We pride ourselves on being a local carrier and look forward to partnering with Wisconsin agents.
Please note, you must reside in Wisconsin to acquire an appointment with
Common Ground Healthcare Cooperative.
New Agent Appointment Requests: The following forms must be returned with your complete application –
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Broker Form
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Signed broker agreement
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Application background questions
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Copy of WI Insurance License
- Copy of E&O Language
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Please submit all forms to sales@commongroundhealthcare.org and allow up to 30 days for processing.