Contracting Information M - Z

The purpose of an Assignment is to legally assign an Agent’s/Agency’s commissions to another Agent/Agency. This is done when an Agent/Agency sells or buys a book of business or for other reasons. Please review the checklist carefully.  We cannot proceed with this Assignment until all paperwork is received in good order. Send all forms to Email: healthagent@wellabe.com 

Assign of Commissions Form 

• The Assignor is the Agent/Agency assigning their commissions to another Person/Entity.  (If Agency is involved, contracted agency name should be inserted in top section of Form.  Signature of Agency principle is at bottom.)
• The Assignee is the Person/Entity to receive the commissions from the Assignor.  (If Entity is involved, Entity name should appear on top section of Form.  Signature of principle is at bottom.)

W-9 – Assignee complete 

• Please fill out the W-9 form in its entirety with the Assignee’s Tax information.
• Please verify that the Tax ID number matches the Assignee’s Tax ID Number on the Assignment of Distributor’s Agreement Form.
• If the numbers do not match, we cannot process the Assignment

Wellabe Direct Deposit Form – MI9F 4320-DD-11012016 – Assignee complete 

• Please complete the Direct Deposit form in its entirety with the Assignee’s Bank information where commissions are to be deposited.   (Electronic payment is our only option available.)       

Thank you for your interest in contracting with Molina ACA . AGA is partnered with our Integrity Partner, Plan Adviors, 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.

Molina ACA Contracting Guide

Agents can complete transfers using one of the following options:

Immediate Transfer with Release – include the Molina Release Form with the Transfer paperwork email. Send corresponding paperwork to mpbrokercontracting@molinahealthcare.com. Please Cc info@myplanadvisors.com and contracting@appliedga.com on the email

Delayed Release – if policies have been written in the past six months and the agent does not have a release letter from their current upline, they can complete the Molina ACA Delayed Release Form via DocuSign. Your completed paperwork will be sent to the carrier immediately after submission.

Email changes to contracting@appliedga.com and info@myplanadvisors.com and inform us which ACA carriers need to be updated with the new information.

Molina ACA does Just in Time appointments

Thank you for your interest in contracting with Mutual of Omaha.

To get started selling Med Supp, Dental, Accidental Death, Critical Advantage, Disability Income, Long Term Care (LTC13) complete the Mutual of Omaha Med Supp, LTC, AD, Crit, DI via DocuSign. Your contract will be sent to AGA and Mutual of Omaha immediately after submission for processing.

We recommend starting with Med Supp appointment. Agents have 18 months to submit one piece of business. If no business is submitted the MOO appointment will be terminated and a new contract will need to be submitted.

To get started selling Term Life Express (TLE)*, Index Universal Life Express (IULE)*, Children’s Whole Life*, Universal Life (UL)*, Index Universal Life (IUL)*, Term Life Answers (TLA)*, Final Expense (Living Promise), Deferred Annuity**, Immediate Annuity**, Income Annuity w/Premium Return**, Ultra Income SPIA** complete your Life and Annuity Mutual of Omaha Contracting through SuranceBay. Please see additional SuranceBay instructions

*Life Appointments: Agents selling LTC in states that have implemented LTC Partnership or product training programs must complete their state’s initial training requirement before soliciting and submitting any LTC policies and must provide proof of training prior to the application issuing. Please refer to the LTC Partnership Programs on Sales Professional Access under the LTC Product link for information regarding the LTC Partnership states and the training requirements.

**Annuity Products. Copies of continuing education and Company-specific certificates are required for producers soliciting annuities in specific states. For more information on the regulation and training, please refer to the NAIC Annuity Suitability link in SPA, then click on the Compliance link under the Product tab. Federal regulations dictate that Anti-Money Laundering training is required for producers soliciting permanent life insurance or annuities. For more information on the regulation and training, please refer to the Anti-Money Laundering link in SPA, then click on the Compliance link under the Product tab.

If an agent wrote business within the past 6 months or has contracted with current upline within the past 6 months please complete a MOO Transfer Form and complete a MOO AGA DocuSign Contract.

Mutual of Omaha Transfer Guidelines

Agents can change their information is through the producer website https://www.mutualofomaha.com/sales_professionals/

Agents can change their direct deposit information is through the producer website https://www.mutualofomaha.com/sales_professionals/

Once logged in, the agent needs to click on the person in the upper right-hand corner, select Direct Deposit, then click the Update button.

View your current appointments through the producer website https://www.mutualofomaha.com/sales_professionals/

Email add state requests with a copy of your non resident license to contracting@appliedga.com and CONTRACTSANDAPPOINTMENTS@MUTUALOFOMAHA.COM. Include your name, carrier ID and NPN.

Appointment Requirements
Pre-appointment States (Pennsylvania, Montana): A party must have an effective appointment prior to solicitation. If applications are dated prior to the appointment effective date with Mutual of Omaha these applications will be rejected, and a letter will be mailed to the client. A party must have an effective appointment prior to solicitation. If applications are dated prior to the appointment effective date with OHIC, the application will be processed, and the producer will not be paid commission.
Non-Pre-appointment States: A party may solicit prior to having an effective appointment (applications may be submitted with contracting paperwork). However, the policy cannot be issued until the appointment is effective with Mutual of Omaha, or OHIC. Insurance department regulations DO require us to have producers appointed within a certain period of time after receiving applications (typically 10-15 days).

Thank you for your interest in contracting with NCD – Dental/Vision. 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.

NCD – Dental/Vision Direct Pay Contracting Link: Agents are paid directly by NCD.

(Not Common) NCD – Dental/Vision Indirect Pay Contracting Link: AGA pays you for your enrollments

You will complete the submission online including your W-9, ACH information, and state resident license. NCD will pull other state licenses via NIPR system. The contract is processed by NCD within 24 hours, and you will receive a welcome email from Agent Support Team and a welcome phone call from a dedicated account manager.

External Agents must follow the National Care Dental (NCD) Release Policy when ending or changing an affiliation with an upline agency. This policy applies to agents and agencies, hereafter referred to as “agents”, contracted to sell NCD products.

