Date of Appointment with a representative of Transitions Benefit Group on or before: December 07, 2023. After submitting this form you can schedule an appointment on a date and time of your choosing.
By submitting this form, you agree to meet in person or remotely with a Licensed Sales Representative to discuss the products clicked above. The Licensed Sales Representative is either employed or contracted by a Medicare plan and may be paid based on your enrollment in a plan. They do not work directly for the federal government. Signing this form does not affect your current or future enrollment. in a Medicare plan, enroll you in a Medicare plan or obligate you to enroll in a Medicare plan. All information provided on this form is confidential.