Providers

Agents

Becoming Appointed with USHL.

Agents and agencies wishing to become appointed with USHL must download the applicable checklist and agent and/or agency appointment forms. Complete and return required documents to USHL Sales Support at salessupport@ushealthandlife.com (fax 586-693-1211).

Agents must complete the following:

Access all Agent Licensing Documents electronically

For downloadable PDFs, please click on links below.

  • Assignment Form (*not included in the electronic Agent Licensing Documents packet): Appointed agents must use this form to reassign commissions to another agent or agency. Select either the downloadable PDF or DocuSign icon to complete.

Agencies must complete the following:

Access all Agency Licensing Documents electronically

For downloadable PDFs, please click on links below.

*Submittal of W-9 is required for both agents and agencies seeking appointment:
  • Agents not assigning commissions to an agency must submit their W9 only.
  • Agents assigning commissions to an agency must submitboth their W9 and also the agency W9.