Immediate Release Policy – To receive an immediate release, external agents must secure a release letter from their current direct upline. It is at their discretion whether 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. Release letters must be sent to NCD’s Agent Support at AgentSupport@NCD.com. If the immediate release is accepted, it will be processed within 5 business days. NCD will notify the agent via email when the release has been processed. LOA agents who were employed by their upline are immediately eligible for a release should their employment end, but LOA agent business remains the property of the original upline and is governed by any contracts in place between the LOA agent and their upline. Agents with no business written in the past 6 months, qualify for an immediate release.

Delayed Release Policy – In instances where an immediate release is not granted, the agent may request a delayed release.* The delayed release will be effective 90 days after the agent’s request is received. Such requests must be requested of NCD with proof of notification of intended release to the current direct upline 3-6 months before the delayed release request. Note: Agents above an SGA/SGA2 commission level are not eligible for a Delayed Release

Impact on Agent’s Book of Business
New: Any business submitted to NCD while the agent was aligned with the previous upline will result in the appropriate overrides and commission being paid as indicated by the contracts and schedules in place at the time of the sale.
Renewal: Any renewals earned while the agent was aligned with the previous upline will result in the appropriate overrides and renewals being paid as indicated by the contracts and schedules in place at the time of the sale.

The release ONLY affects business that occurs after the date of the release.

NCD reserves the right to grant releases and/or adjust hierarchies without the approval of the agent hierarchy. Hierarchy changes will affect the requesting agent and their downline agents.

Thank you for your continued support and participation of NCD. If you have questions, contact our Agent Support Team at 844-284-4944 or AgentSupport@NCD.com.

Changes can be made with NCD Agent Support Team at 844-284-4944 or AgentSupport@NCD.com

Changes can be made with NCD Agent Support Team at 844-284-4944 or AgentSupport@NCD.com

States can be added just in time. When NCD sees applications come in for an agent without the appropriate state license, NCD runs an NIPR report and updates the agent’s licenses accordingly.  Agents can also proactively let AgentSupport@NCD.com know via email that they have a new state license if they prefer (and we will run an NIPR report).  There is no additional information required on behalf of the agent.

Thank you for your interest in contracting with Oscar ACA. AGA is partnered with our Integrity Partner, Heath Insurance Store, for us to offer this carrier to our agents.

To get started follow the Oscar ACA Contracting Instructions via DocuSign.

Instructions for submitting Upline Agency Release Letter for 2025

The Upline Agency Release Letter must be filled out in its entirety by an Authorized Representative of the releasing Upline Agency/General Agency. Oscar will not accept incomplete letters.

Oscar will only accept Upline Agency Release Letters submitted to Oscar between June 1st and August 31st of each year. Changes will be effective for Open Enrollment 2025 (starting 11/1/2024).

If the Agent should be released during a different time than Open Enrollment 2025, please reach out to your Sales Executive.

Completed letters should be emailed to brokers@hioscar.com, contracting@appliedga.com and Kiara@hisagents.com for processing. Letters may take several weeks to process.

If an Upline Agency would like to release an Agent and have them appointed directly under Oscar, they may do so at any time of the year by emailing their Oscar Account Advisor or brokers@hioscar.com. Agents released this way may not join a different Upline Agency without written approval from Oscar.

Oscar reserves the right to decline an Agent Release for any reason and without explanation.

Updates can be made on https://accounts.hioscar.com/account/login/?client_context=business

Updates can be made on https://accounts.hioscar.com/account/login/?client_context=business

Updates can be made on https://accounts.hioscar.com/account/login/?client_context=business

Thank you for your interest in marketing PacificSource through Applied General Agency. AGA is partnered with our Integrity Partner, Plan Advisors and Guided Medicare Solutions, for us to offer PacificSource to our agents. PacificSource 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”.

In a few days you will receive contracting forms to begin your contracting via DocuSign.

Agents must present a release and they will be able to re-contract. Exception to this is an agent can contract immediately if no business written in the past 12 months.

If you are moving a direct contract to an FMO, a business case must be put together and will require prior approval.

Send an email to medicarebrokerserivces@pacificsource.com to update your EFT and demographics

Send an email to medicarebrokerserivces@pacificsource.com to update your EFT and demographics

Email a copy of your license and send your add state requests to contracting@guidedmedicaresolutions.com with a copy to eric.clarkson@guidedmedicare.com

Thank you for your interest in contracting with PeakHealth. AGA is partnered with our Integrity Partner, Agent Pipeline, for us to offer this carrier to our agents. To get started please complete the PeakHealth request link via DocuSign. In the DocuSign, you will see the Miramar code and link to begin contracting. Open Miramar and complete the PeakHealth contracting. Miramar Guide

To transfer your PeakHealth complete the PeakHealth request link via DocuSign. In the DocuSign, you will see the Miramar code and link to begin your transfer. A letter of release will need to be uploaded in Miramar if you have contracted with another upline in the past 6 months or have written in the past 6 months. A letter of release is not needed outside of those dates. Miramar Guide

Update your profile on https://miramar-agent.com

Update your EFT with Agent Pipeline EFT Change Form

Carrier only in WV

Thank you for your interest in contracting with Physicians Mutual. Begin your contracting today by completing the Physicians Mutual contracting link.

 Physicians Mutual Direct Pay Contracting Link: Agents are paid directly by Physicians Mutual

(Not Common) Physicians Mutual Indirect Pay Contracting Link: AGA pays you for your enrollments

Begin your transfer today by completing the Physicians Mutual contracting link.

 Physicians Mutual Direct Pay Contracting Link: Agents are paid directly by Physicians Mutual

(Not Common) Physicians Mutual Indirect Pay Contracting Link: AGA pays you for your enrollments

Agents can change demographics by emailing our sales office coordinator their change in information – Vickie Minor – at Vickie.Minor@PhysiciansMutual.com

Agents can change EFT for either themselves or for their clients by emailing our sales office coordinator their change in information – Vickie Minor – at Vickie.Minor@PhysiciansMutual.com

Agents can add states by submitting business in the associated state, and then email our sales office coordinator their license information – Vickie Minor – at Vickie.Minor@PhysiciansMutual.com 

As of 7/18/2024 New Agent Contracting has been suspended indefinitely.

