Contracting Information A - L

To add a state new contracting forms will need to be submitted. Follow initial contracting instructions for Anthem as described above.

Fee Schedule

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’.

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.

Coming soon.

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:

https://surelc.surancebay.com/sbweb/login.jsp?branchEditable=off&branchRequired=off&branch=Applied%20General%20Agency%20Inc.&branchVisible=on&gaId=238&gaName=Premier%20Companies

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:

https://surelc.surancebay.com/sbweb/login.jsp?branchEditable=off&branchRequired=off&branch=Applied%20General%20Agency%20Inc.&branchVisible=on&gaId=238&gaName=Premier%20Companies

SuranceBay User Guide.

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/

Blackout period for FMO upline changes are yearly from 8/1 through 1/1; no FMO change requests can be made during the blackout period.

To begin the FMO change email your current upline, BUHPSales@bannerhealth.com and contracting@appliedga.com requesting to transfer to AGA. Example: Hello, my name is John Smith. NPN 123. I would like to change my upline from XYZ agency to Applied General Agency. Please let me know if you need anything else. Thank you,

After you have sent the email to Banner requesting to be under AGA. You can begin a delayed or immediate release.

For an immediate release provide a letter of release from your current upline to BUHPSales@bannerhealth.com and contracting@appliedga.com.

For a 30 day delayed release, email your current upline, contracting@appliedga.com and BUHPSales@bannerhealth.com. State your name, NPN and confirmation you would like to transfer to AGA. BUHP will respond with approval, denial or questions within 30 business days. Once 30 days have expired, it is auto approved, and new business will fall under the new FMO as of the effective date of the change. If entity does not certify after 12/31, new FMO can create new case for entity and new business will fall under the new FMO.

Updates are made on https://mybannerhealthinsurance.my.site.com/BrokerPortal/s/login/

Or send a request through via email to BUHP inbox: BUHPSales@bannerhealth.com

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.

BCBS AR Request

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/

Assignment of commissions are available

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

1. 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.
2. AGA will submit the following to MedSalesCon@azblue.com for processing.
   1. Email stating “This is an FMO transfer request”
   2. New Producer Upload Spreadsheet (completed by AGA)
   3. Copy of your release request
3. 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.
4. Only complete contract(s) will be submitted to our Contracting Team for processing.
   1. Please allow 7-10 business days for processing.
5. 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.

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

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

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

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.

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: Complete your Blue Shield certifications and align yourself to AGA. To align to AGA log in and select Profile Update, update your Primary Agency to Applied General Agency, TIN 330961867, and SAVE.

To change your upline align yourself to AGA on Blue Shield certifications. To align to AGA log in and select Profile Update, 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 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 above contracting instructions.

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.

Thank you for your interest in marketing Bright Health, Central and Brand New Day through Applied General Agency. Please begin your contracting today by following the Brand New Day Central Onboarding Instructions.

Step 1

Complete new agent contracting on https://www.centralhealthplan.com/broker/

Enter your personal information

Contract Type is Downline Broker – Select Applied General Agency

Submit

Step 2

Brand New Day/Central will send you an email requesting you to register your Portal Account. It can take up to 72hr to process your request. If you get a denial email, please fix and resubmit the necessary information

• Navigate to https://www.centralhealthplan.com/broker/
• Click on “Register Account”
• Agree to the Legal Agreement
• Enter your Email Address and NPN# and click “Continue”.
• You will be re-directed to our Broker Portal

Step 3

Complete annual certification: You will need to complete the annual certification process through Litmos. Once you are registered for the certification you will receive an email to the email associated with your account, you may also access Litmos from the home page by clicking on “Begin Certification”. You will need to log into Litmos to access the certification.

Complete your document upload: Upload the needed files via the Broker Access drop down, Certification Status -> Certification. Next to your name there will be a “View Detail” link under the “Action” column. Click here to reveal the list of documents you will need to complete and upload to continue the contracting process. These documents include:

• Valid DOI
• Valid E & O
• Annual AHIP Certificate
• EFT
• W9
• Voided Check (must match W9)
• Agent Agreement

If you are interested in transferring your Bright Health / Brand New Day / Central appointment  please complete the below DocuSign transfer form.

Bright Health Transfer Form

Brand New Day Transfer / Release Policy

• Agents may request to change their affiliation only once per calendar year.
• No transfers are permitted from October 1 – December 31st.
• Agents can begin an immediate or 60-day release
• This form 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, the agent is effective with new agency Feb 1st).
• 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

Make changes via DocuSign BND EFT Change

Email changes to Marketing@universalcare.com please include your full name and NPN

Medicare Advantage is currently only in CA

Make changes via DocuSign on BND AOC Form

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

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 14^th.

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 14^th. 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.

CalOptima Health is only in CA

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

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, agentsupport@cnchealthplan.com, and contracting@premiersmi.com

Care N Care is only in TX

Updates can be made on https://www.cnchealthplan.com/

Updates can be made on https://www.cnchealthplan.com/

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.

