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| Become a Connecticare Producer |
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| Appointment Process |
You're about to join a team of professionals proud to represent one of America's highest-rated health plans.
If you're not currently selling ConnectiCare products and services, you're in the right place. Because all producers must be licensed and appointed prior to representing ConnectiCare, we've assembled the following policies and procedures to help guide you through the process.
Effective January 1, 2011, ConnectiCare will no longer pay the agent's or agency's appointment or renewal fees in CT or MA. See Important Change to Appointment and Renewal Fees for more information.
Producers who are marketing ConnectiCare products in the states listed below must submit the following:
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If you are marketing
ConnectiCare Products in: |
You must submit these items:
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Connecticut
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Check made payable to ConnectiCare, Inc. for $305.00 per each agent and agency for initial appointment fees. See more details.
 Direct Deposit Form
Producer Information Sheet
Completed W-9 Form
Copy of Declarations page of Errors & Omissions policy
Complete the Business Associate Confidentiality Agreement
Two signed ConnectiCare Agent/Agency Agreement or e-Broker Agreement; one signed by the agent and one signed by an officer or principal of the agency, if applicable.
A copy of current Connecticut Producer License for the agent as well as the agency, if applicable.
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| Massachusetts |
Check made payable to ConnectiCare, Inc. for $75.00 per each agent and agency for initial appointment fees. See more details.
Direct Deposit Form
Producer Information Sheet
Completed W-9 Form
Copy of Declarations page of Errors & Omissions policy
Complete the Business Associate Confidentiality Agreement
Two signed ConnectiCare of Massachusetts Agent/Agency Agreement or e-Broker Agreement; one signed by the agent and one signed by an officer or principal of the agency, if applicable.
A copy of current Massachusetts Producer License for the agent as well as the agency, if applicable.
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| Both, Connecticut and Massachusetts |
Check made payable to ConnectiCare, Inc. for $380.00 per each agent and agency for initial appointment fees. See more details.
Direct Deposit Form
Producer Information Sheet
Completed W-9 Form
Copy of Declarations page of Errors & Omissions policy
Complete the Business Associate Confidentiality Agreement
Two signed ConnectiCare Agent/Agency Agreement or e-Broker Agreement; one signed by the agent and one signed by an officer or principal of the agency, if applicable.
Two signed ConnectiCare of Massachusetts Agent/Agency Agreement or e-Broker Agreement; one signed by the agent and one signed by an officer or principal of the agency, if applicable.
A copy of current Connecticut Producer License for the agent as well as the agency, if applicable.
A copy of current Massachusetts Producer License for the agent as well as the agency, if applicable.
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**Please note: all forms are in PDF format and require the freely available Adobe Acrobat reader. If you don't have Adobe Acrobat reader and would like to download it now, please click here.
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