Broker interest Form

Fill out the form below and select the CareSource-contracted Managing General Agency of your choice in your state of residence. Your information will be sent to the General Agent once submitted below. To learn about our GAs, visit caresource.com/producers/get-contracted and select your state.

Your full legal name, as it appears on your state license

Residence Address
Business Address
 
 
Products of Interest
 
 
 

Other states offer Medicare and Marketplace plans. The state you selected only offers Producers to sell Marketplace plans.

In order to get contracted to sell CareSource health plans in , you must utilize one of our exclusive Managing General Agencies located conveniently across the state of . Please select one of the MGA’s listed here.