA Med Supp Contract via DocuSign.
A letter of release is required if agent has written business in the past 6 months or has contracted with previous upline in the past 6 months.
If the agent is unable to obtain the required release or does not meet the 6 month rule, he/she will need to communicate to CSBLicensing@Cigna.com & contracting@appliedga.com that he/she intends to switch hierarchies in 6 months. The communication from the agent to the contracting mailbox will serve as the start of the 6-month waiting period and we will track that date on the agent’s profile.
Call 800-903-7711 or email ProducerCommissions@cigna.com to change or terminate EFT
CIGNA ACA
Thank you for your interest in contracting with CIGNA ACA. AGA is partnered with our Integrity Partner, Plan Advisors & New Health Partners, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your ACA contracting.
Agents will need to complete the Acknowledgement of Contractual Obligation form which will terminate the current contract.
Once this release is completed, you will be sent a new contracting link for CIGNA ACA. Once your new contract is completed CIGNA will need approximately 7-14 business days, subject to current carrier volume. Until the you are notified that the release/transfer is completed, you should NOT write any new business.
If the agent has a book of business release an release this may be uploaded on the Acknowledgement of Contractual Obligation form. This will transfer the book of business that is listed on the transfer form. This is not required to complete your transfer.
No blackout period
Downline does need to recontract, and each will need to follow above process
The agent needs to submit the request via email to dash@cigna-ifp.com, joan@newhealthpartner.com and bzarkos@myplanadvisors.com
Complete the ACA EFT form via DocuSign
The agent needs to submit the request via email to dash@cigna-ifp.com, joan@newhealthpartner.com and bzarkos@myplanadvisors.com
Clear Spring Health
Thank you for your interest in marketing Clear Spring Health through Applied General Agency. Clear Spring Health uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days.
First time portal users: use the link in the email from CSH Certification ( certification@clearspringhealthcare.com )
Returning portal users: go to https://csh.evolvenxt.com
Complete online carrier contracting, see Clear Spring Contracting Guide.
Please complete the Clear Spring Release Policy and Transfer Form and send to Brokers@clearspringhealthcare.com and contracting@appliedga.com. For an immediate release the form must be completed in its entirity. For 30 day delayed release the form needs to be completed, except for the two upline sections.
Please see additional notes from the carrier:
All Clear Spring Health External Agents must follow the Clear Spring Health Release Policy when terminating or modifying any hierarchy relationship.
Agents will not be permitted to transfer from one hierarchy to another until they have been under contract for at least 60 days.
Agent requesting a release from its contract must wait 30 days (delayed release) following the release request and receive approval from Clear Spring Health before being permitted to contract under another hierarchy.
The 30-day waiting period may be waived if the Agent receives an immediate release from their current hierarchy or if the agent has not submitted any new business to Clear Spring Health in 180 days or more.
When a hierarchy change is made the Agent must remain at their existing override or commission level for 6 months before any increase can be requested by the new hierarchy.
If the transferring entity is a General Agent all subagents that are contracted to sell with the Company will move collectively along with the General Agent during transfer.
No releases or hierarchy changes will be processed during the annual AEP Blackout which occurs from October 1st through December 31st. Any releases requested during the AEP Blackout will be effective January 1st of the following year if a release is requested or 30 days following the release request if submitted within 30 days of December 31st. If a release is requested less than 30 days before the beginning of the AEP Blackout (without immediate release) the release will be effective January 1st of the following year.
Agent must be in good standing with Clear Spring Health to make any hierarchy change. The General Agent or Agent may not be under investigation internally or externally, must have acceptable compliance and sales metrics, and not be in debt to the carrier.
Impact on Book of Business:
New Business: Any business submitted to Clear Spring Health while the General Agent or Agent was under the previous hierarchy will result in the appropriate overrides and commission being paid as indicated by the contracts and schedules in place.
Renewals: Any Clear Spring Health renewals earned while the General Agent or Agent was under the previous hierarchy will result in the appropriate overrides and renewals being paid as indicated by the contracts and schedules in place.
An agent that is set up for Direct and wants to change to LOA would need to contact Brokers@clearspringhealthcare.com and contracting@appliedga.com to change to LOA. CSH will then change the agent to LOA. An agent that is LOA and wants to change to Direct would need to contact us about the change and also complete a W-9 and an EFT form the agent’s banking information. CHS will provide the agent with our EFT form.
Clever Care
Thank you for your interest in contracting to represent Clever Care plans through AGA. You will be completing contracting through Clever Care’s online contracting system Clever Care Broker Portal.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After you return the 5.6 Add Carrier Request you will receive an invitation with a link from donotreply@evolvenxt.com and “Evolve Agent Contracting Registration” as the subject line. The email will include the contracting link, username, and password. Click on the link to begin contracting. The contracting link will always be https://ccmapd.evolvenxt.com/login.htm, and your username is your email.
Please have your E&O and AHIP certificate handy, and be prepared to complete the Clever Care training. The entire process will take 15 minutes to an hour. After logging in you will see the pending contract to complete. Select “Start”.
After initial log in just hit START then verify your NIPR status.
From here just follow the steps/Test and Contract will come after uploading E&O and AHIP at DOCUMENTS
For an immediate release, a letter of release from your current upline needs to be sent to broker@ccmapd.com and contracting@appliedga.com.
In instances where the FMO refuses to immediately release the agent, the agent may contact Clever Care and request a delayed release. The delayed release will be effective 90 days after the agent’s request is received. Release requests must be in writing and submitted by email at broker@ccmapd.com and contracting@appliedga.com.
The delayed release request must include the following information:
- A clear statement stating the agent/broker’s intent to switch FMOs
- Name of agent/broker
- Agent NPN
- Name of old FMO
- Name of new FMO
- Downline agents if any.
Example. Clever Care my name is John Stark, NPN 12345. I would like to begin my delayed 90-day release. After 90-days, please transfer my Clever Care appointment from XYZ Agency to Applied General Agency.
Agents/Brokers can continue to write new business for Clever Care during the waiting period.
Clever Care will confirm receipt of request and make the changes after 90 days from request received date.
Changes can be made on https://ccmapd.evolvenxt.com/login.htm See Clever Care Agent Guide
If your commissions are paid to AGA and you would like to be paid direct complete the Clever Care Exhibit A and email to Broker broker@ccmapd.com
Clover Health
Thank you for your interest in marketing Clover through Applied General Agency. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
Please begin certifications for Clover.
Direct pay Clover Registration Code: 2294CloverDirect25
(Not Common AGA pays you for your enrollments) Clover LOA Registration Code: 13CloverLOA25
Miramar website: (https://miramar-agent.com) to the portal and access the program from your dashboard to start certification.
If an agent is logging in for the first time logging into Miramar then click “register as an agent”. Once you register as an agent, you will have to verify your SSN. Agent will then enter “Registration Code” on the main dashboard.
If you have an account in Miramar already, please login as you normally would. If you forgot your login credentials username/password/security question, please reach out to our Broker Support team brokers@cloverhealth.com or (855) 979-2236. Our team can help provide your credentials to log into Miramar if you are running into any questions.
TIPS & Tricks: If you are using an ios (Apple/Mac) platform, please make sure that you are using Chrome and not Safari. When using Safari we have experienced instances of pages not completely loading and pages that don’t allow agents to see all of the content or to proceed through the certification. Make sure your pop-up blockers are disabled. While uploading your license, please make sure that your name on your licenses matches EXACTLY how it does in Miramar. This is important because this stage matches to NIPR.
Miramar User Guide: https://miramar-agent.com/KnowledgeBase/Article?kb=5
Miramar Knowledge Base: https://miramar-agent.com/KnowledgeBase
Clover Health agents may change their upline agency. Clover Health’s blackout period is October 1st – December 31st. Agents may NOT move during this period.
