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Existing Agent Additional Carrier Contracting Request
Manager First/Last Name
(Required)
First
Last
Agent First/Last Name
(Required)
First
Last
Direct Upline First/Last Name
(Required)
First
Last
First/Last Name (Who receives Lead Bill?)
(Required)
First
Last
Carrier
(Required)
AmAm | Occidental (Same Commission Level)
AIG
RNA
GTL
LBL
CFG
Gerber
Great Western
Prosperity
Aetna
Other
Agent AmAm & Occidental Commission Level
0 (CF23)
40 (CF24)
45 (CF22)
50 (CF21)
55 (CF20)
60 (CF19)
65 (CF18)
70 (CF17)
75 (CF16)
80 (CF15)
85 (CF14)
90 (CF13)
95 (CF12)
100 (CF11)
105 (CF10)
110 (CF09)
112.5 (CF26)
115 (CF08_s)
120 (CF07)
125 (CF06)
130 (CF05)
135 (CF04_IMO)
Direct Upline AmAm & Occidental Commission Level
0 (CF23)
40 (CF24)
45 (CF22)
50 (CF21)
55 (CF20)
60 (CF19)
65 (CF18)
70 (CF17)
75 (CF16)
80 (CF15)
85 (CF14)
90 (CF13)
95 (CF12)
100 (CF11)
105 (CF10)
110 (CF09)
112.5 (CF26)
115 (CF08_s)
120 (CF07)
125 (CF06)
130 (CF05)
135 (CF04_IMO)
AIG
Brokerage Channels have nothing to do with the commission levels assigned to the agent. The BC tells us how many people are allowed in a hierarchy. Brokerage Channels (Are spaces Available) 1. RGA - ORCA Life 2. GA - (Executive Team Lead) 3. GA1 - Can have downlines 4. GA2 - Can have downlines 5. PRD - CAN NOT have downlines
Agent AIG Brokerage Channel
(Required)
GA
GA1
GA2
PRD
Agent AIG Commission Level
45% (T)
50% (Q)
55% (P)
60% (N)
65% (M)
70% (L)
75% (K)
Other
Direct Upline AIG Commission Level
45% (T)
50% (Q)
55% (P)
60% (N)
65% (M)
70% (L)
75% (K)
Other
RNA
Agent RNA Commission Level
50%
70%
75%
80%
85%
90%
95%
100%
110%
115%
120%
125%
Direct Upline RNA Commission Level
50%
70%
75%
80%
85%
90%
95%
100%
110%
115%
120%
125%
GTL
Agent GTL Commission Level
50%
70%
75%
80%
85%
90%
95%
100%
110%
115%
120%
125%
Direct Upline GTL Commission Level
50%
70%
75%
80%
85%
90%
95%
100%
110%
115%
120%
125%
LBL
Agent LBL Commission Level
0% (CAO)
50% (CR)
55% (CQ)
60% (CP)
65% (CO)
70% (CN)
75% (CM)
80% (CL)
85% (CK)
90% (CJ)
95% (CI)
100% (CH)
110% (CF)
115% (CE)
120% (CD)
125% (CC)
Other
Direct Upline LBL Commission Level
0% (CAO)
50% (CR)
55% (CQ)
60% (CP)
65% (CO)
70% (CN)
75% (CM)
80% (CL)
85% (CK)
90% (CJ)
95% (CI)
100% (CH)
110% (CF)
115% (CE)
120% (CD)
125% (CC)
Other
CFG
Agent LBL Commission Level
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
110%
115%
120%
Direct Upline LBL Commission Level
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
110%
115%
120%
Gerber
Agent Gerber Writing Commission Level
45% (Level 1)
50% (Level 2)
55% (Level 3)
60% (Level 4)
65% (Level 5)
70% (Level 6)
75% (Level 7)
Other
Agent Gerber Recruiter Commission Level
60% (Level 4)
65% (Level 5)
70% (Level 6)
75% (Level 7)
Other
Direct Upline Gerber Recruiter Commission Level
60% (Level 4)
65% (Level 5)
70% (Level 6)
75% (Level 7)
Other
Great Western
Agent Great Western Commission Level
0%
75%
80%
85%
90%
95%
100%
105%
110%
115%
120%
125%
Direct Upline Great Western Commission Level
0%
75%
80%
85%
90%
95%
100%
105%
110%
115%
120%
125%
Aetna (SuranceBay Not Required)
Agent Aetna Commission Level
70%
77.5%
85%
92.5%
100%
107.5%
115%
120%
125%
130%
Direct Upline Aetna Commission Level
70%
77.5%
85%
92.5%
100%
107.5%
115%
120%
125%
130%
Additional Information
Who's Paying for Leads (Leads Billing | Email)
(Required)
Due Date
MM slash DD slash YYYY
More details
Priority
1
2
3
4
5
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Agencies Form
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Agency Contact Name
Email
Phone
Explain how we could partner.
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Agent Career Form
Name
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Email
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Phone
Address
Street Address
City
State
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Individuals - Submit Your Resume
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American Samoa
Arizona
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Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
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Michigan
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North Carolina
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Northern Mariana Islands
Ohio
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Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Resume
*
Accepted file types: doc, docx, pdf, Max. file size: 5 MB.
Phone
This field is for validation purposes and should be left unchanged.
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