Thank you for your interest! Complete the form below and a representative from GarityAdvantage will reach out.
Contact us with any questions: (800) 234-9488
Thank you for your request for Optima Medicare contracting. Upon sumitting this form, you will be directed to start your contract appointment process.
Appointment Instructions - please read carefully
Important Notice: Broker Appointment Policy: Please ensure all required documentation is complete, legible and signed. If any required information is missing, incomplete or illegible, your request will be rejected and you will be required to resubmit the application in its entirety.
Broker Appointment Changes: Email broker appointment changes to Appointment@sentara.com. The Broker Appointment Form link below should be used for new appointments only.
Appointment Requirements Items below are required to complete the appointment application:
Before you begin this process, there are two important items to note about the appointment form:
1) First, near the top of the form, Optima asks the following question: “Are you currently working with an Optima Health General Agency”
^^ For this question, please select "NO".
Then please complete the next four answers with ‘GarityAdvantage’, BLANK, ‘Victoria Bailey’, ‘email@example.com’ as shown below:
2. The Second question that needs an explanation is found in the ‘Attach Required Documents’ section.
Here you will find a request to attach your W-9 form.
This is not necessary to complete for agents requesting Medicare contracting BUT you still need to upload something to allow you to proceed in the process. Optima recommends downloading the SF-W9 form and simply re-upload the unfilled/blank file to their system.
Get Appointment Click the button below to requst the Optima Medicare Appointment link. By starting your application, you acknowledge that you have read and agree to the above requirements.
After you hit submit, check your email for the link and a copy of the instructions above.