The guidelines and all forms can be found on the Clover Health website under Broker Frequently Asked Questions. Please review our guidelines below for how agents can request a transfer. https://www.cloverhealth.com/en/brokers/frequently-asked-questions
To begin your transfer have you written Clover Health business in the past 6 months?
NO, I have not written Clover Health business in the past 6 months: Request a change to your new upline in your Miramar: https://miramar-agent.com/identity/login?signin=feede4235bda31b147df8bf21626f031#/ From your Miramar dashboard, go to Groups and Change Group. You will need to enter the Miramar code for your new group. AGA Agency code Clover2022AppliedGADirect.
YES, I have written Clover Health business in the past 6 months: If you have written business in the past 6 months, agents have 2 options to transfer agencies.
Option 1: Agent is granted a Signed Release from their current agency and submits the release to Clover Health. https://cdn.cloverhealth.com/filer_public/b1/f5/b1f5fa71-6428-4b4b-a743-e1b69ae1f309/ch_2022transferform_final.pdf
Option 2: Agent submits a Notice of Intent to Transfer request to Clover Health. There is a 90 day waiting period from the date this form is submitted to when the change can be processed. You may continue to write business during this time. You will be moved on the 1st of the month after your 90 days (see below).
Submit Signed Release or Notice of Intent to Transfer form on https://docs.google.com/forms/d/e/1FAIpQLScJW7wzzrblLFullxgF9YqJjKFphaiCgcn83sM_zHwL0jG1lQ/viewform
REMINDERS:
Agents are moved only on the 1st of each month!
Example: If an agent submits a signed Release on January 3rd, they will be moved on February 1st.
Example: If an agent submits a Notice of Intent to Transfer on January 3rd, they will be moved on May 1st
Email Clover Health Broker Support (brokersupport@cloverhealth.com) and notify them to add your requested state. Include your name and NPN.
Commonwealth Care Alliance
NOTE: Commonwealth Care Alliance exiting the Medicare Market effective December 31, 2024.
Thank you for your interest in contracting with Commonwealth Care Alliance. To get started please complete the Request link via DocuSign. After the DocuSign submission, you will receive an email from CCA from their online training system (“LMS”) containing a link. At your convenience, please use that link to log in and complete your online CCA Health Agent Certification.
Send your AHIP to CCA via AHIP: https://www.ahipmedicaretraining.com/clients/CCA/external
Commonwealth Care Alliance Contracting
Important: Enter your full name as it appears on your license after clicking the contracting link.
For an immediate transfer please send a copy of your letter of release to contracting@appliedga.com and let us know you need to transfer your CCA contract.
If you are unable to obtain a letter of release from your current upline, CCA can review transfers on a case by case basis. Please reach out to Brian Barry at BBarry@commonwealthcare.org, to discuss your situation.
Denver Health Medical Plan
Thank you for your interest in contracting with Denver Health Medical Plan through AGA. To get started complete the Docusign Denver Health Agent Contract.
If you are currently contracted with Denver Health Medical Plan through another upline please email contracting@appliedga.com, James.moses@dhha.org, and elevatebrokers@dhha.org. State you are contracted with Denver and would like to transfer to AGA. Example: Hello, my name is John Smith. NPN 123. I would like to change my Denver Health upline from XYZ agency to Applied General Agency. Please let me know if you need anything else. Thank you,
Email changes to email contracting@appliedga.com, James.moses@dhha.org, and elevatebrokers@dhha.org
Devoted Health Plans
Thank you for your interest in contracting with Devoted Health Plans. We have top doctors, cutting edge technology, and personalized care teams that help us provide high quality healthcare to our members. We’re on a mission to make healthcare better — learn more about the Devoted Health Difference! We are excited to partner with you and look forward to working together.
How to Access the Agent Portal. Create an account using either direct or AGA Pay.
Devoted Direct Pay Contracting Link: Agents are paid directly by Devoted Health.
(Not Common) Devoted Indirect Pay Contracting Link: AGA pays you for your enrollments
Devoted Health’s Onboarding & Certification Process:
- Account creation for Devoted Health’s Agent Portal
- W-9 & Direct Deposit (Direct Payees only)
- Agent Questionnaire
- Code of Conduct Acknowledgement
- Agent Agreement
- Background Check Consent
- Core Medicare Training or equivalency upload (AHIP or Pinpoint)
- CMS Fraud, Waste & Abuse & Compliance Training
- Devoted Certification Training & Exam
- Agents will have 3 attempts to pass the training exam with a minimum score of 85% (If the agent is unable to pass within 3 attempts, they will need to certify for the next year)
- Each time the exam is opened (initiated) it will count as an attempt and must be completed in one sitting (~30 min).
- License Check
- Appointment
The agent’s progress will be saved if they cannot complete the certification all at once — they will be able to continue at a later time with the exception of the Devoted training exam.
Once the appointment process for the agent’s respective state(s) is complete, agents will receive an email notification that they’re “Ready to Sell” (RTS).
For more guidance, please refer to the Devoted Health Agent Portal Quick Start Guide or visit us at www.devoted.com/brokers. Contact us at 1-877-764-9446 or email us at agent-support@devoted.com.
Please review Devoted Health’s Release / Transfer Policy & Timeline:
Devoted Immediate Release
A broker or their immediate receiving / terminating upline agency (FMO/GA) may request the release & transfer(s).The release & transfer may be requested by:
-
- Sending a release letter in an email to agent-support@devoted.com and contracting@appliedga.com, noting the broker’s NPN
- A phone call into agent support, 877-764-9446.
- A Help Ticket within the agent portal.
All parties will be notified via email once the release & transfer has been processed. Processing timeline for an immediate release is 7 business days.
Devoted Delayed Release
If you do not have a letter of release, a request for a delayed release can be made by sending an email to agent-support@devoted.com, contracting@appliedga.com and your current upline. Example, Hello Devoted and current upline, please begin my 60 day delayed release to Applied General Agency. Thank you, Toby Stark NPN 123456.
Receipt date of the delayed release request will start the clock for the 60 calendar days window.* The broker may continue to write business during the delayed release period. All parties will be notified via email once the delayed release has been processed. *Please reference the release timeline below for specific processing effective dates :
Requests Received | Immediate Release Requests Effective | Delayed Release Requests Effective |
8/15 – 10/8 | Processed within 7 business days | Effective 12/8 |
10/9 – 8/14 | Processed within 7 business days | Effective 60 days after request |
Email agent-support@devoted.com to request any updates.
Email agent-support@devoted.com to request an add state.
Email agent-support@devoted.com and contracting@appliedga.com to change from AGA pay to direct pay and vice versa.
If you are assigning commissions to your corporation, agents can update their demographic, banking, and W9 information within their Devoted agent portal. Simply click on MY ACCOUNT beneath their name in the upper right corner of the screen. This will bring you to your account information and you can review or update as needed.
Elderplan
Link: https://miramar-agent.com/
For New brokers, use Registration Pin: EPAGA25New
- Note: this specific certification pin is for agents who are not currently appointed with Elderplan. If you have been Elderplan appointed before, but were terminated, you are still considered a NEW agent.
For Existing brokers, use Registration Pin: EPAGA25Existing
- Note: this specific certification pin is designed for agents who are currently appointed with Elderplan. If you are not appointed by Elderplan (or were previously appointed by Elderplan and were terminated), you are considered a NEW agent and you must contact your FMO manager or EPsales@mjhs.org to receive the appropriate registration pin.
Please note: If you do not have an existing agent profile in Miramar, you will need to create one. Once you log in, you will need to click “Register New” on the top left of your dashboard. You will then enter the appropriate registration Pin highlighted above, and click “Start” on the next page to begin the training (screenshot below). If your page is not loading properly, try using a different browser (i.e.: If you are using Google Chrome, try switching to Internet Explorer – or vice versa).
