Welcome To Joining One Of The Fastest Growing Agencies...

Before you complete your agent application, we invite you to watch an insightful video from a 30+ year industry veteran. Hear firsthand why joining C & K Healthcare Advisors could be the decision that transforms your entire career, offering unmatched support and opportunity for long-term success.

Welcome to C & K Healthcare Advisors, one of the fastest-growing agencies in the nation. As President and Co-Founder, I’m thrilled to have you join our team and embark on this journey with us. We’re dedicated to providing you with the tools, support, and opportunities to succeed, and I look forward to seeing you thrive within our organization. Welcome to the C & K family!

– Paul Castner, President & Co-Founder

To Begin Your Journey Please Fill Out The Application Below

Welcome to C & K Healthcare Advisors, one of the nation's fastest-growing organizations, where we are thrilled to have you on board. Here, you'll find a supportive team mentality dedicated to helping you succeed while building a strong future for yourself and your family.

As you begin your journey with C & K Healthcare Advisors, the following pages contain important questions to help us align your goals with the right products and carrier contracts. Please complete this onboarding packet in its entirety so we can tailor our support to best meet your needs and set you up for success.

First Name *

Last Name *

Address *

City *

State *

Postal code *

Date of birth *

Email *

Phone *

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

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Agency 0.0: Are you principal of a licensed agency?

Yes

No

Agency 0.1: Are you appointing your agency with the Carriers you are requesting?

Yes

No

Agency 0.2: What is the legal name of your agency?

Agency 0.3: What is your agency Tax ID?

Agency 0.4: What is your agency NPN?

Agent 0.0: Social Security Number *

Agent 0.1: National Producer Number *

Agent 0.2: Resident License Number: *

Agent 1.0: What License Line of Authority Do You Posess *

Health and Life

Health Only

Life Only

Agent 2.0: Do Currently Have An Active E & O Insurance Policy *

Yes

No

Agent 2.1: Who Is You E & O Policy Through

Agent 2.2: What is Your E & O Policy Number

Agent 3.0: Have Your Completed Your AML Training In The Last 2 Years *

Yes

No

Agent 3.8: Are You A Newly Licensed Insurance Agent? *

Yes

No

Agent 3.9: To Expedite Your Contracts What Products Would You Like To Focus On? (Select All That Apply)

Medicare

ACA - Individual and Family Healthcare

Ancillary Healthcare Plans (Hospital Indemnity, Cancer Insurance, Accident Insurance, etc.)

Life Insurance

Annuities

Group Insurance (FREE B2B LEADS Available)

To begin processing your application and getting you contracted with the products and carriers you've requested, please provide your signature and today’s date. Welcome to the C & K Healthcare Advisors team—you're making a great choice by joining us, and we look forward to supporting you in building a successful future!

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Date of application

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Disclaimer:

Please note that any information obtained in this application will only be used for the purpose of contracting you with the product lines and carriers you request. Your privacy and confidentiality are our top priority.