Become a Health New england broker

Credentialing Information Required


To receive commissions for new sales please complete the following information and return it to us:

Copies of License (Massachusetts)
Copy of Declaration Page of E & O Policy

Please mail this information to:
Health New England
Attn: Jennifer Murray 
One Monarch Place Suite 1500
Springfield MA 01144-1500
(800) 842-4464, Ext 3380 

*Please click on the form that you need and it will open in PDF format so you can print it. If you need acrobat reader please click  here to download it.