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Present your clients with Connecticut’s own health plan, where we pride ourselves on locally-based, internationally-recognized service.

Become a broker

Brokers who are marketing ConnectiCare products in the states listed below must submit the following:

  • Completed W-9 Form
  • Copy of Declarations page of Errors & Omissions policy
  • Complete the Business Associate Confidentiality Agreement: one signed by the agent and one signed by an officer or principal of the agency, if also appointing the agency.
  • Signed ConnectiCare Agent/Agency Agreement: one signed by the agent and one signed by an officer or principal of the agency, if also appointing the agency.

You must complete the requirements for becoming appointed with ConnectiCare as outlined in the Connecticut section above.

In addition, you must be trained and certified by Access Health CT prior to signing and submitting this ConnectiCare Benefits, Inc. Producer Agreement.

Completed agreement should be faxed to 1-860-678-5224 or emailed to: ccibrokercommission@connecticare.com.

Learn about training and certification.

  • Completed W-9 Form
  • Copy of Declarations page of Errors & Omissions policy
  • Signed ConnectiCare of Massachusetts Agent/Agency Agreement; one signed by the agent and one signed by an officer or principal of the agency, if also appointing the agency.

**Please note: all forms are in PDF format and require the freely available Adobe Acrobat reader. Download Adobe Acrobat reader if you don't have it already. 

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Ready to sell Medicare?

To find out more information about becoming a certified ConnectiCare Medicare broker, please call Medicare broker support at 1-877-224-7994.