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.

See Centene Transfer Guide

• 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.

See Centene User Guide

• 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

See Centene User Guide

• 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.

See Centene User Guide

• 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.

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.

 See CIGNA eContracting Guide

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.

A letter of release is required to immediately transfer an agent from one hierarchy to another. The letter of release needs to be signed by your top of hierarchy and dated within 60 days. If the topline agency is unwilling to grant a release the agent can submit a Release and Request for Self-Release from Topline Form to begin a delayed 90-day release.

To begin the 90-day release, complete the section for Request for Self Release from Topline of the Release and Request for Self-Release from Topline Form and the form will be sent to contracting@appliedga.com and Carl@cigna.com. This will serve as the agent’s notice of intent to change to a new sales hierarchy and will start a 90 calendar-day waiting period to be eligible to switch hierarchies without a release. Once the 90-day waiting period is over a new contract will need to be completed with the new hierarchy within 60 days, or a new request, qualification check, and waiting period are required. The 90-day timeframe officially begins the day CARL email box receives the form. Agents may continue to sell during the 90-day time frame. Agents are permitted to change their topline agency once per calendar year.

Transfers will not be processed from 9/1 to 12/31

**IMPORTANT DATES**

July 15^th – Last day to submit any 90-day release requests until 10/03

September 15th – December 31st  – Annual blackout period for topline changes

October 15th – Last day of grace period for topline changes to be accepted/processed assuming valid release (signed no later than 9/15) or 90-day release request is on file. Please note that packet must be completed by the agent/agency and in Contracting’s queue no later than EOD 10/15; packets submitted 10/16/2023 or later will be immediately closed.

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.

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.

CIGNA Med Supp Contract Direct Pay – Carrier will pay your commissions

(Not Common) CIGNA Med Supp Contract In direct Pay – AGA will pay your commissions

Important: Enter your full name as it appears on your license after clicking the contracting link.

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

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.

CIGNA ACA Producer Onboarding

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

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.

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

Changes can be made on https://ccmapd.evolvenxt.com/login.htm

See Clever Care Agent Guide

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: 2294CloverDirect24

(Not Common AGA pays you for your enrollments) Clover LOA Registration Code: 13CloverLOA24

Clover Onboarding Guide

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.

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.

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

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 :

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.

Thank you for your Elderplan request. Please find the registration link and PIN codes for Elderplan Certifications

Link: https://miramar-agent.com/

For New brokers, use Registration Pin:  EPAGA24New

• 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: EPAGA24Existing

• 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.)
• 2024 certifications should be completed prior to AEP in order to be Ready To Sell for the following year.  If your certification is not completed by 3/31/2024, your Elderplan appointment will be terminated, and you will be ineligible to receive commissions or residuals.
• If you recently completed our 2023 training, you still have to complete the 2024 certification.
• 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. 

Email THall@mjhs.org, ealmanza@mjhs.org, and contracting@appliedga.com, and notify us of your EFT change.

Demographic changes can be made to your Miramar profile.

https://miramar-agent.com/

Log into https://miramar-agent.com (Registration assistance https://miramar-agent.com/KnowledgeBase)

Click on “Register New” and enter 2024 registration code 2802EmblemHealth1113

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. Existing agents can add CT by entering code: Emblem2023Connecticut

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,

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.

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

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.

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

Changes can be made on https://miramar-agent.com/

Changes can be made on https://miramar-agent.com/

Available in AZ only

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.

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.

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

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.

FL Blue Onboarding Guide

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

FL Blue How to set up Direct Deposit 2022

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

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.

Friday Health ACA Onboarding Job Aid

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.

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

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.

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.

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.

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

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.

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.
• 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.

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.

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.

https://hf.org/health-first-health-plans/brokers

https://hf.org/health-first-health-plans/brokers

FL only

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.

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

Horizon / Braven Contracting Request

Email license@ritterim.com with the requested changes.

Complete EFT Change Form Via Docusign

Email license@ritterim.com with the requested additions.

LOA contracting is available

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.

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.

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 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

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

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.

Kaiser Contracting CO, OR, WA

Kaiser Contracting GA, VA, MD, WV, and DC

See KelseyCare Release and Hierarchy Change Rules

1. Agent/Agency movement between and among FMO’s is allowed as follows:
   1. 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.
      1. 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:
         1. The date and signature of the principal or his/her designee
         2. Agents’/principal’s name as it appears on the KCA agreement
2. The Agent/Agency must submit the release letter/email along with the KCA FMO Hierarchy Change Form.
   1. The hierarchy change will be effective on the date on which the change is
   2. Hierarchy changes are submitted to kcabrokersupport@kelseycareadvantage.com by the Top of Hierarchy FMO only. Requests received from Agent/Agency will be returned
   3. 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.
   4. 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.
   5. 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.
3. 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.
4. An Agent/Agency may not change hierarchies more than once in any 12-month
5. 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
6. 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.