Apply Manually
If you would prefer to fill out a paper application and submit it by mail, please print the PDF provided below.
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Advisor Information
Please use the information below to complete the advisor fields. That way we’ll know who sent you to us.
Advisor Code
C9016
Office Code
GPB100
MGA Code
8915
Advisor Name
Cathy Baleck
Office Name
BrokerLink Associations
MGA Name
Prosum Health Benefits Inc.
Application Forms (PDF)
Download the form for the plan you are interested in applying for:
LINK Plan Application Form