855.443.4735
 hfbroker@hf.org

  Attention:
 
Thank you for your interest in becoming appointed with Health First Health Plans and AdventHealth Advantage Plans.
In order to complete the application process, please have the following documents available as they are required for upload:
E&O
Health License
W9 for each entity in which you are paid
Documents needed if applicable:
AHIP Certification (if selling Medicare)
FFM Certification (if selling on the Marketplace)
 
 Agent Information
*
*

* indicates a required field

*
*
*
*
*
*
*
*
 Home Address
*
*
*
*
 
 Mailing Address (Must Be Physical Address)
 Errors and Omissions
*
*