Important things to note:
- Ensure all of your Agent Profile details on Miramar are up to date to avoid any discrepancies (current address, phone number, etc.)
- 2025 certifications should be completed prior to AEP in order to be Ready To Sell for the 2025 plan year. For existing agents, if their 2025 certification is not completed by 3/31/2025, their Elderplan appointment will be terminated, and they will be ineligible to receive commissions or residuals. New agents will have until 12/1/2025 to complete their training.
- Even if they complete our 2025 certification, they will still need to complete our 2024 certification if they would like to sell for the current plan year. Any questions regarding our 2024 certification program, feel free to contact us.
- For technical support within in Miramar (unable to log in, certification not loading, etc.), please call (855) 828-8015 or submit a ticket to https://convey.na2.teamsupport.com/createticket
To make a change to your current upline for ElderPlan, simply log in to your Miramar portal, request a group change, go to the “Groups” field on the left > click “Change Group” > type the group code and select “Change Groups”. AGA’s Code is AGA2242
Link: https://miramar-agent.com/
You can also just email us at epsales@mjhs.org and contracting@appliedga.com to request your transfer.
Changes can be made to your Miramar profile. https://miramar-agent.com/
Emblem
Log into https://miramar-agent.com (Registration assistance https://miramar-agent.com/KnowledgeBase)
Click on “Register New” and enter 2025 registration code 3078EmblemHealth1113
Click “Start” in Programs section, complete contracting and certifications.
Note: CT has an appointment fee and a renewal fee. If the agent writes less than 5 they will be responsible for that fee which is around $300 and the agent needs a CT license.
If you are with a different agency and want to move to AGA, ask your current FMO for a release, and email the release to contracting@appliedga.com.
If an FMO will not release you, you can move to the FMO of your choice two ways.
One, by using the FMOs registration code for the next certification period. For example, if they use another FMO’s ID for 2020 certifications, they will need to wait until 2021 certifications are available to move to AGA.
Second, Emblem will release a broker 90 days after an email is sent to the current FMO. Please email your current upline, contracting@appliedga.com and PGreco-Cavallaro@emblemhealth.com. Please indicate you are currently contracted and would like to transfer to AGA. Example: Hello, This is John Smith, NPN 123456, I would like to transfer to AGA for Emblem. Please issue a release or I would like to start my 90 day delayed release. Thank you,
EmblemHealth ACA
Thank you for your interest in marketing Emblem ACA through Applied General Agency. To get started complete your contracting request on Emblem ACA via DocuSign. Please have your NY licenses and NYSOH certification ready for upload. Complete your NYSOH certification on https://nystateofhealth.ny.gov/agent/
If there is a selling agent who already appointed with EmblemHealth Individual and actively with another general agent/FMO, wants to transfer to AGA:
A request letter from the selling agent directly, indicate the date of GA transfer with effective date, with signature & date. Agent transfer will process the into future effective date, and not retroactively. Any transfer request received before the 15th of the month, will process the next 1st of the month; any transfer request received after the 16th of the month, will process the 1st of the following month.
i.e. Transfer request received on 08/10/2024, will process for 09/01/2024 effective.
Transfer request received on 08/28/2024, will process for 10/01/2024 effective.
To update banking information, please complete a new ACH form, along with the voided check to IndividualSupport@emblemhealth.com
If a selling agent needs to update the demographic information such as address a new W9 form is required, and send to IndividualSupport@emblemhealth.com
If a selling agent needs to update the contact information, such as mobile phone & email address: Please email the request to IndividualSupport@emblemhealth.com
Essence Healthcare
Thank you for your interest in marketing Essence through Applied General Agency. To get started complete your contracting request on Essence Healthcare via DocuSign. This is a request to be sent contracting. Once you have completed this DocuSign you will be loaded in Essence’s system and will be sent an email with a portal and login. You will use this to complete contracting.
Essence requires two parts to certify producers: attend a virtual or in-person training session and complete onboarding via our online producer portal. Please reach out to help@appliedga.com for available Essence trainings.
If your DocuSign link was requested previously so please use the below instructions to complete the contract.
- Log into https://producer.essencehealthcare.com
- Use NPN as log in
- Click Forgot password
- Password Reset email will arrive in the inbox on file
- Complete steps to onboard
- Reach out to producer support at 1.877.259.8657 if any issues arrive during onboarding
For an immediate transfer please send a copy of your letter of release to contracting@appliedga.com and let us know you need to transfer your Essence contract.
If you are unable to obtain a letter of release from your current upline, you may begin a delayed six month release. Complete the SHC Advantage Agent Release Form and send a completed copy to your current upline, contracting@appliedga.com and producersupport@lumeris.com
Once received a six-month clock will start. At the end of the six-month period the agent will be release from their current hierarchy / FMO and can recontract with Essence Healthcare through a new hierarchy / FMO.
Agents will have the ability to produce for Stanford during the delayed release process under thier current hierarchy.
Email changes to contracting@appliedga.com and producersupport@lumeris.com
Changes can be made on https://producer.essencehealthcare.com./account/Login?ReturnUrl=%2fDashboard%2fHome
eternalHealth AZ
Thank you for your request to contract with eternalHealth. Please begin by logging into Miramar: https://miramar-agent.com/. If you do not have an existing agent profile in Miramar, you will need to create one. Once you log in, you will need to click “Register New” on the top left of your dashboard. You will then enter the appropriate registration Pin highlighted above and click “Start” on the next page to begin the training. If your page is not loading properly, try using a different browser (i.e.: If you are using Google Chrome, try switching to Internet Explorer – or vice versa).
Miramar: https://miramar-agent.com/
AGA 2024 PIN Code: 2024eternal3345
After you select AZ, the system will advise you that there is nothing else to do at this time (while it verifies the documents you uploaded). You will need to go back in the next day (possibly even after a few hours) to upload the attached certificate eternalHealth sends. When you get to the certification section, please remember to select attended in-person training and then attach the Certification eternalHealth attached. Once you have completed all the steps and uploaded your certification you will receive an email notifying you that you are RTS within 24-48 hours.
Changes can be made on https://miramar-agent.com/
Changes can be made on https://miramar-agent.com/
eternalHealth MA
To get started please request the carrier by completing our Request Form then we will email you the contracting instructions.
Excellus – Univera
Thank you for your interest in contracting with Excellus – Univera. To get started complete the Request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer Excellus – Univera to our agents. Ritter Insurance Marketing will email you the link to complete your certifications through Miramar. MiramarAgent AgentUser Guide
Excellus – Univera Contracting Request Direct pay (your or your corporation will be paid)
Indirect Pay (Not common) Excellus – Univera Contracting Request
Important: Enter your full name as it appears on your license after clicking the contracting link
To begin your transfer, complete the Request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer Excellus – Univera to our agents.
Excellus – Univera Contracting Request Direct pay (your or your corporation will be paid)
Indirect Pay (Not common) Excellus – Univera Contracting Request
Transfer your appointment immediately by uploading a letter of release
Start 3 month delayed release. To start a delayed release you will need to email excellusBSD@excellus.com. license@imritter.com, contracting@appliedga.com. State your name, carrier ID, and you are transferring your appointment to Ritter. Blackout from 10/1-12/31, no transfers or requests processed in that time.
Update your profile on https://miramar-agent.com
Complete EFT Change Form Via Docusign
Fallon
Fallon is closed to onboarding effective 04/01/2024
To get started please request the carrier by completing our Request Form then we will email you the contracting instructions.
Florida Blue
Thank you for your interest in marketing Florida Blue through Applied General Agency. Florida Blue will send you online contracting to complete and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive Florida Blue contracting forms from the carrier in a few days.
