(within an existing Prevea360 Health Plan Contracted Agency)
Please submit a completed Agent Information Sheet and a copy of your current Wisconsin accident and health license.
Agent Information Sheet PDF
Medicare Advantage Part D Certification
Sign up to become a Certified Medicare Advantage Part D agent.
Prevea360 Health Plan reviews applications for new agencies/brokers periodically throughout the year. To be considered for a Prevea360 Health Plan partnership, the following must be submitted:
Agency Information Sheet PDF
Attach a letter of intent including:
- Background of agency
- Sales expectations
- Geographic location(s)
- Sales history
- Mission statement
- Any additional information that helps us determine if our partnership will be an effective one