Thank you for your interest in marketing Premera through Applied General Agency. AGA is partnered with our Integrity Partner, Plan Advisors and Guided Medicare Solutions, for us to offer Premera to our agents. Premera 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”.

• You will receive a Docusign email with the subject “Guided Medicare Solutions – Initial Agent Setup Files [Your Name]”
• Please fill that out so we can get you into our system
• Sent to you before you received this email
• Can you confirm if you are currently contracted through Premera via another upline or direct to carrier? Or will this be a new contract with this carrier?
• Once that is completed, you will receive a DocuSign email for the contracting  titled “Premera Blue Cross Contract” that will reference Guided Medicare Solutions (not BRP; see below)
  • You will also receive an email from our contracting team following up throughout the process
• Upon completion, you will receive an additional email from Premera for the certification
• Also, keep in mind that although we operate to our agent/agency partners as Guided Medicare Solutions (GMS), we often contract with the carriers under our parent company Baldwin Risk Partners (BRP Medicare) with Sidney “Chase” Bedsole as our principal agent
• This can often be confusing during the initial onboarding for agents not used to working with us
• At different steps, the carrier may refer to use as Guided Medicare Solutions or as BRP Medicare; we are one in the same

Coming Soon

Send information to info@myplanadvisors.com and medicaresupport@primera.com

Coming Soon

Send a copy of your license to info@myplanadvisors.com

Thank you for your interest in marketing Prominence Health Plan through Applied General Agency. Prominence Health Plan uses an online contracting system and please use the below contracting link to get started.

https://www.myagentworld.com/signup?id=1653930340490×162190815400820740

 Click to Contract Option = The AGA Contract option code for is “AppliedGeneralPHP”

Prominence User Guide

To begin a transfer to AGA, log in to My Agent World and scroll to the Upline section. Press the “Request Change” button to initiate your Upline change to AGA. https://www.myagentworld.com/

Once you updated your upline to AGA email PHPMASalesGeneralMailbox@uhsinc.com & contracting@appliedga.com and notify us of your changes. If you have a letter of release from your previous upline please attach it.

https://www.myagentworld.com/

See Direct Deposit Guide

Prominence User Guide

If adding Non-Resident State post credentialing, please use the “Contact Us” button within the My Agent World application to request the Non-Resident State

Thank you for your interest in marketing Providence Health Plan through Applied General Agency. Providence Health Plan 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 with your current year’s AHIP 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, AGA contracting will send your information to Providence, they will review and send you a workflow contracting link. You will need to complete the contract and certification, then submit it for processing. After completion Providence will send you a ready-to-sell letter.

Transfers are allowed once per year.

For an immediate transfer provide a letter of release from your current FMO. If you are unable to obtain a letter of release, please forward the emails you sent to your previous FMO requesting a release to contracting@appliedga.com, and indicate you want to move your Providence contract to AGA. We will then reach out to Providence for further instruction.

Send changes to AgtCoordinatorUnit@providence.org and contracting@appliedga.com

Send changes to AgtCoordinatorUnit@providence.org and contracting@appliedga.com

Send updated license to AgtCoordinatorUnit@providence.org and contracting@appliedga.com 

Thank you for your interest in contracting with Quartz. To get started please complete the Quartz contract via DocuSign. Your contract will be sent to AGA and Quartz immediately after submission for processing. Please be prepared to upload a copy of your license and your AHIP or FFM Certification.

Quartz DocuSign Contract

Thank you for your interest in contracting with Quartz. To get started please complete the Quartz contract via DocuSign. Your contract will be sent to AGA and Quartz immediately after submission for processing. Please be prepared to upload a copy of your license,  your AHIP or FFM Certification and release.

Quartz DocuSign Contract

Email changes to agent.appointments@quartzbenefits.com

AGA pay only

To add a state complete Quartz DocuSign Contract

Thank you for your interest in contracting with Asuris/Regence. To get started please complete the Request link via DocuSign. 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.

Regence – Asuris Contracting Request

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.

Upload a copy of the release on Asuris Contracting Request Form

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.

Upload a copy of the email request, Asuris Contracting Request Form

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 and void 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.

Thank you for your interest in contracting with Asuris ACA. AGA is partnered with our Integrity Partner, Plan Advisors & Health First, 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 a Plan Advisors contractor sends the you the first email instructing you of the contracting process. Plan Advisors will let you know that we go through Health First for the contract and you will receive communications from them going forward. You will also be given the Health First Assignment of Commissions form to fill out and return to Health First. Then Health First will then send the contracting paperwork to complete.

To begin your transfer email a letter of release from your current upline to contracting@appliedga.com, and notify us you are being released from Asuris ACA. After a few days a Plan Advisors contractor sends the you the first email instructing you of the contracting process. Plan Advisors will let you know that we go through Health First for the contract and you will receive communications from them going forward. You will also be given the Health First Assignment of Commissions form to fill out and return to Health First. Then Health First will then send the contracting paperwork to complete.

Email changes to AgentDesk@regence.com or call 800-331-7880

Complete the ACA EFT form via DocuSign

Email a copy of your license to info@myplanadvisors.com

Renaissance AGA Contracting Link:
https://contracting.mwadmin.com/Portal/AGA-Agent/?u=6187022&mgmtrep=1a4c388b-b7a0-4207-b608-70f816848c04&

Thank you for your interest in marketing SCAN through Applied General Agency. SCAN 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.

An Onboarding Invite will come from SCAN@evolvenext.com with instructions to register to your Okta Single Sign-On account. Once you have registered and logged into the account navigate to the Producer Dashboard where you will find ‘My Certification Case’ and Click the Blue Start Button and follow the steps. Once the contract portion is complete the Mandatory Training will appear.

AGA will then request SCAN to send you a Hierarchy Transfer From. SCAN will then email you the Hierarchy Transfer form, complete the form electronically, and this will be sent directly to SCAN. SCAN will confirm completion via email.