Agents will receive one email from ChannelPartnerManagementTeam@bcbsfl.com, this email will contain one link for the Agent to click and complete an appointment request, contract, W-9, and direct deposit
Upon successful completion of the appointment (5-10 days), the Agent will receive a Welcome Email from ChannelPartnerManagementTeam@bcbsfl.com.
- This Welcome Email will contain
- Florida Blue Medicare AOR #
- Instructions to register for AgentPoint
- Instructions to complete and submit AHIP
- Information on how to complete and submit Florida Blue Medicare Product Training
Upon completion of the above activities, the Agent will receive a Ready to Sell communication from ChannelPartnerManagementTeam@bcbsfl.com.
Agents must be in Good Standing with Florida Blue to be eligible for a hierarchy change. No releases or hierarchy changes will be processed or honored between September 1 and December 31. An agent may not change hierarchies more than once in any 12-month period.
Agents who have been contracted longer than 6 months or who have not changed hierarchies within the previous 6 months may change hierarchies by submitting the Hierarchy Change Form.
For an immediate transfer the agent and the agent’s current upline will need to complete the Hierarchy Change Form. Send the completed form to contracting@appliedga.com.
For a delayed release only the agent portion of the Hierarchy Change Form needs to be completed. Send the completed form to medicarebrokersales@bcbsfl.com and contracting@appliedga.com.
Full release procedures per carrier: FL Blue Release Procedures
Updates can be made on www.flordiablue.com/agents
Updates can be made on www.flordiablue.com/agents
Freedom Health – Optimum Healthcare
Thank you for your interest in marketing Freedom Health – Optimum Healthcare through Applied General Agency. You can begin your Freedom Health – Optimum Healthcare contracting today!
- New Agent Registration Link: https://vipagentsupport.com/Agent/AgentRegistration
- Agency ID:524
- Registration ID: AP00038
- Top of Hierarchy: Applied General Agency
Please see Freedom/Optimum Guide for step-by-step submission instructions.
Enter the 3 digit Agency ID and the alpha numeric Registration Code provided by your agency and then click to select the certifications available to your agency. Select the “Click and Get Company” to bring up the list of contracted lines of business available for your agency. Choose the companies you wish to train and certify for. Check the Captcha box marked “I’m not a robot”, which will allow you to select Continue.
All Fields with a Red * are required. You must provide a valid email address to receive your temporary password. SSN is required in order to be appointed; hyphens included. A Valid DL in good standing is required to be appointed. You do not need hyphens for the DL number.
Fill in your address. Check the box next to “VRA text communication”, which is required to continue. Verify that the phone number you have listed for Work Phone is a cellular phone (such as your work cell), as this will be where your confirmation texts are sent to. All phone numbers must include hyphens (not parentheses) and the area code. (i.e. XXX XXX XXXX) Check the acknowledgement box, then click Submit.
Once you click submit, you will receive a message stating that your profile was created successfully. If you click on the “Back to Login” link you will be directed back to the User Home Page. **An email will be sent to you with a link to set up your password**
Keep in mind that this email is temporary and will only last for 24 hours. If you do not complete the remaining steps within the time period, you will be locked out of the portal and need to call Agent Services, at 1-877-8770539.
Agent must request a release from the current FMO via email and cc agentlicense@freedomh.com and contracting@appliedga.com. If you have not written business in the past 90 days Freedom will process your transfer in 3-5 business days. There is no blackout period. Example Hello ABC FMO, I would like to request a release to transfer my Freedom/Optimum appointment to Applied General Agency. Thank you, Nick Spark NPN 12345
If you have written business in the past 90 days then a letter of release from your current FMO is required. If you are unable to obtain a release then you will need to wait 90 days without writing business.
Note: If you are contracted with Amerilife then the waiting period is 18 months and does not receive a release.
Updates can be made on https://vipagentsupport.com
Please see Freedom/Optimum Guide
Updates can be made on https://vipagentsupport.com
Please see Freedom/Optimum Guide
Friday Health ACA
Thank you for your interest in contracting with Friday Health ACA . AGA is partnered with our Integrity Partner, Agent Pipeline, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your ACA contracting.
Agent email Broker Support at brokers@fridayhealthplans.com and state that you request to transfer your contract to Agent Pipeline. Please make sure you include your NPN. Please Cc apcontracting@agentpipeline.com and contracting@appliedga.com on the email request.
If you are under another upline (not direct), you will need to attach a release letter from your current upline to the transfer request email.
A new Friday Health contract will need to be completed
Friday Health ACA Transfer Process
No delayed release process
Downline does not need to recontract, but upline must be contracted as an agency
No blackout period
Changes are made on the Friday Health Portal
Email contracting@appliedga.com and inform us which states you want to add for each ACA carrier.
Geisinger Health Plan
Thank you for your interest in contracting with Geisinger Health Plan. To get started complete the request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer this carrier to our agents. After the DocuSign submission, you will receive an invitation to begin contracting in a few days. Click on the link to begin contracting.
Geisinger Health Plan Contracting
Important: Enter your full name as it appears on your license after clicking the contracting link
To begin your transfer, complete the Request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer this carrier to our agents. After the DocuSign submission, you will receive an invitation to begin contracting in a few days. Click on the link to begin contracting.
Geisinger Health Plan Contracting
Important: Enter your full name as it appears on your license after clicking the contracting link
Updates can be made on the carrier portal, or requests can be sent to license@ritterim.com
Complete EFT Change Form Via DocuSign
Updates can be sent to license@ritterim.com
Gold Kidney
Thank you for your interest in contracting to represent Gold Kidney through the AGA. You will be completing contracting through Gold Kidney’s online contracting system EvolveNxt.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a contracting link.
Gold Kidney will send you a contracting email from EvolveNxt titled, donotreply@evolvenxt.com. You will then complete the training module with a passing score of 90% or better, upload a current AHIP, a current E&O, a signed Gold Kidney contract, and a current license. After completion allow 5 business days to pass background checks. Then you will receive a Welcome Letter once RTS.
To initiate the request for a Hierarchy Change submit the following to: Contracting@GoldKidney.com, brokers@goldkidney.com, and contracting@appliedga.com
- Name of Agent
- National Producer Number (NPN)
- New Agency
- State License Number
- Valid Email Address
For example, Hello. Please transfer my Gold Kidney appointment to Applied General Agency. Thank you Tony Stark, NPN 123456, AZ license no. 123456, tony@stark.com
Make demographic changes on https://gkhp.evolvenxt.com/login.htm
Make changes on https://gkhp.evolvenxt.com/login.htm
Agents may add states in their dashboard in https://gkhp.evolvenxt.com/login.htm or contact brokers@goldkidney.com
Guarantee Trust Life
This is a just in time carrier, except in PA, meaning we contract you at the same time you write your first piece of business.
If you would like to contract, new agents can complete the GTL contract by using the below links. The processing time is approximately 5-7 business days. If an agent is changing a hierarchy, commission level, etc and they already have a code with GTL a paper contract is needed to make the hierarchy change.
GTL Direct Pay Link GTL Online Contracting for AGA Downline Agents
(Not Common) GTL AGA Pay Link GTL Online Contracting for AGA Downline LOA Agents
If you need product information or supplies create a support ticket in your AGA portal. Click on Sales Tools > Tickets and Messages > Add New. Select subject, add your message, then click create.
If you are currently contracted with GTL and would like to transfer to AGA, please email contracting@appliedga.com. Please advise when you last submitted business and/or contracted with your previous FMO. If you do not qualify for a self release include a copy of a letter of release from your previous FMO. See below release policy. Once received we will send your paper GTL contract to the carrier.
