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  • Agent Inquiry Request

    • Commissions Inquiry 
    • Single Policy Inquiry - Allow up to 48 hrs for response 
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    • Please confirm with the carrier the policy is active prior to submitting form.

    • Multiple Policy Inquiry - Allow up to 48 hrs for response 

    • To inquire on multiple policies, download the template and upload completed sheet.

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    • Contracting Inquiry 
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    • General Inquiry 
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    • New Agent Referral Request 

    • Please fill out the below if you would like to refer a new agent to the WeCanHelpYou Agent Network. Once the new agent is contracted, we will pay you $250!

    • Co-op Marketing Reimbursement Request 
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    • If you have not been paid a co-op or commissions from Hilb Group Medicare before, please complete and electronically sign the document at this link:

      Broker Payment Forms

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    • Medicare Marketing Prospect List Request 

    • Fill out the fields below to request a .CSV file with your requested data.

      List will include prospect name, address, phone number and T65 month.

      Please only request lists that you plan on using within the next 30 days.  Thank you!

    • AgencyBloc CRM Setup Request 
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        $75.00 for each month
          
      • Jotform Form Creation Request 
      • Refer a client to Hilb Group Medicare, LLC 

      • This form is only to ensure we track your referral correctly and you receive your referral fee once the commission is received by the agency.

        Please have your client call our team at 855-479-4005 and follow the prompts for new clients or email clientservice@hilbmedicare.com.

      • MedicareCENTER Issue 

      •  Our marketing partner, GarityAdvantage, is your resource to inquire on issues with MedicareCENTER enrollment software. Please submit the MedicareCENTER Support Request on the GarityAdvantage Agent Dashboard if you need assistance.

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