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Health Broker Appointment Process

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Thank you for your interest in marketing Golden Rule’s competitive portfolio of health products. After your appointment is processed, we will send you a complete marketing package with supplies, rate disks, and broker guides to help you write your first application.

Print the checklist below for complete instructions.

If you have any questions, contact us at 1-800-474-4467 Option 5. One of our licensing representatives can help you complete the appointment process over the phone.

Online Appointment
Appointment Process
Health Insurance 37835-G-0408 Assignment of Commissions
Health Insurance w9-0204f Commissions - W9
Health Insurance fcra-0306F Fair Credit Reporting Act Disclosure and Authorization
Health Insurance 34829-1105F Non-Resident Broker Application (For use if already authorized in resident state)
Health Insurance W9-0105 Administrative form W-9
Health Insurance 34547-G-0809F Appointment Fee Credit Card Authorization
Health Insurance 34520-0207 Appointment Process Checklist
Health Insurance 34370-0306F Broker Application
Health Insurance 34822-0903F Broker Application Explanation
Health Insurance 36224-X-0709F Direct Deposit of Commissions Form
Health Insurance ibc-0405F Independent Broker Contract (IBC) with Signature Page

Note: No business may be solicited until all state licensing and Golden Rule appointment and/or contract requirements have been met, and Golden Rule has advised you of that in writing.