Release Contracted with NO Business:
All agent contracts submitted to GTL that have not written business will be honored for up to six months. After this time period the agent may contract with another agency.
Contracted with Business:
If an appointed sub-general agent under an agency or FMO (Field Managing Office) has written new business within the past 6 months and wishes to become contracted with another agency or FMO, GTL will require a letter of release from the current agency or FMO.
If an appointed sub-general agency and its down line have not written business in the past 6 months, they are free to move hierarchies.
LOA (License Only Agent): If an appointed LOA has not written business in the past 12 months, they are free to move hierarchies.
Any transfer will not be honored if the producer has a debit balance with GTL.
Harvard Pilgrim Healthcare – Stride
To get started please request the carrier by completing our Request Form then we will email you the contracting instructions.
Hamaspik
As of 8/1/2023 no new agent contracting will be processed.
To get started please request the carrier by completing our Docusign https://na2.docusign.net/Member/PowerFormSigning.aspx?PowerFormId=5de24fb9-80af-4a2d-8bf5-430bf07d51f0&env=na2&acct=f21e1181-07d7-4ccd-80c9-9c076c3f6f7e&v=2
Once complete your contract will be sent to Hamaspik, and you will be sent an online certification and in person certification to complete.
HCSC ACA
Thank you for your interest in contracting with HCSC ACA . AGA is partnered with our Integrity Partner, Plan Advisors, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your ACA contracting. The email invitation from producer_service_center@hcsc.net. The subject line is, Onboarding Invitation.
Agents are responsible for submitting a transfer request by email during one transfer period per year determined by HCSC. Outside of the transfer period agents can terminate their appointment. To terminate agents have to contact the carrier to have their current appointment terminated, once the termination is approved re-contracting will be needed. There is no waiting period to re-contract once an appointment is termed.
By terminating to transfer all previous business and renewals are lost.
If you would like to continue to transfer your appointment to AGA email either the below individual or corporate termination template to Producer_Licensing@bcbstx.com and contracting@appliedga.com. BCBS will confirm your termination, and AGA will send you a BCBS contracting link. Please see BCBS Onboarding Instructions for Individual or BCBS Onboarding Instructions for Corporation
Individual Termination Template: Please term my, (NAME), individual ACA appointment (PRODUCER ID#) in order for me to recontract as a direct pay under Plan Advisors.
Corporation Termination Template: Please terminate my current individual ACA appointment (PRODUCER ID#) in order for me to re-contract my agency (NAME) and as an LOA sub-producer under it.
Changes can be made on https://producers.hcsc.net/producers/login
Health New England
To get started please request the carrier by completing our Request Form then we will email you the contracting instructions.
Health First NY
Thank you for your interest in marketing Health First through Applied General Agency. You can get started contracting with Health First right now. To get contracted you will initiate a contracting link on Health First’s website and then complete the contracting link that is sent to you from WPM@Webcominc.com.
Create a contracting invite click https://healthfirst.org/brokers, select Info for Brokers, select Medicare Advantage Plans, then the green Get Appointed button. On the contracting form enter your first name, last name, and email. Select Medicare for Business Type. Agent for Onboarding type. Applied General Agency for Up-line.
Note: If your email is already in use you will not be able to create an invite. If you are not currently contracted, your invite can be reset by reaching out to Health First at 855-456-3668 or EmployerandBrokerservices@healthfirst.org. If you are currently contracted with another upline please follow the below transfer instructions. If you cannot find your email from Heath First you can attempt to log in.
Once you have sent yourself an invite, you can now complete your contracting forms. The invite from Health First does not come from a Health First email, it comes from WPM@Webcominc.com; make sure you check your spam and junk mail. Once you start the process, make sure to use Google Chrome; it will not work on Safari (Apple), Explorer, or Edge properly.
Here is a full walkthrough from Health First on how to submit your contract: https://assets.healthfirst.org/pdf_9c21aa06c1df3c7849d08db121a679e4?v=0818181422
- Contracting link: https://social.webcomserver.com/wpm/index.jsp?tenantName=healthfirst
- Username: Your email from the invite
- Password: Obtained from invite. Select Forgot Password if you cannot find your invite, and only enter your email address
- Domain: healthfirst
Links in Email to Medicare Broker Resources:
- Medicare Broker Onboarding Video: https://vimeo.com/577256546/7dfdf3c32c
- Medicare Broker Recontracting Video: https://vimeo.com/577256649/c6c83a35bc
Find below a quick guide on how to initiate your onboarding: https://assets.healthfirst.org/pdf_9c21aa06c1df3c7849d08db121a679e4?v=0818181422
If you have any question and need help with your onboarding and background check, please call broker support at 855.456.3668.
Agents are responsible for submitting a transfer request by email during one of the two transfer periods determined by Heath First NY.
Requests are reviewed by HF’s Commission Analyst team to determine eligibility for transfer. If eligible, the agent must complete the transfer agreement (completed via DocuSign) which requires the approval of the agent, current FMO, and new FMO. Failure of the current FMO to respond within 15 days, will result in a transfer without FMO consent. If the transfer is denied by the current FMO, the agent is allowed to resubmit a request during the next transfer period without the current FMO’s consent.
- Communications
- Broker emails their requests to change from current FMO to Transfers@Healthfirst.org and contracting@appliedga.com
- Example: Hello my name is John Smith NPN 123456 please transfer my Health First appointment from ABC Agency to Applied General Agency.
- Requests are not accepted from the FMO, they are only accepted directly from the broker, only allowed if the broker is included in the email communication.
- Only one FMO transfer is allowed per year, brokers must remain with the FMO they transferred to for a minimum of one year.
- Broker emails their requests to change from current FMO to Transfers@Healthfirst.org and contracting@appliedga.com
- Process
- Broker emails their requests to change from current FMO to Transfers@Healthfirst.org and contracting@appliedga.com
- Example: Hello my name is John Smith NPN 123456 please transfer my Health First appointment from ABC Agency to Applied General Agency.
- Commission Team validates appointment status and FMO details and the following required steps are executed by the transfer deadline:
- Transfer forms are sent via DocuSign- Most information is pre-populated for brokers. (Dates are updated to reflect the current transfer period).
- Broker signature required
- Current FMO signature required
- New FMO signature required
- Current FMO release
- FMO must approve or decline the transfer within 15 days
- Failure to respond will result in an automatic transfer
- New FMO
- FMO must approve or decline the transfer
- If denied, transfer is voided
- FMO/Broker notices
- All parties involved will receive notification once the transfer is processed.
- Sales team, oversight, and commissions are BCC in the email
- Previous transfer denials
- If current FMO denied transfer for broker during the previous transfer period, broker may resubmit the transfer request.
- Approval from current FMO not required for this request (based on previous conversations current FMO can only decline a release once)
- New FMO signature required.
- If current FMO denied transfer for broker during the previous transfer period, broker may resubmit the transfer request.
- Broker emails their requests to change from current FMO to Transfers@Healthfirst.org and contracting@appliedga.com
Health First FL
After your 5.6 is submitted we will be sending you instructions to contract with Health First FL
Health First FL Release Policy
Requests for change in FMO affiliation are accepted between August 1 to October 15 of each calendar year. Realignment request has to be submitted via email stating you’d like to realign under AGA’s Integrity Partner, Plan Advisors NPN 17235707, along with a release letter from the current FMO. Send the release letter to hf-brokers@plusoscar.com (for Medicare), hfhpindividualsales@hf.org (for Individual) and cc info@myplanadvisors.com and contracting@appliedga.com.
Example, Hello, My name is John Smith, NPN 123456, please align my Medicare and Individual Family lines of business with Plan Advisors NPN 17235707, through AGA.
