• Additional State Appointment Request

  • I am requesting to be appointed as an:*
    • Agency Information 
    • Contact/Contract Info 
    • Format: (000) 000-0000.
    • Carrier(s):
    • States Requested:*
    • * Just-In-Time non-resident state appointments: carrier submits the producer’s appointment to the state insurance department after the producer has solicited and submitted their first new business case for that carrier. Agent can submit this business through the carrier's portal or via a paper enrollment, since MedicareCENTER Ready to Sell status won't be updated after the agent has submitted their first case in the new state. The only exception to this is Anthem appointments, Anthem does not offer Just-In-Time appointments.

      ** If requesting North Carolina, please be sure to add the Med Supp/Long Term Care Line of Authority, as this is required to enroll any clients into any Medicare plans in the state. This must be added along with Accident & Health or
      Sickness 

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