What forms do Mutual of Omaha and United Concordia require for producer appointments?
A packet of forms is available through your Mutual of Omaha service representative or through Producer Snapshot on www.dentabenefits.com, Producer Appointment Information and Forms. This packet includes Appointment Requirements and Commission Payment Policy, and Authorization for Disclosure, a Producer Information Checklist, Producer Information Form, Certifications and Authorization to Obtain Investigative Consumer Report, Producer Agreement, and W9 form. Also included in the packet will be any state specific forms required by the group situs state. Note: All producers and/or agencies are required to be appointed by United Concordia in the state where the client group is sitused.
