Present your clients with Connecticut’s own health plan, where we pride ourselves on locally-based, internationally-recognized service.
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Get Appointed to Sell ConnectiCare
- Direct Deposit Form: Have your commission payments sent directly to a bank.
- 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.
- Signed ConnectiCare Benefits, Inc. Producer Agreement: one signed by the agent and one signed by an officer or principal of the agency, if also appointing the agency.
