Thank you for your interest in contracting to represent SelectHealth plans through the Plan Advisors Agency. Please use the link(s) below to complete the contracting packet. If you want to be appointed in both NV and UT, both packets need to be completed. You will need to return the entire packet and also include the following:
- Copy of Driver’s license with picture or a digital head shot
- Insurance License (s) – NV and/or UT
- E&O Insurance Certificate
- AHIP Certificate
SelectHealth – Assignment of Commissions (not mandatory)
- Complete all requested information
- You can use the digital signing feature built into the form or sign manually. You can NOT type a signature.
- Be sure to include your signature on pages:
- Page 1 of Appoint Application
- Page 14 and 21 of the Sub-Agent Agreement
- Page 1 of W9
- You will only use the Assignment form if you are assigning commissions. You do not need to return this form if you are NOT assigning commissions.
Send the entire contract package and additional forms back to:
- Email – firstname.lastname@example.org
- FAX – 502-470-5746
Contracting will typically take 10 business days to process. You will receive an email to confirm the contract has been processed along with information regarding the face-to-face certification class that will be required. Please do NOT market any products until your certification is complete.
Again, thank you for your interest in representing SelectHealth through the Plan Advisors Agency.