QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1...

16
Page 3 of 54 QUOTING AND ENROLLING BROKER QUOTING FOR CLIENT Log in to www.hometownhealth.com Click

Transcript of QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1...

Page 1: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 3 of 54

QUOTING AND ENROLLING

BROKER QUOTING FOR CLIENT

Log in to www.hometownhealth.com

Click

Page 2: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 4 of 54

Page 3: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 5 of 54

Page 4: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 6 of 54

If a dependent is

to be enrolled add

here

Page 5: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 7 of 54

Page 6: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 8 of 54

You can narrow down the search for plans here.

Page 7: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 9 of 54

Page 8: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 10 of 54

Member will be required to create a login. If it’s a returning member they will need to use

the sign on they had previously.

Page 9: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 11 of 54

If a Hometown Health Employee is

assisting with the sale of the plan

then the Employee number should

be included here.

Page 10: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 12 of 54

Page 11: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 13 of 54

Page 12: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 14 of 54

Page 13: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 15 of 54

Page 14: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 16 of 54

Email confirmation is sent to the client:

Email confirmation is sent to the broker:

Page 15: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 32 of 54

CHANGING STATUS ON MEMBER

This member is a child so you will notice the verbiage indicates this policy is not eligible to have any

dependents.

Page 16: QUOTING AND ENROLLING - Hometown Health · Resume Application . Physical Address Address Line 1 City Mailing Address Address Line 2 Zip Code Next ... will become part of my contract

Page 33 of 54

PAYMENT INFORMATION

The member can indicate if they would like to have a recurring payment (automatically debited

from credit card on the 1st of the month) OR Manual payment (Member logs in and makes

payment).

Payment is due on the 1st of each month with a 30 day grace period (Due no later than the 30th of

the month by 5pm)


Version number: 1.4 Date updated: 03/01/2017 · Address Usage Code Address Details Line 1 Text AmountAddress Details Line 2 Text Address Details Line 3 Text Address Details Line 4

Version number: 1.4 Date updated: 03/01/2017 · Address Usage Code Address Details Line 1 Text AmountAddress Details Line 2 Text Address Details Line 3 Text Address Details Line 4

Block Quoting

Block Quoting

Network Agent Name Agent Location Name Address Line · PDF fileNetwork Agent Name Agent Location Name Address Line 1 Address Line 2 City Province Postal Code Phone Code City Phone

Network Agent Name Agent Location Name Address Line · PDF fileNetwork Agent Name Agent Location Name Address Line 1 Address Line 2 City Province Postal Code Phone Code City Phone

Supplier Name Address Line 1 Address Line 2 Address Line 3 ... › downloads › file106631.pdfNeopost Limited - postage only BACS Neopost House South Street Romford Essex RM1 2AR

Supplier Name Address Line 1 Address Line 2 Address Line 3 ... › downloads › file106631.pdfNeopost Limited - postage only BACS Neopost House South Street Romford Essex RM1 2AR

S.No. Store Name Address Line 1 Address Line 2 City State ...testmailer.hdfcbank.com/May16/LB/Coding/May_segmented_Program… · S.No. Store Name Address Line 1 Address Line 2 City

S.No. Store Name Address Line 1 Address Line 2 City State ...testmailer.hdfcbank.com/May16/LB/Coding/May_segmented_Program… · S.No. Store Name Address Line 1 Address Line 2 City

Etude technico-économique des conditions de … Business Address Your Address Line 2 Your Address Line 3 Your Address Line 4 Phone: 555-555-5555 Fax: 555-555-5555 E-mail: someone@example.com

Etude technico-économique des conditions de … Business Address Your Address Line 2 Your Address Line 3 Your Address Line 4 Phone: 555-555-5555 Fax: 555-555-5555 E-mail: [email protected]

s3images.coroflot.com · Physical Address Address Line 1 Address Line 2 City,

s3images.coroflot.com · Physical Address Address Line 1 Address Line 2 City,

Letterhead NY LA CH no · Web viewAddress Line 1 Address Line 2 Address Line 3 Address Line 4 PROFESSIONAL SERVICES: Previous Balance per: $-Less Amount Paid On: $-Accounting and tax

Letterhead NY LA CH no · Web viewAddress Line 1 Address Line 2 Address Line 3 Address Line 4 PROFESSIONAL SERVICES: Previous Balance per: $-Less Amount Paid On: $-Accounting and tax

All Businesses Account Number DBA Name Address Line 1 Line ...