Transfers must be submitted by the 15th of the month for the transfer to be effective on the first of the following month. (Example: Form is received by Jan 14th, agent is effective with new agency Feb 1st).

Transfers are accepted once a year.

Not available for 10/1 to 12/1 effective dates.  To transfer to AGA for the current year’s AEP transfers must be submitted by 9/15

Email your demographic changes to scanbrokercontracting@scanhealthplan.com or updates can be made on https://www.scanproducerportal.com/ 

Changes can be made by going to https://www.scanproducerportal.com/ and see SCAN EFT Walkthrough

Changes can be made by logging into the producer dashboard, https://www.scanproducerportal.com/, and edit the information and complete a new W9 form under “payee”.

Changes can be made by going to https://www.scanproducerportal.com/, then click on Producer Dashboard , then under my credentials navigate to the Manage My License and Declare the state by checking the Box Next to their Active License and add selected States.

SCAN has a Successor Agent program that provides you with the ability to transfer your book of business to another SCAN contracted agent. If your successor is not currently ready to sell at the time of death, they will then have 90 days in which to do so.

What is a successor agent? A qualified agent who will service the members in the book of business you transfer to them in exchange for renewal commissions.

When does a successor agent agreement make sense? Exiting the business or death of an agent.

Exiting the business (i.e., retirement or illness)

• • Agents transferring and receiving book of business must be in good standing according to SCAN’s contracting requirements and certified to receive renewal commissions with SCAN
  • Original agent transferring book of business must be paid directly by SCAN
  • Agents must complete Successor Agent Transfer Form
  • Annual renewal payments must exceed $5,000

Death of an agent

• • Agents transferring and receiving book of business must be in good standing according to SCAN’s contracting requirements and certified to receive renewal commissions with SCAN
  • Original agent transferring book of business must be paid directly by SCAN
  • Agents must complete Successor Agent Transfer Form prior to death
  • Annual renewal payments must exceed $5,000

Contracting link https://social.webcomserver.com/wpm/caseEditPrepare.do?&token=ho38c7t%2F5dSaLKh8cZ5hYHwlNWnyeVRfEDcvdG9qNAc%3D&tenantName=scott_white

FMO affiliation: Applied General Agency, Inc.

Complete contracting link and current year’s certifications, then S&W will send you a ready to sell letter.

Complete the S&W Affiliation Change Form and email to HPBrokerCommission@BSWHealth.org and contracting@appliedga.com

Agents can change from one FMO to another FMO once a year. (Pending release based on contract review)

Agents can submit a change anytime during the open “Change Period” from 02/01 through 08/31 annually. Change requests will not be accepted from 09/01 to 01/31. These will need to be resubmitted during the open change period.

Thank you for your interest in contracting with Scott & White 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 from Scottwhite@onboarding.com with the subject Onboarding Application to complete your contracting.

Complete the agent portion of the S&W Affiliation Change Form and email to info@myplanadvisors.com and contracting@appliedga.com

Agents can change from one FMO to another FMO once a year. (Pending release based on contract review)

Agents can submit a change anytime during the open “Change Period” from 02/01 through 08/31 annually. Change requests will not be accepted from 09/01 to 01/31. These will need to be resubmitted during the open change period.

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 Docusign contracting packet from the carrier.

After you have completed the Docusign contracting packet, you will then need to RSVP for a virtual training. Once the virtual training has been completed, you will receive a ready to sell email from the carrier.

The virtual training is only required for your initial training. Subsequent years only require an online training.

If you are unable to obtain a release, you can begin a delayed 3-month release. Email a request to be released to your current upline, Stephanie.Crandall@selecthealth.org, and contracting@appliedga.com. This starts the 3 month clock to transfer without a release. If your upline ignores your email request for a release, it still counts (this is not the same with other carriers that require that your FMO actually deny your request).

After your release or delayed release is submitted, SelectHealth will send you a Docusign contract to finalize your transfer to AGA.

Thank you for your interest in contracting with Select Health ACA. AGA is partnered with our Integrity Partner, Plan Advisors and Health First, 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 DocuSign contracting link to complete your contracting.

SelectHealth Release Policy (Blackout September 1st-December 31st) 

You must request a release from your current upline FMO via email and cc Plan Advisors at info@myplanadvisors.com and Select Health at agent.relations@selecthealth.org. The FMO can agree to the release and email agent.relations@selecthealth.org. 

If the current FMO does NOT agree to the immediate release, Select Health will begin a 90 day count down from the original request.  The agent will be realigned on the 1st of the month following the 90 days.  

Updates can be made by emailing agent.experience@selecthealth.org

Updates can be made by emailing info@myplanadvisors.com

Simply has the same policy as Anthem Blue Cross. Please review the updated Anthem policy https://appliedga.com/medicare-insurance-agents-resources/workflows-a-l/

Thank you for your interest in contracting with Solis Health Plans. AGA is partnered with our Integrity Partner, Heath Insurance Store, for us to offer this carrier to our agents.

To get started follow the Solis Health Plans Contracting Request. After the request has been completed Solis will send you a contracting request after a few business days. The contracting packet from will be sent from sosagents@solishealthplans.com with the subject of “Solis Agent Initial Certification Invitation”.

To get started follow the Solis Health Plans Contracting Request. If there is no current active business the agent can email Solis a request to re-align under new FMO. Solis will inform both uplines entities and will align agent as requested. To begin your request please email SalesSupport@SolisHealthPlans.com, Example Hello, my name is Toby Stark NPN 12345, I would like to transfer my Solis appointment to Heath Insurance Store and Applied General Agency.

If there is active business, the agent will need a release letter from current FMO. The agent should email the current FMO and cc SalesSupport@SolisHealthPlans.com. If the FMO does not provide release and Solis is included, the agent will wait 60 days from the day of the request made. Example: Hello FMO, my name is Toby Stark NPN 12345, I would like to transfer my Solis appointment to Heath Insurance Store and Applied General Agency.

Changes can be made by contacting SalesSupport@SolisHealthPlans.com

Solis is currently in FL only 

Changes can be made by contacting SalesSupport@SolisHealthPlans.com

Thank you for your interest in marketing Sonder through Applied General Agency. Sonder requires an agent to certify then a contracting link will be sent to the agent.

