Existing Agent Commission Change Request - ORCA Life

Login

ABOUT US
CLIENTS
AGENTS
CONTACT
APPLY
844-851-3846
Menu Menu

Existing Agent Commission Change Request

"*" indicates required fields

Person Completing Form First/Last Name*

First Last

Agent First/Last Name*

First Last

First/Last Name (Who Recieves Lead Bill)*

First Last

Carriers*

American Memorial / TruStage

Second ChoiceAmAm | Occidental (Same Commission Level)

AIG

RNA

GTL

LBL

CFG

Gerber

Great Western

Aetna

Choose all carriers that need to be changed

Hierarchy & Commission Info

See Photo Example of how we need each hierarchy for EACH CARRIER. We will no longer accept "Bump agent 5 points" we need actual levels as we will no longer assume any information

Hierarchy & Commission Info*

Please list out all hierarchy and commission information. We can no longer assume any information. Please list hierarchy with Executive members at the top and New Agents toward the bottom.

CAPTCHA

Δ

© ORCA Life 2023 | All Rights Reserved

LinkedIn
Instagram
Facebook

Agencies Form

Agency Name*
Agency Contact Name
Email
Phone
Explain how we could partner.
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

Δ

Agent Career Form

Name*
Email*
Phone
Address
Street Address City State ZIP Code
Resume*
Accepted file types: doc, docx, pdf, Max. file size: 5 MB.
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

Δ

Individuals - Submit Your Resume

Name*
Email*
Phone
Address
Street Address City State ZIP Code
Resume*
Accepted file types: doc, docx, pdf, Max. file size: 5 MB.
Email
This field is for validation purposes and should be left unchanged.

Δ

Scroll to top