In addition to obtaining a release letter, for the Medicare Advantage line of business, the FMO selection for the upcoming (new) year is completed as part of the annual Medicare Advantage Certification. Like with the Individual Family Plan line of business, there is not the opportunity to change your FMO mid-year.
It should also be noted that, for the Individual Family Plan line of business, the requests for change accepted between August 1 and October 15 go into effect on January 1 of the following year. There is not normally the opportunity to change your FMO selection mid-year.
Changes can be made on https://hf.org/health-first-health-plans/brokers
Changes can be made on https://hf.org/health-first-health-plans/brokers
Changes can be made on https://hf.org/health-first-health-plans/brokers
To assign commissions to AGA put AGA’s TIN and W-9 under payment requirements. Please reach out to contracting@appliedga.com for this information.
Health First FL ACA
Thank you for your interest in contracting with Health First FL ACA . AGA is partnered with our Integrity Partner, Plan Advisors, for us to offer this carrier to our agents. To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After a few days, you will be sent a contracting link to complete your ACA contracting.
Requests for change in FMO affiliation are accepted between August 1 to October 15 of each calendar year. Realignment request has to be submitted via email stating you’d like to realign under Plan Advisors NPN 17235707, along with a release letter from the current FMO. Send the release letter to hfbroker@hf.org (for Individual) and cc info@myplanadvisors.com and contracting@appliedga.com on the email request.
In addition to obtaining a release letter for the Medicare Advantage line of business, the FMO selection for the upcoming (new) year is completed as part of the annual Medicare Advantage Certification. Like with the Individual Family Plan line of business, there is not the opportunity to change your FMO mid-year.
It should also be noted that, for the Individual Family Plan line of business, the requests for change accepted between August 1 and October 15 go into effect on January 1 of the following year. There is not normally the opportunity to change your FMO selection mid-year.
HealthPartners
Thank you for your interest in contracting with HealthPartners. AGA is partnered with our Integrity Partner, IFC, for us to offer HealthPartners to our agents. To get started complete the HealthPartners IFC Contracting Request Form. Once this request form is completed you will be sent a DocuSign from IFC to collect your information and to move forward with your carrier specific contracting.
Please note this carrier’s processing time normally takes 3-6 weeks
Thank you for your interest in contracting with HealthPartners. AGA is partnered with our Integrity Partner, IFC, for us to offer HealthPartners to our agents. To get started complete the HealthPartners IFC Contracting Request Form, and upload the HealthPartners Transfer Form that is signed by your current upline. The HP Transfer form will need to be signed by your current upline and IFC. Transfer blackout period is from 9/1 to 12/1 each year. Once the request form is completed with a HP Transfer Form you will be sent a DocuSign from IFC to collect your information and to move forward with your carrier specific contracting.
Changes can be made by contacting Contracting@ifcnationalmarketing.com
Changes can be made by contacting Contracting@ifcnationalmarketing.com
Changes can be made by contacting Contracting@ifcnationalmarketing.com
Heartland (Hospital Indemnity Plan)
Thank you for your interest in contracting with Heartland National Life through AGA. Heartland is a just in time carrier except when business is needed in AL, GA, OH, LA, MT, PA, and WY. If you have potential business in these states or would like to be pre-appointed, please email contracting@appliedga.com and indicate you would like AGA to send you the Heartland contracting link.
When an agent is being contracted with Heartland National Life, they are required to pay appointment fees. Fees will be charged upon the first piece of business for just in time states.
To transfer your appointment to AGA please complete the Heartland Transfer Form. Send the completed form to contracting@appliedga.com and Agency@hnlic.com
Email or call Agency Services: 833.964.4555 or Agency@hnlic.com
Email or call Agency Services: 833.964.4555 or Agency@hnlic.com
Email or call Agency Services: 833.964.4555 or Agency@hnlic.com
When an agent is being contracted with Heartland National Life, they are required to pay appointment fees. The only states that are required to be paid as pre-appointment fees and must be paid upon being contracted are: AL, GA, OH, LA, MT, PA, and WY. All other states are considered just in time states meaning those states will only be appointed to the agent once the agent has written business in that state and after they have been contracted unless we are instructed otherwise.
Highmark
Thank you for your interest in contracting with Highmark. To get started complete the Highmark Contracting link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer Highmark to our agents. Once your paperwork has been received and processed by Ritter, Highmark will email you a contracting link to complete the contracting process electronically. The contracting link will be sent from HighmarkMedicareContracting@medadv360.com. See Highmark Portal User Guide – FOR AGENTS. You will be required to review and complete any missing demographic information, upload your E&O, and complete your training. Once training is complete, your appointment will be processed. You will then receive a notification that your appointment is complete; the email will contain your login to the Highmark producer portal.
Highmark BoB and Hierarchy change policy
To begin your immediate transfer you and your current upline will need to complete the Highmark – Hierarchy Change Form and send the completed copy to contracting@appliedga.com and license@ritterim.com
To begin your delayed transfer, complete the Request link via DocuSign. Highmark Contracting Request Direct pay (your or your corporation will be paid)
Updates can be made on https://producer.highmark.com/login
Complete EFT Change Form Via Docusign
Email license@ritterim.com with the requested additions.
Horizon / Braven
Thank you for your interest in contracting with Horizon / Braven. To get started please complete the Request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer Horizon / Braven to our agents. Be prepared to upload a copy of your E&O, void check, and if necessary a letter of release. After the DocuSign submission, you will receive a Miramar invitation to begin contracting in a few days. Click on the link to begin contracting. Miramar Guide
Horizon / Braven Contracting Request Direct pay
Indirect Pay (Not common) Horizon / Braven Contracting Request
Important: Enter your full name as it appears on your license after clicking the contracting link
To begin your transfer complete the Request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer Horizon / Braven to our agents. Be prepared to upload a copy of your E&O, void check, and a letter of release. After the DocuSign submission, you will receive a Miramar invitation to finalize the transfer. Miramar Guide
Update your profile on https://miramar-agent.com
Complete EFT Change Form Via Docusign
Email license@ritterim.com with the requested additions.
Humana
Thank you for your interest in marketing Humana through Applied General Agency. Humana uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive an invitation with a link to begin contracting in a few days. Click on the link to begin contracting.
Please note that if you are contracting for yourself and your agency, there will be separate links for your application and your agency’s application. However, you must complete both applications before they can be processed. You will have 30 days for a full contract and 10 days for an amendment to complete the invitation before it expires and it is no longer accessible. You will receive a reminder prior to the invitation expiring.
The contracting process should take approximately 20-30 minutes. The attached Job Aid link may be helpful to you in navigating the online onboarding process.
One of the key items that often trips agents up is forgetting to electronically sign the forms. You will be prompted to scroll to the bottom of each required form to “click and sign”. When complete, make sure you double check the “sign” icons, confirming acceptance of each document. They are along the left side of the “Forms” confirmation page. You will also receive an email confirmation upon successful submission of the contract.
Once you submit to Humana, allow 5-7 business days for processing. At that point you’ll be issued a 7 digit SAN (producer number) which can be used to register for Humana’s agent portal and begin your certification training for PDP and/or MAPD. Certification instructions are in your AGA back office portal under Sales Tools, My Sales Tools then Certifications.
Immediate Release Policy
To receive an immediate release, external agents must secure a release letter from their current upline. It is at their discretion whether or not to release an agent prior to 90 days (see Delayed Release Policy below). The current upline is required to formally communicate the release of the agent in writing using company letterhead, signed by the principal, with a current or future effective date of the release. Complete a Humana Agent to MGA Form via DocuSign and attach a letter of release. A copy will be sent to AgentSupport@humana.com & contracting@appliedga.com. Please see the timeline for processing times.
