Know someone starting their career in the Insurance Industry? Or maybe they're just looking for an upline who offers more support.

Submit their basic information below and we'll reach out!

Our mission is to assist all agents in their marketing efforts and growing their book of business, we would love to partner with them.

Plus, you know they'll be in excellent hands!

PLEASE ONLY USE THIS FORM IF YOU ARE CURRENTLY AN AGENT PARTNERED WITH US

Prospect First Name *

Prospect Last Name *

Prospect Email *

Prospect Phone *

Referred By *Complete in Sentence Case *

What states do they hold a license in? *

Are they currently licensed? *

YES

How will they be contracting? *

As an Agent

As an Agency with 5 or more downline

As an Agency with less than 5 downline

Immediate Upline *

Do they currently hold contracts with any of the carriers that they are looking to contract with? *

YES
NO
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*Be sure that the prospect is aware that they will need a release from their current upline for contracts they currently hold.

Select their requested contracts then click submit.

Ancillary Products *

Aetna

APEX Dental

Heart National Life

Medico (Wellabe)

American Home Life

NCD

Medicare

Aetna / Coventry

Elevance Health (Anthem)

Cigna

UHC

Humana

Clover Health

Devoted Health

Wellpoint (Elevance Health)

BCBS of OK IL NM TX

WellCare/ Allwell / Centene / Health Net / Ascension / Fidelis

Kaiser

Molina Healthcare

SCAN

Life & Final Expense

Aetna

AIG

American Amicable

American General

Assurity

Baltimore Life Insurance Company

CICA Life of America

Gerber

GWIC (Great Western)

Foresters

Mutual of Omaha

Transamerica

North American Company

Anthem

American Home Life

Heartland National Life

SILAC

National Life

Affordable Care Act (ACA)

Aetna

Ambetter

Anthem (Elevance)

CareSource

Cigna

Oscar

UnitedHealthcare

Wellpoint (Elevance)

Molina Healthcare