Contracting & Appointments (All Lines of Business)
Request all line of business carrier contracts and appointments
Name
*
First Name
Last Name
Email
*
example@example.com
Requesting Contract As:
*
Agency
Agent
Golden Outlook A-Code
*
National Producer Number (NPN)
*
https://nipr.com/help/look-up-your-npn
Medicare
Select which Medicare carriers you like to contract with:
Aetna Medicare Advantage
Aetna Supplemental
Alignment
Allstate Health Solutions - National General
American Benefit Life
American Home Life
America's 1st Choice (Optimum and Freedom)
Anthem (Elevance Health)
BayCare
BCBS IL (HCSC)
BCBS LA
BCBS MN
BCBS MT (HCSC)
BCBS NM (HCSC)
BCBS OK (HCSC)
BCBS TN
BCBS TX (HCSC)
Blue Shield CA
Centene/Wellcare
Cigna Medicare Advantage
Cigna Supplemental
Clear Spring Health/Eon Health
Clover Health
Connecticare/Emblem Health
Devoted Health
Elevate
Florida Blue (BCBS FL)
Humana/CarePlus
Heartland National
Independent Care Health Plan (iCare)
Kaiser Permanente
LA CARE
LifeShield
Medica
Medical Mutual
Mutual of Omaha
Molina
Nassau
Network Health
Peoples Health
Physicians Mutual
Presbyterian
Priority Health
Providence
SCAN
Select Health
Ultimate Health Plans
United American
UnitedHealthcare
Medico/Wellabe
Wellpoint (Amerigroup, Elevance Health)
Zing
Individual Family Plan (ACA)
Select which IFP/ACA carriers you would like to contract with:
Ambetter Health
AmeriHealth
Anthem/Wellpoint
Aetna
Aspirus Arise
BCBS AR
BCBS AZ
BCBS IL
BCBS LA
BCBS MN
BCBS MI
BCBS MT
BCBS NE
BCBS NC
BCBS NM
BCBS OK
BCBS SC
BCBS TN
BCBS TX
Blue Cross of Idaho
Blue Shield of CA
Bridgespan
Capital BlueCross
CareFirst
CareSource
Cigna
Common Ground Health CoOp
CommunityCare
ConnectiCare
Cox Healthplans
Geisinger
Health Alliance Individual Health
Health First
Health Plan of Nevada/Sierra Nevada
Highmark BCBS DE
Highmark BCBS PA
Highmark BCBS WV
Horizon BCBS
Independence Blue Cross
Kaiser Permanente of CA
Kaiser Permanente of CO
Kaiser Permanente of GA
Kaiser Permanente of Mid Atlantic
Kaiser Permanente of NW
Kaiser Permanente of WA
LifeWise
Maine Community Health Options
Medica
Medical Mutual
Molina Healthcare
Montana Health Co-Op
Allstate Health Solutions - National General
Network Health
Oscar
Pacific Source
Priority Health
Premera Blue Cross
Providence Health Plans
Quartz Benefits
Regence BS
Regence UT
Rocky Mountain HMO
Security Health Plan
Select Health
Sharp Health Plan
UPMC
Valley Health Plan
Vantage Health Plans
UnitedHealthcare - Rocky Mountain Health
University of Utah
Ancillary
Select which Ancillary carriers you would like to contract with:
Aetna
Allstate
Anthem BC/BCBS
Anthem (Elevance Health)
Ameritas
Assurity
Bankers Fidelity
Blue Shield CA
BCBS IL (HCSC)
BCBS MN
BCBS MT (HCSC)
BCBS NM (HCSC)
BCBS OK (HCSC)
BCBS TC (HCSC)
Cigna Supplemental
Equitable Life and Casualty
Guarantee Trust Life
Heartland National Life Insurance Company
Humana/CarePlus
Liberty Bankers Life
LifeShield National
Loyal American
National Care
NCD
Physicians Mutual
Renaissance Life
SureBridge
United American
UnitedHealthOne/Golden Rule
Wellabe
Life
Select which Life carriers you would like to contract with:
Aetna
American National
American-Amicable Occidental Life
Americo
Ameritas
AsOne Insurance Group
Assuring Life
Baltimore Life
Bankers Fidelity
Capitol Life
Cigna Supplemental
Corebridge (AIG)
Equitable Life and Casualty
Fidelity and Guaranty Life
Foresters Financial
Gerber Life
Great Western
Guarantee Trust Life
Guardian Life AsOne
Kansas City Life
Liberty Bankers Life
LifeShield
Lincoln Financial Group
Loyal American
Lumico Life
Mutual of Omaha Life
Mutual Trust Life
Allstate Health Solutions - National General
National Guardian Life
National Life Group
National Western Life
Nationwide
North American Company
Oxford Life
Physicians Mutual
Prosperity Life
Royal Neighbors of America
Sagicor
SECURIAN/Minnesota Life
Sentinel Security Life
Transamerica Life
The Chesapeake Life Insurance Company/Formerly SureBridge
United American
UnitedHealthOne/Golden Rule
United Home Life
United Life Insurance
United of Omaha
Washington National
Wellabe/Formerly Great Western
Annuities
Select which Annuity carriers you would like to contract with:
Allianz
American Equity
American Life
Americo
Aspida - Market Synergy
Assurity
Athene Annuity
Atlantic Coast Life
Baltimore Life
Bankers Life
Clear Spring Life and Annuity Company
Corebridge (AIG)
Delaware Life
Equitable Life and Casualty
EquiTrust Life
Farmers Life Insurance Company
Fidelity and Guaranty Life
First Symetra
GBU Life
Global Atlantic
Guaranty Income Life Insurance Company
Integrity Life
Legacy Marketing Group
Liberty Bankers Life
Lincoln Financial Group
Nassau Re
National Life Group
National Security Insurance Company
National Western Life
Nationwide
North American Company
Oceanview Life and Annuity
Ohio State Life
Oxford Life
Prudential
Reliance Standard Life
Royal Neighbors of America
Sagicor
Sentinel Security Life
SILAC
Stellar National Life
Symetra Financial
The Standard
United American
United Life Insurance
United of Omaha
Upstream Life
Additional Information
List States per Carriers for Appointments Requested
Include writing number and check if carrier is available in state requested
Upload Release from Former Upline/FMO
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Upload Non-Resident License(s)
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Additional Notes for Contract Requests
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