UIG Brokerage Division

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PTNA

United Insurance Group Agency, Inc. provides the following licensing forms on line. Please contact UIG for commission schedules.

The downloadable forms available on this page contain everything you need to get started.

If necessary, download the free Acrobat Reader (required to view and print the online forms)

Click on the contracting forms below that you want in Adobe PDF format
Print and completely fill out the printed forms
Fax completed forms to (248) 676-0713

QUICK LINKS
Aetna	Life Secure
Allianz	Molina
American General	Mutual of Omaha
AmeriChoice	Old Mutual (F & G)
American National	Oxford Life
Antex	Penn Treaty
Baltimore Life	Priority Health
BCBS of MI	Prudential
CAMADS	PTNA
CIGNA	SecureHorizons
Conseco	Senior Choice
Elderplan	Standard Life
Evercare	Today's Options
Foresters	Transamerica
Forethought Life	United American
Genworth	United Health
GTL	United of Omaha
HealthNet	United Teachers
Humana	United World
John Hancock

PTNA

PTNA Forms:

State specific:

All States - PTNA Forms

General Agent
Solicitor

WV, ME, MA, CT, KS, NJ - ANIC Forms

NY - AIN Forms

Complete state specific paperwork for resident and non-resident states that you are going to appoint in. Example: If you appoint in NY, then complete AIN paperwork. However, if you also appoint in NJ, complete ANIC paperwork as well.

For more information, please contact your Broker Support Specialist.