The first step is to complete the training at https://sonderhealthplans.com/agents/#training

Review the training presentation then take the agent exam. Agent ID will be your NPN. The name of your FMO will be Applied General Agency.

Once you have completed the test with a passing score, and you will be sent a contracting link. With the subject of Invitation to Onboard with Sonder Health Plans”. You will need copies of your AHIP, E&O and drivers license ready for upload.

After submission a background check is ran prior to appointment. The time it takes depends on the agent’s city and county court system. When the background check is processed and passed you will get an email with the subject “Congratulations! You have been appointed to Sell Sonder Health Plans” with your temporary Connecture login credentials.

Listed below are your temporary login credentials.

https://sonderhealth2.destinationrx.com/PC/Agent

Username: 1st initial and last name (e.g. – JSchmoe) An email will be sent to those that have a unique username. (e.g. – JASchmoe)

Password: Your default password is Welcome123!

You will be prompted to change immediately upon account creation.

Your writing number is your NPN.

Generalsales@sonderhealthplans.com

When an agent wants to make a change in their FMO Sonder Health Plans will honor a signed release from the highest level in hierarchy. This is also called a “Signed Release.” It happens immediately upon the two parties signing the release and submitting it to Sonder Health Plans. The other option is referred to as a “Self Release” which takes a little longer to honor.  Sonder Health Plans policy is a 3 month Self-Release period. During this time the agent can continue to write business. However, Sonder Health Plans does have a Lockout period when there will be no releases honored during Oct 1st – December 31st of every year. Email your self release to Contracting@appliedga.com and Generalsales@sonderhealthplans.com. 

Email changes to Generalsales@sonderhealthplans.com 

Email changes to Generalsales@sonderhealthplans.com 

Thank you for your interest in marketing True Freedom. Please complete the True Freedom contracting via DocuSign True Freedom Contracting

Thank you for your interest in marketing True Freedom. Please complete the True Freedom contracting via DocuSign to complete your transfer True Freedom Contracting

For updates please contact reps@truefreedomhomecare.com

For updates please contact reps@truefreedomhomecare.com

Once you are appointed you can market in all 50 states. This is not a Medicare plan

To get started please request the carrier by completing our Request Form then we will email you the contracting instructions.

To transfer you will need to obtain a letter of release from your previous upline and send a new conract.

UnitedHealthcare The Chesapeake Life Insurance Co. / SureBridge is a carrier that offers Dental & Vision, Disability, Accident, Critical Illness, Cancer, Heart Attack, and Life Insurance products. If you are interested in contracting with Surebridge please email contracting@appliedga.com and advise us if you would like us to send you a SureBridge contracting link. Surebridge requires annual compliance training to be completed every 365 days (based on when you first complete the initial training).

UnitedHealthOne – Golden Rule is a carrier that offers Life, Hospital Indemnity, Dental/Vision, Short Term, Accident, Critical Illness and Teladoc. If you are interested in contracting with UnitedHealthOne please email contracting@appliedga.com and advise us if you would like us to send you a UnitedHealthOne contracting link.

 If you would like to contract as a corporation you must first complete your individual contract. Once you are approved, please complete the UnitedHealthOne AOC form via DocuSign.  

If you are currently contracted with UnitedHealthOne – Golden Rule with another upline or are contracted directly and have not written business in 90 days complete the UnitedHealthOne Transfer Form  and email to uhocommissions@uhc.com. If you have written business in the past 90 days, then please include a letter of release from your current upline.

Changes can be made on UHOne Broker Portal | UnitedHealthOne

Complete the UnitedHealthOne EFT Form and email to uhocommissions@uhc.com

Thank you for your interest in contracting with UCare. AGA is partnered with our Integrity Partner, IFC, for us to offer UCare to our agents. To contract with UCare you must be a MN resident. Complete the UCare IFC Contracting Request Form. Transfers are allowed from 4/1 to 9/1 each year. There is a specific form we will send to agents via DocuSign to complete and sign. Once this request form is completed you will be sent a DocuSign from IFC to collect your information.

Thank you for your interest in contracting with UCare. AGA is partnered with our Integrity Partner, IFC, for us to offer UCare to our agents. To contract with UCare you must be a MN resident. Complete the UCare IFC Contracting Request Form. Transfers are allowed from 4/1 to 9/1 each year. There is a specific form we will send to agents via DocuSign to complete and sign. Once this request form is completed you will be sent a DocuSign from IFC to collect your information.

Changes can be made by contacting Contracting@ifcnationalmarketing.com

Changes can be made by contacting Contracting@ifcnationalmarketing.com

Only available in Minnesota

Thank you for your interest in contracting with UCLA. AGA is partnered with our Integrity Partner, Berwick, for us to offer this carrier to our agents.

Please follow the following steps to become ready to sell.

1.  Submit the UCLA Contracting Request via JotForm. Please have your CA license, individual E&O, AHIP, and void check ready for upload.
2. Berwick will send you a contract using Adobe Sign. The email will be from adobesign@adobesign.com.
3. After the contract is complete you will receive the UCLA certification link from UCLAcontracting@berwickinsurance.com
4. After certifications are complete, Berwick will perform a Federal and State Exclusion check.
5. After the exclusion check is passed, you will receive your RTS notification.

Submit the UCLA Contracting Request via JotForm. Please have your CA license, individual E&O, AHIP, and void check ready for upload.

Agents can transfer hierarchies ONCE per calendar year.

Immediate release is not necessary. Regardless of if the agent can obtain an immediate release, the carrier will only allow the agent to transfer once per calendar year.

Blackout – 9/1-12/31

Hierarchy transfers submitted after 9/1 will be rejected by the carrier. A new contracting request can be submitted after 12/1

Agents can submit a new hierarchy transfer 12/1 for a 1/1 effective transfer

Email changes to uclacontracting@berwickinsurance.com 

Email changes to uclacontracting@berwickinsurance.com 

As of 5/25/2023 New Agent Contracting has been suspended indefinitely.

