Health Carrier Appointment Applications

Below are the links to downloadable health carrier applications. Once you have filled these out please return to

Blue Cross and Bridgespan do not have formal applications to submit. If you are interested in becoming appointed with them please email your current Errors and Omissions Insurance (personal not agency), Utah Insurance License (personal not agency), and 2015 FFM Certifications

Select Health is not currently appointing new agents at this time; however, we can put you under Stone Hill’s appointment for the time being. The differences you will find are 1) commissions will be paid to you from Stone Hill instead of Select Health 2) Stone Hill is listed as the agent of record, however, we still view it as YOUR book of business. Once your Select Health book grows large enough to meet their monthly requirements of $5,000 per month in premium, we can get you your own appointment at that time and we will transfer your book under your writing number.

In the meantime, you will need to fill out an AOR for each new client. Please send these AOR’s to Jamie Dawes ( for processing.


Aetna/Altius 2015 – This Application is submitted all online.

Arches 2015

Humana 2015

Molina 2015 Update

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