Agent Agreement

Agent Agreement(s)
Please review and agree to the following statements to complete your registration for the Agent Referral Desk.

Agent Referral Desk

Review the program description and product offerings below and select “I have read and understand the program description” to sign electronically and continue.

Agent Referral Desk is pleased to be offering you a solution to your clients’ questions surrounding Medicare. Our dedicated Benefit Advisors are licensed, contracted and certified nationwide to serve you and your clients. Multiple “A” rated or better insurance carriers provide your clients the coverage they want at a competitive rate.

Product Offerings

Medicare Supplement
Insurance plans with predictable monthly premiums that help budget yearly out-of-pocket healthcare expenses. These plans can cover 100% of Medicare deductibles and co-insurance. There are no network limitations so your clients can continue to see their current physician as long as he/she accepts Medicare assignment. Enrollment is year-round.

Medicare Advantage
Insurance plans feature monthly premiums as low as $0 per month in some areas. Generally, there are co-pays and deductibles to pay when treatment is received. Some plans reduce out-of-pocket expenses when treatment is through a network provider. Unless there is qualification for an exception, enrollment is limited to certain times of the year. Most plans include Medicare Part D Prescription Drug coverage.

Medicare Part D
Insurance plans that provide stand-alone prescription drug coverage. Delaying Medicare Part D enrollment can possibly limit options and incur penalties. Some Medicare Advantage plans include Part D prescription drug coverage. Unless there is qualification for an exception, enrollment is limited to certain times of the year.

At Agent Referral Desk, we also accept referrals and pay a fixed percent to licensed agents for: home, auto, commercial, farm, and specialty lines.

*Please note we will only offer services to your referrals that have been previously agreed upon when we contact you after you submit your registration form.

Please click link to download W-9 Form*. Complete and return via fax to (402) 505-8498.

W-9 Form*

* Completed W-9 needs to be received before any fees can be paid.  Please scan and email this for to the email address

Electronic Signature

Request Your Quote Here

Are you ready to save time, aggravation, and money? The team at The Insurance Center is here and ready to make the process as painless as possible. We look forward to meeting you!