Phil-Am Insurance Agency

Get Contracted

Start your contracting request below. Enter your NPN to auto-fill your producer information, then complete the remaining fields.

1 Verify Your Producer License

National Producer Number (NPN)*

Don't know your NPN? Look it up at NIPR →

Please enter a valid NPN (6–10 digits).

2 Your Information

✦ Fields marked with a dashed border were auto-filled from your NIPR record. Please verify they are correct.

First Name*

Required.

Last Name*

Required.

Email Address*

Please enter a valid email.

Phone Number*

Required.

Resident State*

Required.

Date of Birth*

Required.

3 Mailing Address

Street Address*

Required.

Suite / Apt / Unit

City*

Required.

ZIP Code*

Required.

4 E&O Insurance

Do we have your E&O on file?*

Yes, on file No, need to update

Please select an option.

Active Errors & Omissions coverage is required for contracting. Don't have E&O? We recommend Next Insurance.

E&O Carrier*

Required.

Policy Number*

Required.

Effective Date*

Required.

Expiration Date*

Required.

Coverage Amount*

Required.

5 Carrier Appointments

Lines of Business*

Select all you would like to contract with.

Medicare ACA Life Ancillary

Please select at least one line of business.

Medicare Carriers

Select all you would like to contract with.

KelseyCare Advantage Aetna Anthem - Healthy Blue (LA only) Anthem - WellPoint BCBS WellCare CHC Cigna Humana Devoted Scan UHC Molina Memorial Hermann Mutual of Omaha Physicians Mutual Verda Other

ACA Carriers

Select all you would like to contract with.

Ambetter Cigna Aetna Oscar UHC CHC HCSC Molina

Ancillary Carriers

Select all you would like to contract with.

GTL Manhattan Life NCD Dental Ameritas All-State

Life Carriers

Select all you would like to contract with.

Royal Neighbors TransAmerica Trinity Life Manhattan Life Liberty Bankers Forresters American General / Corebridge

Additional Carriers

By submitting, you authorize Phil-Am Insurance Agency to initiate the contracting process on your behalf. Your information is handled securely and never sold.

✓

Request Received!

Thanks, . We've received your contracting request.

Next step: Please upload your required onboarding documents to complete your setup.

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