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Commission Inquiry Form

Please use this form to submit any commission questions or concerns you may have and our team will respond to your inquiry within 7 to 10 business days. 
 


    Click on each carrier name to download the aligned reconciliation

    Aetna Reconciliation Form

    Ambetter Reconciliation Form

    AmeriHealth Caritas Next Reconciliation Form

    AvMed Reconciliation Form

    Cigna Reconciliation Form

    HealthFirst Reconciliation Form

    Oscar Reconciliation Form

    UnitedHealthcare Reconciliation Form

    Molina Healthcare Reconciliation Form


    Upload the completed Reconciliation to be sent to the Carrier(s)

    Click "Choose Files" to upload your reconciliation

    Commission Reconciliation Emails:

    Aetna Commission Reconciliation

    Ambetter Commission Reconciliation

    AmeriHealth Commission Reconciliation

    Anthem Commission Reconciliation

    AvMed Commission Reconciliation

    BCBS TX Commission Reconciliation

    BCBS AZ Commission Reconciliation

    Christus Commission Reconciliation

    Cigna Commission Reconciliation

    Health First Commission Reconciliation

    Oscar Commission Reconciliation

    Oscar Commission Reconciliation

    Surebridge Commission Reconciliation

    United Commission Reconciliation

    Commission Dispute Submission Instructions

    If you believe there is an issue with your commission payment, please follow the steps below to submit your commission dispute for review:

    1. Download the Commission Dispute Form
      Click the link provided to download the official Commission Dispute Form. Please complete all required fields carefully to ensure a timely review.
    2. Submit the Form
      You have two options to submit your completed form:
      • Option 1 – Submit to the Agency:
        Upload your completed form directly through this page. Our agency team will review your request and contact you once the evaluation is completed.
      • Option 2 – Submit Directly to the Carrier:
        If you are a directly contracted agent, you may send the completed form directly to the carrier at the email address listed on the form.
        In this case, the carrier will review your commission dispute without agency intervention.
    3. Important Notes:
      • Incomplete forms or missing documentation may delay the review process.
      • Please allow up to 7–10 business days for the agency to process and respond to commission review requests.
      • If submitting directly to the carrier, response times may vary depending on their internal procedures.

    Thank you for your cooperation and attention to detail in ensuring your commission records remain accurate and up to date.