Delayed Release Policy
In instances where an immediate release is not granted, the agent may request a delayed release. Complete the Humana Agent to MGA Form via DocuSign and a copy will be sent to AgentSupport@humana.com & contracting@appliedga.com. Please see the timeline for processing times.
Log into https://www.humana.com. Click on your name or agency name in the top right, select Profile. Then Edit Profile Information.
Log into https://www.humana.com. Click on Update Direct Deposit under the Commissions section.
View your current non resident appointment on www.humana.com. Navigate to Licensing & Contracts.
Active agents can add a license by sending an email to agencymgt@humana.com. Ask for the state to be loaded on your Humana appointment. Include your SAN number and copy of the license is not needed.
The resident license and all non-resident licenses are pulled from NIPR during the initial contracting and all are loaded upon activation.
Complete the Humana Assignment of Commission form via DocuSign. The completed form will be sent to agencymgt@humana.com and contracting@appliedga.com.
Imperial Health Plan
To obtain online certification email contracting@appliedga.com and agents@imperialhealthplan.com . Include your Name, NPN, state, Upline as AGA and email address.
Example: Hi Imperial and AGA, Please contract me with Imperial in CA under AGA. My name is Gerry Joe, NPN 123554, GIjoe@gmail.com. Thank you.
Imperial will then send you an agent online contracting and certification link.
Any general questions can be addressed by calling Imperial’s Agent Support line 800-838-5197.
Policy: A letter of release is required to transfer an agent if they have written business in the past six months. If no business has been submitted in the past six months then the agent is able to transfer to a new upline.
Start your transfer today by emailing contracting@appliedga.com. Tell us you are currently contracted with another upline, would like to move to AGA, and when you last submitted Imperial business. If you are not sure when your last piece of business was submitted please reach out to Imperial’s Agent Support line 800-838-5197.
Example Email: AGA Contracting, I am currently contracted with Imperial through Jones Agency, but I would like to transfer to AGA. I last wrote business in November of last year. Thank you, Sally Ann
When received we will send Imperial your email and complete a form to transfer you to AGA. The entire transfer process can take from one to three weeks.
To conduct enrollment with Medicare beneficiaries into any of the Imperial plans, agents must be certified in each state.
To obtain online certification email contracting@appliedga.com and agents@imperialhealthplan.com . Include your Name, state, NPN, Upline AGA and email address.
Example: Hi Imperial and AGA, Please contract me with Imperial in CA under AGA. My name is Gerry Joe, NPN 123554, GIjoe@gmail.com. Thank you.
Steve will then send you an agent online contracting and certification link.
Indiana University Health Plans
Thank you for your interest in marketing Indiana University Health Plans through Applied General Agency. Please complete IUHP contracting via DocuSign.
To begin your transfer please complete IUHP contracting via DocuSign.
Indiana University Health Plan Contracting
For an immediate release, attach a letter of release from your current upline.
For a delayed release the contract will start a delayed 6-month release, and move you after those 6 months.
Current IU Health Plans contracted agents with no business on the books will not be subject to the 6‐month release policy if they have been appointed more than 6 months and have never sold a policy or if they do not have any renewal commissions being paid. Current contracted IU Health Plans agents who have not sold a policy in the past24 months will not be subject to the 6‐month release policy.
Complete the IU EFT and send it with a void check to submit to Brandi Mccarthy (bmccarthy1@iuhealth.org)
IMG
You can immediately begin IMG contracting by using the following contracting link: https://producer.imglobal.com/login/new-producer-contracting.aspx?mga=182158
Innovative Integrated Health Community Plans
Thank you for your interest in marketing IIHCP through Applied General Agency. To get appointed you will first need to certify for IIHCP certification by using IIHCP certification instructions in your AGA back office portal under Sales Tools, My Sales Tools then Certifications.
On the certification training indicate that your upline is Applied General Agency. Sales Agents must pass this test with a score of at least 85% in order to be appointed or re-appointed with Integrated HealthPlan. There are 20 questions and the test is not timed. You may attempt the test up to 5 times in order to achieve the passing score. If you do not pass after 5 attempts, please contact your broker manager.
Then once you have completed your exam, IIHCP Broker Support will be forwarding you DocuSign to complete your contract.
Agents may change sales hierarchies once during a twelve month cycle with written notice to IIHCP brokersupport@iihcplans.com.
Transfers are processed once during a 12-month cycle and only January-September. No hierarchy change is permitted October-December. The last day to submit a hierarchy change is September 15th for an October 1 effective date. All hierarchy requests must be submitted by the 15th of the month for a 1st of the following month effective date. If received after the 15th of the month the request will be processed 2 months out. Example: written request received Jan 1st-15th, the transfer is effective Feb 1st. If written request is received by Jan16th-Feb15th the transfer will become effective March 1st.
IIHCP will send written notification to the current and new agency notifying them of the transfer request.
Email changes to brokersupport@iihcplans.com
Intervalley
Intervalley closed as of Jan. 1st 2023 and they currently have no members. They are no longer listed in Medicare.gov in 2023.
You can immediately begin Intervalley certification by using Intervalley certification instructions in your AGA back office portal under Sales Tools, My Sales Tools then Certifications.
Intervalley currently requires a letter of release to transfer uplines. Please send a copy of your letter of release to contracting@appliedga.com and let us know you need to transfer your Intervalley contracting.
Intervalley: 909-623-6333
Jefferson Health Plans
Thank you for your interest in contracting with Jefferson Health. To get started please complete the request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer Jefferson Health to our agents. After the DocuSign submission, you will receive an invitation to begin contracting in a few days. Click on the link to begin contracting.
Jefferson Health Plans Contracting Request Direct pay
Indirect Pay (Not common) Not available
Important: Enter your full name as it appears on your license after clicking the contracting link
To begin your transfer complete the Request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer Jefferson Health to our agents. After the DocuSign submission, you will receive an invitation to begin contracting in a few days. Click on the link to begin contracting.
Jefferson Health Plans Contracting Request Direct pay
Indirect Pay (Not common) Not available
Important: Enter your full name as it appears on your license after clicking the contracting link
Updates can be made on the carrier portal, or requests can be sent to license@ritterim.com
Complete EFT Change Form Via Docusign
To add a state, please complete Jefferson Health Plans Contracting Request via DocuSign
Kaiser Permanente
Thank you for your interest in contracting with Kaiser Permanente. Complete the below DocuSign in according to the state you are going to contract in. You will need to upload your Kaiser certification onto the DocuSign.
Kaiser Contracting GA, VA, MD, and DC
Certifications can be completed on https://miramar-agent.com, Kaiser Registration Code is found in your DocuSign contracting. Once submitted the carrier will send out the state specific “in-person” virtual training to the email address provided.
FMO to AGA/Integrity:
The agent(s) will need to be terminated from their current FMO’s hierarchy and is responsible for working with their current FMO to ensure the termination is completed. There is no delayed release process for Kaiser. Kaiser does not get involved in transfers/hierarchy changes. From the carrier’s perspective, all business belongs to the contracted FMO. Any business written by the agents does not follow the agents and will remain with the previous FMO.
*All FMO’s use the same spreadsheet onboarding process that Integrity uses as this is Kaiser’s appointment process/management system for agents.
Once the agent(s) receives verification from their previous FMO, the agent(s) will need to communicate with contracting@appliedga.com that the termination has been completed so that AGA can submit the agent’s information back to Kaiser to realign the appointment.
Integrity Partner to Integrity Partner:
Agent(s) will need to wait 6 months in their current Integrity Partner’s hierarchy or obtain a signed release from their current Partner on their company letterhead.
If a release is obtained, the release will need to be submitted to the Integrity Contracting team for processing. Release will be added to the agent’s profile and the hierarchy will be updated internally. Nothing will be submitted to the carrier as all Integrity hierarchy is tracked internally only.
