Fast Start

Before you submit, please verify that these criteria are met:

  • For agent use only.
  • Policies issued within 60 days of welcome letter receipt, as determined by your marketer.
  • Applies to pre-determined carriers and product lines (your marketer has the details).
  • Applies only to carriers you are appointed and certified through Network Insurance Senior Health Division and/or Grupo Latino Americano de Seguros.
  • Applications cannot be combined with any other promotion.
  • Open enrollment and underwritten business only on Medicare Supplement Insurance.
  • Agents must abide by Network Insurance or Grupo Latino’s compliance program described at http://www.nishd.com/compliance or http://www.insurancegls.com/compliance

  • Agent Info

  • Policy Information

  • Please enter the information for each policy into their respective fields as labeled below.

    More policies can be added by clicking the icon for each one you wish to add. To remove a policy, simply click the icon.

    CarrierAgent NumberMember NamePolicy NumberIssue Date 
  • Please provide any comments, explanations, or additional info pertaining to the policies you are submitting.

For agent use only. Not for use with consumers. Certain exclusions and limitations may apply. Not affiliated with the United States government or the federal Medicare program. For more information, call your marketer at (Network Insurance 800.662.5080 or Grupo Latino 877.719.8716)