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Personal Information

Employment

Are you contracted with any other insurance agency?

Are legally eligible to work in the United States?

Are you willing to work weekends?

Please provide any additional information that you believe would be needed to know by your employer? (Allergies, background, etc.)

Professional Information

America's Health Insurance Plans (AHIP) Certification

Have you completed the annual AHIP certification required to sell Medicare insurance plans?

Do you have a 2-15 (Health & Life) or 2-40 (Health) license?

Additional Questions

Do you speak Spanish?

Do you have Errors and Omissions Insurance?

Are you willing to acquire more states under your license if needed?

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