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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:
Broker Agreement* (pdf)
Copies of License (Massachusetts)
W-9 / Request for Taxpayer ID* (pdf
)
Standard Broker Information Sheet
Copy of Declaration Page of E & O Policy
Broker Compensation Electronic Funds Transfer Form (EFT)* pdf
Please mail this information to:
Health New England
Attn: Sales Department
One Monarch Place, Suite 1500
Springfield MA 01144-1500
(413) 233-3535
Email:
salesoperations@hne.com
*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.
Medicare Brokers
If you are interested in becoming a
Medicare
broker, please contact
msupport@hne.com
or call (413) 233-3222.