800-642-0483

(Licensed Insurance Agent)

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Agent Advisor Contract Submission

Contract Submission Page

Use this online form submission to send contracting requests directly to the contracting team!

There are two separate forms on this page:

Producer Appointment Form
Producer Profile Hierarchy & Commission Form.

APPOINTMENT FORM

Agent First Name

Agent Last Name

National Producer Number (NPN) *

Agent Advisor *

Advisor Email *

Appointment State(s)

Carrier(s) Requested *

Other Carrier(s)

Appoint As: *

Agent
Agency

Immediate Upline

Commission Level

Advisor Notes

Attach Any Supporting Forms

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

Contracting Contact *

Kristen Hailey (Agent Last Name A - F, M, N)
Nancy Benton (Agent Last Name G - L, O, P)
Ashley Watson (Agent Last Name Q - Z)

PRODUCER PROFILE HIERARCHY & COMMISSIONS FORM

Agent/Agency Name

National Producer Number (NPN) *

Direct Upline Hierarchy

Appointment State(s) *

Advances Requested *

Yes
No

Number of Months Advance Requested

Commission Level *

Street Level for All
LOA for All
Other (Complete Below)

Carrier #1

Carrier #1 Product

Carrier #1 Comm Level

Carrier #2

Carrier #2 Product

Carrier #2 Comm Level

Carrier #3

Carrier #3 Product

Carrier #3 Comm Level

Carrier #4

Carrier #4 Product

Carrier #4 Comm Level

Carrier #5

Carrier #5 Product

Carrier #5 Comm Level

Carrier #6

Carrier #6 Product

Carrier #6 Comm

Carrier #7

Carrier #7 Product

Carrier #7 Comm

Carrier #8

Carrier #8 Product

Carrier #8 Comm

Carrier #9

Carrier #9 Product

Carrier #9 Comm

Carrier #10

Carrier #10 Product

Carrier #10 Comm

Agent Advisor *

Advisor Email *

Advisor Notes

Attach Any Supporting Forms

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

Contracting Contact *

Kristen Hailey (Agent Last Name A - F, M, N)
Nancy Benton (Agent Last Name G - L, O, P)
Ashley Watson (Agent Last Name Q - Z)

Contact Info

800-642-0483

(Licensed Insurance Agent)

info@saversmarketing.com

Mon-Thur: 8am-5pm | Fri: 8am-1pm

601 West Fourth St. Suite 110
Winston-Salem, NC 27101

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Do Not Sell My Information

*For Agent Use Only

We do not offer every plan available in your area. Currently we represent 0 – 78 organizations which offer 0 – 2,613 products in your area. Please contact Medicare.gov, 1‑800‑MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

The exact carrier and plan counts are determined by where you live.

A premium is a monthly fee you pay to have medical insurance coverage. To decide your premium, insurance companies will consider: your age, where you live, whether you smoke or use tobacco and whether the coverage is for one person or a family. Premiums usually go up when the coverage is renewed to reflect your age and higher health care costs.

This is not a Long-Term Care policy. This policy may not cover all of your medical or health care expenses. This policy should not be purchased as a substitute for major medical coverage, Medicare, Medicare Supplement, or Medicare related health plans. Premiums may increase upon renewal.

This policy may not cover all costs associated with short term recovery care incurred by you during the period of care. Increase in health care costs may reduce the value of this policy between the purchase date and the date you become eligible for benefits.

Final Expense

Final expense life insurance can be used by the beneficiary designated as needed rather than being limited to specific funeral services and providers. Final expense life policies will have a lower face value than most traditional term or whole life policies as they are intended for a specific purpose of covering those final costs rather than providing comprehensive support for surviving family members. This type of policy generally doesn’t require a medical exam, but premiums will be higher the older you are, and some benefit payouts may be limited during the first few years of coverage for those with significant health issues. Reducing or skipping premium payments will impact the amount of interest paid and may impact how long the policy lasts. Accessing the cash value of a policy will reduce the available cash surrender value and the death benefit. Policy guarantees are based upon the claims-paying ability of the issuing life insurance company.

This is a solicitation of Indexed Universal Life Insurance (IUL). A licensed agent/producer may contact you. Coverage, products, and features may not be available in all states, may vary by state, and will vary by policy. Your rate and availability for this product will be subject to underwriting. An IUL life insurance policy cash value earns interest based on the performance of an index, but isn’t directlly invested in the stock market. IUL policies can have an interest crediting floor, which is typically 0%. The cash value can decline even with a floor due to premiums and other costs. IUL policies contain specific limitations, exclusions, termination provisions, and requirements for keeping them in force. Please see your policy or contact the insurance company for full details. Approval is based on your answers to the questions on the application and information obtained from other sources. Life insurance is not a bank deposit, is not federally insured, may involve risk, and may lose value. All guarantees are subject to the financial strength and claims-paying ability of the issuing life insurance company.

Reducing or skipping premium payments will impact the amount of interest paid and may impact how long the policy lasts. Accessing the cash value of a policy will reduce the available cash surrender value and the death benefit. Any loans from a policy’s cash value are subject to interest and the balance is deducted from your death benefit. A policy owner does not have the ability to make unlimited payments into the policy. If too much money is paid into the policy, it will become a Modified Endowment Contract (MEC) and withdrawals and loans will be taxable.

The death benefit generally will not be paid if the insured’s death results from suicide, while sane or insane, within the contestability period. Instead, the benefit will pay the sum of the premiums paid since issue, less any loan and loan interest due and any withdrawals. Exclusions and limitations may vary by state and will vary by policy.

This is a solicitation of insurance. A licensed agent/producer may contact you. Coverage, products, and features may not be available in all states, may vary by state, and will vary by policy. Rates may be higher due to tobacco use. Your rate and availability for this product will be subject to underwriting. Policies contain specific limitations, exclusions, termination provisions, and requirements for keeping them in force. Please see your policy or contact the insurance company for full details. Approval is based on your answers to the questions on the application and information obtained from other sources. Accessing the cash value of a policy will reduce the available cash surrender value and the death benefit. Any loans from a policy’s cash value are subject to interest and the balance is deducted from your death benefit. Life insurance is not a bank deposit, is not federally insured, may involve risk, and may lose value. All guarantees are based on the claims paying ability of the life insurance company.

This is a solicitation of insurance. A licensed agent/producer may contact you. Coverage, products, and features may not be available in all states, may vary by state, and will vary by policy. Rates may be higher due to tobacco use. Your rate and availability for this product will be subject to underwriting. Policies contain specific limitations, exclusions, termination provisions, and requirements for keeping them in force. Please see your policy or contact the insurance company for full details. Approval is based on your answers to the questions on the application and information obtained from other sources. All guarantees are based on the claims paying ability of the life insurance company.

There are multiple ways to insure for long-term care needs. Options vary and some are less expensive than others, but may offer fewer guarantees. A financial professional can work with you to determine what coverage is right for you and how much coverage you should purchase. Health insurance doesn’t cover long-term care expenses. Medicare will cover some long-term care costs, but only up to 100 days (after a 3-consecutive-day stay in a hospital under treatment). Medicaid will cover long-term care expenses for individuals with assets of $2,000 or less (varies by state) and covered care may be limited to a nursing home. Paying for long-term care costs out of pocket may not be practical or cost-efficient for many people.