This is a Med Supp carrier that requires agents to pay for their state appointment fee to be contracted. You must be contracted prior to marketing this carrier.

To contract with UCT please note the yearly $36 membership fee plus state fees.

To continue contracting, complete the UCT contract and send the completed contract to contracting@appliedga.com

Email contracting@appliedga.com and agentservices@uct.org, indicate you are currently contracted with UCT, and would like to transfer your appointment to AGA.

https://www.uctagentshub.org/wp-login.php

https://www.uctagentshub.org/wp-login.php

Email UTC Agent Services, agentservices@uct.org, to add a state.

Thank you for your interest in marketing Ultimate Health Plans through Applied General Agency. UHP uses an online contracting system, and you will be contracting and certifying in one sitting. Please have your AHIP, EFT, and W-9 ready to upload.

Ultimate Health Plans Contracting

You will need to request a login on the right side (Green) as a new agent.

Once you have logged in to the portal, it will automatically take you to the “Agent Certification” tab to access our available certification training. Click the button at the top that says, “Click Here To Start Agent Certification.”

Once you are in the certifications, there will be three steps for you to complete.

STEP 1: Agent Application

• Fill out the agent application.
• Select “Applied General Agency” as your FMO Affiliation.
• Upload and attach your AHIP certificate, W-9, and direct deposit/ACH.

STEP 2: Agent Certification Training

• Watch our 2023 Agent Certification training video fully.
• Attest to watching the video by signing and dating electronically.

STEP 3: Certification Exam

• Must pass with an 85% or higher.
• Limited to 5 attempts.
• 30 questions long – no trick questions.
• OPEN book exam: Please utilize our PDF links provided at the top of the screen once you click INTO step 3 before starting the exam for the “Training Slides” and “Benefits Overview”.

 External Agents must adhere to the Ultimate Health Plans Release Policy when terminating or changing their Field Marketing Organization (FMO). This policy applies to all third-party sales representatives certified to sell Ultimate Health Plans (UHP) products.

Immediate Release with FMO Approval – External agents must obtain a release letter from their existing FMO to acquire an immediate release. It is up to the FMO to decide whether to release an agent before the 90-day delayed period. The current FMO must formally communicate the release of the agent either in writing on company letterhead, signed by the principal, and with a current or future effective date, or using the Ultimate Health Plans Agent Release Form. Release letters must be sent to UHP’s Agent Support at AgentAdmin@ulthp.com, cc contracting@appliedga.com. If the immediate release is accepted, it will be processed within 5-7business days, and the agent will be notified by email when completed.

Immediate Release with UHP Approval – External agents who have not submitted new business to UHP under their existing FMO for at least 90 days may be eligible for release without the approval of their FMO. Requests must be submitted in writing to UHP’s Agent Support at AgentAdmin@ulthp.com cc contracting@appliedga.com. The final decision for immediate release without the FMO’s approval is at UHP’s discretion.

Delayed-Release Policy – If an immediate release is not granted, the agent may request a delayed-release in writing. The agent’s request for a delayed-release will take effect 90 days after UHP confirms receipt of the request. Requests must be sent to Agent Support at AgentAdmin@ulthp.com cc contracting@appliedga.com.

Blackout Period – Immediate Release requests submitted between September 1st and December 31st will not go into effect until January 1st. Delayed-release requests submitted between September 1st and September 31st will not go into effect until January 1st. Agents can only terminate or change their FMO once per calendar year.

Agent’s Status upon Release – Once an agent has been released, they are free to join another contracted FMO. The agent must notify UHP in writing of the FMO they wish to join. The new FMO’s name can be mentioned in the original request for release. The agent must maintain all license, training, certification, and appointment requirements with UHP.

Impact on Agent’s Book of Business – Any new business submitted, and renewals earned while the agent was contracted with the previous FMO will result in the appropriate overrides and, if applicable, commissions and renewals being paid to that FMO.

We value your participation and support with Ultimate Health Plans. If you have any questions, contact our Agent Support at 877-322-4029 or AgentAdmin@ulthp.com.

Updates can be made on https://enroll.myultimatehp.com/agportal#/agent-certification

If you would like to contract with United American prior to writing the following appointment fees apply.

Appointment Fee

To continue contracting, email contracting@appliedga.com to confirm you are prepared to pay appointment fees for United American.

AGA will then send you electronic contracting where you can contract and pay your state appointment fee at the same time. See invitation sample: UA Invite

If you are currently contracted with United Americans, please begin the transfer process by emailing contracting@appliedga.com and uainfo@amlifegroup.com stating “Please cancel my current writing number with (Insert Upline), but not with the state of (Insert State) as I am just transferring my appointment to AGA/Natalie Birchard. AGA please send me a new United American contracting link”

AGA will then send you a new United America contracting link. Once complete your transfer will be finalized.

When an agent/agency contracted with UnitedHealthcare wants to align under a new hierarchy or change channels, a Letter of Release or Notice of Intent is required unless the change results in an employment relationship with UnitedHealth Group or its affiliate or a telesales vendor contracted with UnitedHealthcare. You may only move to a contracting level equal to or lower than your current contract level and must stay at that level for a minimum of one year. Agents can only change uplines once a year and transfers will not be processed during United Healthcare’s blackout period, September 1 to December 31.

Do you have a release from your current FMO?
If you have a release, send a copy to contracting@appliedga.com and AGA will send you electronic contracting paperwork. Complete the online contracting forms and AGA will attach your release to your contracting forms. The release letter needs to be on the letterhead of your top of hierarchy, signed by their principal, specifies the producer’s name, and is dated within 90 days. If you do not know the top of hierarchy, please reach out to United Healthcare, 888-381-8581.

Unable obtain a release?
Begin an Intent to Move by sending a simple email. To qualify to send an Intent to Move you will need to have been with your current upline for more than six months.  Once the Intent to Move request is submitted, you will be sent an email notifying you of the date your 3 month waiting period will end. When the transfer period is over new United Healthcare contracting paperwork will need to be submitted within 30 days.

