PLEASE NOTE- the attached forms provide information on where to send enrollment, etc.  As your General Agent, we will continue to quote, enroll, and service your UnitedHealthcare groups. 

For your convenience, please send all completed enrollment forms to our office for processing.

New Enrollment Forms Beginning with

11/1/21 Effective Dates 

Broker Bonus for New Groups 5-50 

Effective Dates 12/1/21-3/31/22

Administrative Credit for New Groups 5-50

Effective Dates 12/1/21-3/1/22

Producer Guide

Employer Guide