ALH NETWORK | Carriers Contracting
Contracting Survey
Full Name
*
Phone
*
Email
*
SSN
*
Contracting TIN
Date of birth
*
Address
Street Address
*
City
State
Country
Country
Postal Code
Contracting Survey
Agent Nick Name
Agent NPN
*
Agency Name (leave empty if none)
Agency NPN
Agency DBA
Contracting Request Type (Choose One)
*
New Agent
Add States
Add Carrier Request
Product Type
*
ACA
MAPD
Medicare Supplement
Ancillary
Ancillary-DVH
Ancillary-Hi
Annuity
Major Med
Whole Life
PDP
Term Life Carrier
ACA Carriers
Centene/Wellcare
Molina Healthcare
UHC
AmeriHealth Caritas
Caresource
Christus Health
Health First
Medica
Wellpoint
Oscar
Contracting MAPD Carriers
AETNA
Centene/Wellcare
Cigna Healthspring
Humana
Molina Healthcare
UHC
Zing Health
BC&BS
Devoted
Contracting Med Supp Carriers
AFLAC
ABL
Gerber Life PPL
GTL
Humana
UHC
Wellabe
Woodman
BC&BS
Transamerica Life
Aetna
Ancillary Carriers
GTL
UHC
BC&BS
Ancillary-DVH Carriers
Ameritas
Humana
Ancillary-Hi Carrier
American Home Life
Annuity Carrier
Americo
Major Med Carriers
Mutual of Omaha
BC&BS
Whole Life Carriers
AFLAC
Americo
Gerber Life PPL
GTL
Wellabe
Transamerica Life
PDP Carriers
Humana
UHC
Term Life Carriers
UHC
Contracting ACA States (Example: TX; CA; GA)
*
States Needed for non ACA Products (Example: TX; CA; GA)
*
NoCall Leads Facebook Group
CMS.GOV
FFM CMS Certification
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