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Medicare Contract Request Form

Please click the button below to request Medicare Contracting with Golden Years Senior Insurance Marketing

Medicare Contract Self-Release Form

If you need to self release your Medicare contracts, please click the button below

Medicare Advantge Release Transfer Process

United Health Care

2 Options to transfer

1. 90 Day release,

no Upline Involvement email sent to UHC

2. Immediate upline and top of hierarchy provide an immediate release on company letterhead

UHC has implemented a program called “Intent to for agents who cannot obtain an immediate release. This program allows the agent to move to a new upline in three  months. The agent can continue to write business and commissions will not be affected.

At the end of the 3-month period, the new upline will send the agent a new contracting link to be aligned with them. How to begin the “Intent to Transfer Process: 

   You will send an email to  [email protected] and include the below and cc me : 

Subject: Intent to Move  

Good Morning/Afternoon, 

My name is ____________________ and my agent number is ________________. I am officially requesting to change my upline to Golden Years Design Benefits LLC    6419900    

Thank you and have a nice day. 

Clover

2 Options to transfer

1. 90 Day release,

no Upline Involvement

2. Immediate upline provides a release and needs to sign the document

Aetna

2 Options to transfer

1. 90 Day release,

no Upline Involvement

2. Immediate upline provides a release and needs to sign the document

AmeriHealth

IBC

2 Options to transfer

1. 90 Day release,

no Upline Involvement

2. Immediate upline provides a release and needs to sign the document

Cigna

2 Options to transfer

1. 90 Day release,

no Upline Involvement

2. Immediate upline provides a release and needs to sign the document

Humana

2 Options to transfer

1. 90 Day release,

no Upline Involvement

2. Immediate upline provides a release and needs to sign the document

This website is for agent use only. Not for public use or distribution.

Golden Years Senior Insurance Marketing

55 Schanck Rd. Suite A14

Freehold, NJ

Email : [email protected]

Phone : 732-526-7659

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