Health First - Contracting
Interested in contracting with Health First? Please use instructions below to contract for the following products:
- ACA Marketplace
If you are already contracted but would like to re-align under Plan Advisors/BishopMarketing - please read Release Policy at bottom of the page
Thank you for your interest in in contracting to represent Health First plans through Plan Advisors/Bishop Marketing. You will need to complete the following forms carefully to ensure contracting goes smoothly. Please make sure you write legibly so that your contract can be set up accurately.
- Agent Broker Agreement - Please complete the highlighted fields on Page 8. At the top of the page, indicate if you are contracting for Medicare, ACA Marketplace or both. Note you are completing all of the left hand side and only the email address and SS# on the right hand side. You will only complete the remaining fields if you are applying as an Agency instead of an agent. Be sure to check the “Agent” selection to get paid. Finally, be sure to sign and date the form. You only need to return Page 8.
- Business Associate Agreement – Please complete the highlighted fields on pages 1, 9 and 10. On Page 9, the “with a copy to” information is optional. Make sure you sign page 10. You only need to return pages 1, 9 and 10.
- W-9 – Request for Taxpayer Information – Complete the highlighted fields. In most cases you will only fill in the Social Security Number and not the Employer Identification number.
- In addition to the above forms, we will need copies of the following:
- Insurance license
- E&O – declaration page
- AHIP Certificate – current year (if contracting for Medicare)
- FFM Marketplce certifcate - current year (if contracting for the Marketplace)
Please scan all the documents to us as one document (not individual documents). There will be 7 or 8 pages in your returned contracting document. Save the scanned document with the following naming convention – “HF- Your First and Last Name”. If you are unable to consolidate everything into one document, please send all the documents in one e-mail with “HF Contract – Your Name” in the subject heading. Send the scanned documents to email@example.com
Contracting will typically take 7-10 business days to process. If you have contracted for Medicare, you will receive an email with instructions on how to begin the certification process. Do not market any products until certification is complete.
- If you are already contracted with Health First and would like to align under Plan Advisors/Bishop Marketing, please obtain a release letter from your current upline FMO and return to: firstname.lastname@example.org
- The release letter needs to be on the FMO letterhead and be signed by the principle of officer of the company. It should state your name the date of the release.