Applying for Intent to Move:
1.Submit a Intent to Move to shcerts@uhc.com & contracting@appliedga.com. You must include your full name, carrier ID, and identify your new up-line in the email, Applied General Agency, 260026.
Ex: Hello, My name is John S. Doe, ID 12312. This is my notice of intent to transfer to Applied General Agency, 260026. Thank you
2. UHC Agent Onboarding will confirm receipt of the Intent to Move and give you a date when your new up-line can submit a new contract for the transfer. This is also copied to your original up-line.
3. There is a three-month waiting period for a transfer from the date of your notice of intent to when a new contracting packet can be submitted. During that time, you will remain under your original hierarchy and can still sell United Healthcare plans.
4. After the three months is up, you have 30 days to submit a new contracting packet. If it is not submitted in that time frame, you will remain in your current hierarchy. At that point, a new notice of intent would be required and the three-month waiting period would start over.

GA levels and higher can now apply for an intent to transfer. Must be with their current NMA for 6 months prior to submission. All downline producers will move with the agency. Can only move at the same or lower level. Upon receipt of the Intent to Move ALM will temporarily “freeze” downline producers, No releases, No hierarchy movement, Promotions within the existing structure are allowed

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, AGA will submit your add state request.

View your current non resident appointments in www.jarvis.com. At the top right click your name/corporation name to open profile. Click Licensure & Appointments. To be ready to sell you need to see a Yes next in the licensed and appointed column.

IMPORTANT UHC FEE INFORMATION:
Non Resident Fee – Agents are expected to pay non resident appointment fees. Please see fee amounts and schedules for non resident appointment fees. You will not be charged for your resident state license. Fee schedule
Admin Fees – Once contracted agents are expected to write at least one piece of business. Failure to produce one piece of business when contracted from 11/31 to 4/1 will result in a $200 to $250 fee and will result in a termination.

To remove a state appointment email uhpcred@uhc.com. Include your name, United Healthcare ID and list the states you would like to remove.

This is a direct pay carrier meaning agent commission will be paid directly to you. Your commission will be paid to you, unless you decide you would like to assign it somewhere else like your own corporation or employer. Commissions can only be assigned to another person or entity represented by a principal, who is currently contracted, licensed, certified, appointed (if applicable) in the state with this carrier. Assignor and assignee must both remain contracted, licensed, certified, appointed (if applicable) in the state for any commission to be issued. Assignment to AGA is not required.

Send the completed UHC AOC form need to sh_commissions_administration@uhc.com or fax to 866-761-9162

Or complete the UHC AOC Form via DocuSign. Upon completion a copy will be sent to sh_commissions_administration@uhc.com

Assignor = the party (individual/entity) that is assigning its commission
Assignee = the party (individual/entity) that is receiving the commission

UHC Assignment of Commission (AOC) Fact Sheet

• • • All fields on the AOC form above the Company acknowledgment must be populated; any forms submitted with an empty field will be returned.
    • The AOC form must be faxed to 866-761-9162 or emailed to sh_commissions_administration@uhc.com. The AOC form is no longer part of the agent on-boarding materials/packet.
    • The assignee, an individual or entity represented by a principal, must be contracted, licensed, certified, and appointed (if applicable) in the state in which the consumer resides and the principal must have a writing number.
    • Commissions can only be allocated in full or at 100%; no partial assignments are allowed.
    • The AOC will be effective within 10 business days of receipt of AOC form, for future commissions. AOCs cannot be applied retroactively.
    • The Assignee will receive the 1099 for payments that are assigned to them.
    • If a new Assignor writing id is issued,
      ○ A new AOC form must be submitted for that writing id.
      ○ Any AOC under previous writing id(s) will not change unless Termination of AOC and/or new AOC forms are submitted.
    • For further detail, refer to the Agent Guide on www.uhcjarvis.com.

Thank you for your interest in contracting with United Healthcare ACA. AGA is partnered with our Integrity Partner, Plan Advisors and New Health Plans, 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.

UHC ACA Onboarding Job Aid

UHC ACA Accessing Alternative Writing IDs in Jarvis

There is a blackout period between October 1st and January 31st. No releases will be done during this period. Secure a Release letter from your current upline/FMO – you will need to upload the release letter when you complete the online contract. Release letter must be on FMO letterhead, be signed by principle or officer, state your name, be dated within the last 90 days.

I’m an agent who signed an agreement for one agency, and then also signed an agreement with a different agency that I also received a evite for. Which agency am I aligned with?

• You will be aligned with the first agency for which you signed the contract
• If you wish to be aligned with a different agency, follow the steps below:
• You can get a release from the top agency in your hierarchy or;
• Submit an Intent to Move and wait 6 months.
• Please note the blackout period for hierarchy changes between October 1 and January 31

I’m an agent who signed an agreement direct with UHC. How do I transfer to Plan Advisors and New Health Plans?

• If you are aligned as Direct to UHC you can complete a new contracting through Plan Advisors and New Health Plans and UHC will request the release from UHC on your behalf (this will go to the regional sales leader to approve or deny).
• Please note the blackout period for hierarchy changes between October 1 and January 31
• Email is sent to shcerts@uhc.com (Needs to specifically specify this is for ACA) cc current upline, contracting@appliedga.com, and info@myplanadvisors.com. Example: Please begin my delayed release to move my ACA appointment to Plan Advisors and New Health Plans. I will be working with Agent Pipeline through Applied General Agency for ACA products. Thank you John Smith, ACA ID 12345.

Updates will be made through the Jarvis portal

Updates will be made through the Jarvis portal

Updates can be made by emailing your license to info@myplanadvisors.com

*Please click on the link below to complete our agent contract to be set up to sell our products under Applied General Agency with 6 month advancing:

Direct Pay Contracting link https://agentonboarding.unlinsurance.com/Agent/OnBoardingConsent?RecruitingAgent=52Wfuo0eGEAmEMhHAx8H6g==&ContractCode=General%20Agent%20Contract%20with%20Advances

Once you begin filling out the contract, it will time out if left idle for more than 20 minutes and you will have to start over.

