Medicare Advantage Lead Mailer Verification Form
Before you submit, please verify that these criteria are met:
- See your specific incentive flyer for the required number of policies to redeem your incentive.
- You are appointed through Network Insurance Senior Health Division with the carriers you wrote the policies with at the time the policies were written.
- Effective dates that qualify: 2/1 – 12/1 2020. Incentive must be redeemed by January 31st 2021.
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. Enrollments for this promotion must be issued with carriers the agent is directly appointed with through Network Insurance at the time the policies were written. Applications may only be used once and may not be combined with any other promotion. Agent must be trained and certified and must abide by Network Insurance’s compliance program described at www.nishd.com/compliance.