All Businesses Account Number DBA Name Address Line 1 Line ...

S P R I N G 2 0 1 3 Family Center the Bridging Those in Crisis · Address Line 1 Address Line 2 Address Line 3 Address Line 4 Archie Morrow, President Kyle Bratton, Vice President

S P R I N G 2 0 1 3 Family Center the Bridging Those in Crisis · Address Line 1 Address Line 2 Address Line 3 Address Line 4 Archie Morrow, President Kyle Bratton, Vice President

Welcome to Standard Life International...#ADDRESSEE #ADDRESS LINE 1 #ADDRESS LINE 2 #ADDRESS LINE 3 #ADDRESS LINE 4 #POSTCODE Welcome to Standard Life International Dear Customer We

Welcome to Standard Life International...#ADDRESSEE #ADDRESS LINE 1 #ADDRESS LINE 2 #ADDRESS LINE 3 #ADDRESS LINE 4 #POSTCODE Welcome to Standard Life International Dear Customer We

FOLIO / DEMAT ID NAME ADDRESS LINE 1 ADDRESS LINE · PDF filefolio / demat id name address line 1 address line 2 address ... 622-type ii bhel jhansi jhansi 0 300 ... thomas c/o price

FOLIO / DEMAT ID NAME ADDRESS LINE 1 ADDRESS LINE · PDF filefolio / demat id name address line 1 address line 2 address ... 622-type ii bhel jhansi jhansi 0 300 ... thomas c/o price

ADDRESS LINE 1 ADDRESS LINE 2 ADDRESS LINE ... - GOV.UK Notify · GOV.UK Notify Letter specification Version 2.4 Page 1 of 10 . 5.00mm 5.00mm 15.00mm 15.00mm GOV.UK Notify Letter

ADDRESS LINE 1 ADDRESS LINE 2 ADDRESS LINE ... - GOV.UK Notify · GOV.UK Notify Letter specification Version 2.4 Page 1 of 10 . 5.00mm 5.00mm 15.00mm 15.00mm GOV.UK Notify Letter

Last Name First Name Address Line 1 Address Line 2 City ...

Last Name First Name Address Line 1 Address Line 2 City ...

Full Name in English Address line 1 Address Line 2 Address ...

Full Name in English Address line 1 Address Line 2 Address ...

ORGANISES GURJAR JAIN PARICHAY MILAN IN KUTCH · Boy or Girl Complexion ... Full Address Line 1 Full Address Line 2 Full Address Line 3 Mobile No. Whatsapp No. Email Id Additional

ORGANISES GURJAR JAIN PARICHAY MILAN IN KUTCH · Boy or Girl Complexion ... Full Address Line 1 Full Address Line 2 Full Address Line 3 Mobile No. Whatsapp No. Email Id Additional

Welcome to Fur and Feather Outdoors Nebraska's Premier ......Primary Business Address Your Address Line 2 Your Address Line 3 Your Address Line 4 Phone: 555-555-5555 Fax: 555-555-5555

Welcome to Fur and Feather Outdoors Nebraska's Premier ......Primary Business Address Your Address Line 2 Your Address Line 3 Your Address Line 4 Phone: 555-555-5555 Fax: 555-555-5555

FOLIO / DEMAT ID NAME ADDRESS LINE 1 ADDRESS LINE 2 ...folio / demat id name address line 1 address line 2 address line 3 address line 4 pi ncod div.amount dwno micr period iepf. tr.

FOLIO / DEMAT ID NAME ADDRESS LINE 1 ADDRESS LINE 2 ...folio / demat id name address line 1 address line 2 address line 3 address line 4 pi ncod div.amount dwno micr period iepf. tr.

Effective Quoting

Effective Quoting

Supplier Supplier Name Email Address Address Line 1 ... · PDF fileSupplier Name Email Address Address Line 1 Address Line 2 Address Line 3 Address Line 4 Address ... A00020 British

Supplier Supplier Name Email Address Address Line 1 ... · PDF fileSupplier Name Email Address Address Line 1 Address Line 2 Address Line 3 Address Line 4 Address ... A00020 British