Please have ready to upload during the e-contract completion:

• • • A copy of your personal voided check to pay your commissions into (or a statement/email from your bank showing your name, account and routing number)
    • A copy of your personal insurance license(s) for the state(s) you will be selling our products in
    • (Note: IF you have your own agency that you are wanting to have your UNL commissions paid to instead, we require a copy of your agency voided check (and your agency insurance license)
    • Then be sure to also complete the Corporation Information (regarding your own agency and it’s FEIN) on the e-contract).
    • If you intend to sell our Life product as well, we require a copy of your AML certification*
    • The explanation(s) to the Financial/Background questions that are only answered “YES” to that can’t fit in the provided “details” box in the e-App

*Need to get AML certified? Please contact us at: agentcontracting@unlinsurance.com

Should you have questions or any issues uploading these items requested above, please email them directly to us at: agentcontracting@unlinsurance.com

For LOA Contracts use UNL Indirect pay contracting link (Not common) UNL LOA e-contract Link and Instructions for any agents you are setting up LOA under AGA- Applied General Agency, Inc Please have ready to upload during the e-contract completion:

• A copy of your insurance license for the state(s) you will be selling our products in
• The explanation(s) to the Financial/Background questions that are only answered “YES” to that can’t fit in the provided “details” box in the e-App.
• If selling our Life product, we require a copy of your AML certificate*

Thank you for your interest in contracting with U of UT ACA. To get started please complete the request link via DocuSign. AGA is partnered with our Integrity Partner, My Plan Advisors, for us to offer U of UT ACA to our agents.

 Be prepared to upload a copy of your license, E&O, Marketplace Registration Certificate, and void check.

 U of UT ACA Contracting Request

To begin your transfer of U of UT ACA  you need to send an email to broker.support@hsc.utah.edu, cc info@myplanadvisors.com and contracting@appliedga.com. In the email, state your full name and NPN, and indicate that you wish to change your affiliation to Plan Advisors.

 After you send the email request to U of UT, please complete the following DocuSign ACA EFT form

Agent may update in the Uof UT broker portal

Complete the ACA EFT form

Currently in UT

Thank you for your interest in contracting with UPMC. 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.

UPMC 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.

UPMC 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

Begin the Verda Healthcare certification process, please follow the link below:

Verda Healthcare Broker Certification Portal

Here are the steps to guide you through the process:

• New Users click on:  “Get Certified”
• Fill in Account, Address and Agency Information accordingly
• Enter Applied General Agency as your agency
• AGA NPN is 8061078
• Click on: “Register & Continue”
• Review the AOC Agreement
• Upload required Documents (License, AHIP and E&O)
• Complete Training
• Take Exam!

If you need to return after your initial registration to complete your certification training and testing, please use the log in information you provided during the registration process.

Upon successful completion, you will receive an email confirmation along with your Certificate of Completion.

A letter of release is needed to complete a transfer. Please send your letter of release to contracting@appliedga.com and advise you need to transfer your Verda Healthcare contract to AGA.

Updates can be made on https://broker.verdahealthcare.com/login

Please submit the completed Verda Payment -EFT Form with a voided check or a letter from your bank providing confirmation of your account, and a copy of your W9 information and email it to Brokers@verdahealthcare.com. 

Note commissions will be paid to the agent. If your commissions need to paid to a corporation you may opt out of EFT and AGA will pay your agent commissions.

Currently Verda is only approved in Texas for counties for Fort Bend, Harris, and Montgomery.

Thank you for your interest in contracting with VNS Health. To get started please complete the request link via DocuSign. AGA is partnered with our Integrity Partner, Ritter, for us to offer VNS 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.

 VNS Health 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 VNS 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.

 VNS Health 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

Currently available in NY

See Commonwealth Care Alliance

See Commonwealth Care Alliance

You will then be sent instructions to complete the training.

WPS Broker Support Line 888-516-5999

To start the release process, email contracting@appliedga.com and angie.karr-nystrom@welbehealth.com. Include your Name, NPN, DOB, email, phone, and upline as AGA.

Example: Hi Angie and AGA, Please contract me with Welbe AGA. My name is Gerald Joe, NPN 123554, GIjoe@gmail.com, DOB 06/30/1942, 888-495-1945. Thank you.

You will then be sent a contracting link to complete your transfer.

To get started please request the carrier by completing our Request Form then the carrier will email you the contracting link.

To start the release process complete Request Form then the carrier will send a new contracting link and you can upload your release letter

Agent Sends Request for Agent Listing by completing WPS Request Form

The Agent will receive an email invitation to complete their onboarding process. Email will come from: WPS Health Insurance (donotreply@vertafore.com). Subject line: Invitation to Onboard with WPS Health Insurance

Agent will be prompted to create an account on Sircon. If agent already has an account, the system will identify them by their NPN when signing in.

After the account is created, agent will complete listing paperwork in their Sircon account by clicking on: “Complete carrier onboarding interview for WPS Health Insurance”. This is located under the “To Do” tab in their account.

Once paperwork is completed and submitted online WPS will review, and the agent along with the agency, will be notified when the listing with WPS is official.

If there are any issues or if agent has any questions on this process please contact: WPS Agent Line 1-800-748-0582

Transfers for WPS are done on a case by case basis. To begin the transfer send the WPS Contract via DocuSign. If additional information is needed WPS will advise after your contract has been received.

Email changes to AgentLicense@wpsic.com

Agent commission is paid by AGA

Agent commission is paid by AGA

Thank you for your interest in contracting to represent Zing & Lasso plans through the AGA. You will be completing contracting through Zing’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 contracting link from the email will include the contracting link, username, and password. Click on the link to begin contracting.

Link https://zing.evolvenxt.com/ Username is your email address.

See Zing Onboarding Instructions

Zing Transfer Process:

For an immediate transfer, submit your letter of release to brokers@myzinghealth.com and contracting@appliedga.com and your transfer will be processed in 3-5 business days.

 If you are unable to obtain a release, start a 90-day delayed release by emailing brokers@myzinghealth.com and contracting@appliedga.com. In the email include your name, NPN and statement agent intends to transfer your appointment to AGA.