Direct to AGA/Integrity
If you are contracted directly with Kaiser you will need to reach out to Kaiser to request a termination/release to realign under Integrity/AGA. Once that has been completed please notify contracting@appliedga.com, and we will begin your onboarding.
Please email changes to contracting@appliedga.com.
To update your commissions for CO, OR or WA complete the EFT Form via DocuSign
To update your commissions for GA, MD, WV and DC complete the Kaiser Contracting GA, VA, MD, WV, and DC via DocuSign
To add a state complete the corresponding Kaiser DocuSign.
KelseyCare
Thank you for your interest in marketing KelseyCare through Applied General Agency. KelseyCare uses an online contracting system and we will need some information to get the process started.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”. After you return the 5.6 Add Carrier Request you will receive a email from kcabrokersupport@kelseycareadvantage.com to begin your contracting and certifications.
- Website https://kelseyportal.kelseycareadvantage.com/
- Username is your email
If you cannot find your KelseyCare email, navigate to the KelseyCare website and reset your password.
Please see KelseyCare Agent Onboarding Guide
See KelseyCare Release and Hierarchy Change Rules
- Agent/Agency movement between and among FMO’s is allowed as follows:
- During the first 6 months of being contracted with KCA or within 6 months of hierarchy change, an Agent or Agency must secure a written release from their current Top of Hierarchy FMO to be eligible for a release and hierarchy change.
- The written release must be on the current Top of Hierarchy’s Agency letterhead or be an official email from the principal of the Top of Hierarchy’s Agency bearing:
- The date and signature of the principal or his/her designee
- Agents’/principal’s name as it appears on the KCA agreement
- The written release must be on the current Top of Hierarchy’s Agency letterhead or be an official email from the principal of the Top of Hierarchy’s Agency bearing:
- During the first 6 months of being contracted with KCA or within 6 months of hierarchy change, an Agent or Agency must secure a written release from their current Top of Hierarchy FMO to be eligible for a release and hierarchy change.
- The Agent/Agency must submit the release letter/email along with the KCA FMO Hierarchy Change Form.
- The hierarchy change will be effective on the date on which the change is
- Hierarchy changes are submitted to kcabrokersupport@kelseycareadvantage.com by the Top of Hierarchy FMO only. Requests received from Agent/Agency will be returned
- The Agent/Agency will be notified at the email address we have on file when the change has been made. The releasing FMO will see the Agent/Agency removed from their KelseyPortal and the new FMO will see the Agent/s populate in their KelseyPortal.
- FMOs releasing an Agent/Agency will continue to be paid Admin Fees on business written while the Agent was under their hierarchy. Enrollments processed after the transfer is made will be credited to the new The Agent/Agency retains their book of business after the transfer is complete.
- Hierarchy changes involving an entire Agency require that the Agency maintain the same administrative fee level under the new hierarchy as they had under the releasing Agency for minimum of 6 months.
- Agents/agencies who have been contracted longer than 6 months or who have not changed hierarchies within the previous 6 months may change hierarchies if, they have been granted a release by existing FMO and submitted proof that Agency/Agent was granted release. If FMO denies release, Agency/Agent will require a 30-day waiting period for Once complete, the Hierarchy Change Form must be submitted for approval and processing at kcabrokersupport@kelseycareadvantage.com.
- An Agent/Agency may not change hierarchies more than once in any 12-month
- No releases or hierarchy changes will be processed or honored between September 1 and December 31 (blackout dates). Any received during this time will not be held for
- The Agent/Agency must be in Good Standing with KCA to be eligible for a hierarchy change.
Email changes to kcabrokersupport@kelseycareadvantage.com
Upon agent’s first enrollment, they need to contact commissions@kelseycareadvantage.com to request a link to register for direct deposit with KelseyCare’s vendor “Paycor”. KelseyCare will also reach out to the agent if they are not registered and are owed commissions.
Agent commission is paid directly by the carrier to either yourself or a corporation you own. If you would like to assign your commission to a corpoation you do not own you will need to contract as an LOA under AGA. Please contact contracting@appliedga.com to be set up as an LOA with KelseyCare. KelseyCare will pay AGA, and AGA will distribute your commission.
LA Care
Thank you for your interest in marketing LA Care through Applied General Agency. LA Care uses an online contracting system, and will require you to complete your own contracting. To get started please create an agent portal and request contracting.
See LA Care portal and onboarding training guide. Please have your license, E&O and AHIP ready to upload. You must reside in CA to offer LA Care.
LA Care Broker Link http://www.lacare.org/agent-central
Apply Now, select LA Care Medicare Plus, Select AGA, complete the basic information and submit. Once completed AGA will review your submission, then you will receive your training link
Per LA Care, agents are only allowed to transfer once a year between January and August. If you submit a request to transfer any time after September 1st, the request will be declined. You will need to resubmit the request in January.
LA Care request transfer by logging into Sales Force, submit a request and upload your release. LA Care transfer process
https://lacareorg.force.com/Login
Transfer*
Agent submits transfer request with L.A. Care Health Plan to existing General Agency (Transfer should be processed by General Agency within 48 hours. If transfer request is not processed within 48 hours, L.A. Care Admin will follow-up with General Agency. L.A. Care Admin may escalate transfer requests if General Agency does not respond)
L.A. Care admin will approve transfer requests within 10 business days.
When transfer is complete, L.A. Care will notify agent via email.
Commission (with book of business transfer)
If transfer is approved by L.A. Care before the 5th of the month (Commission change will reflect change on the following month.)
If transfer is approved by L.A. Care after the 5th of the month (Commission change will reflect change 2 months from the transfer complete date.)
*Please note that transfers are not permissible between September-December, on a yearly basis.
Liberty Medicare Advantage
Thank you for your interest in contracting to represent Liberty Medicare Advantage plans through AGA. You will be completing contracting through Liberty’s online contracting system Liberty Broker Portal.
To get started log into your AGA portal and obtain a 5.6 Carrier Request Form and send it to contracting@appliedga.com. You will find this form in your AGA portal under Sales Tools, My Sales Tools, Forms Library, then “5.6 Contracting Forms”.
After you return the 5.6 Add Carrier Request you will receive an invitation with a link from donotreply@evolvenxt.com and “Evolve Agent Contracting Registration” as the subject line. The email will include the contracting link, username, and password. Click on the link to begin contracting. The contracting link will always be https://lma.evolvenxt.com/login.htm, and your username is your email.
Updates can be made on https://lma.evolvenxt.com/login.htm. Your email is your username.
Updates can be made on https://lma.evolvenxt.com/login.htm. Your email is your username.
Liberty Bankers
Thank you for your interest in contracting with Liberty Bankers through AGA. Please have your void check ready to upload. When completed your contracting will be sent to Liberty Bankers by AGA, and then you set instructions to complete your certifications. Please contact contracting@appliedga.com with questions.
To get started complete the DocuSign Liberty Bankers Contract.
Thank you for your interest in contracting with Liberty Bankers through AGA. To complete your transfer please complete a new contract. Please have your void check ready to upload. When completed your contracting will be sent to Liberty Bankers by AGA, and then you set instructions to complete your certifications. Please contact contracting@appliedga.com with questions.
To get started complete the DocuSign Liberty Bankers Contract.
Updates can be made by contacting contracting@LBIG.com
Updates can be made by contacting contracting@LBIG.com
All NON RES states for an agent are added as an agent writes so all the appointment fees don’t hit his account at one time. Liberty Bankers only pays for resident appointments. However, Liberty Bankers will need an email from you if an agent is about to write in his NON RES state of PA or NM. Email contracting@libertybankerslife.com to add PA or NM. These are PRE APPT states and the agent cannot write an application until he’s appointed. If he writes an app and then sends an email, he will have to rewrite the app.