Brokers
Agents/Brokers

myEmblemHealth

FORMS & DOWNLOADS

SELLING EMBLEMHEALTH

Register for myEmblemHealth

Step 1 of 3: Validation

To register, complete the easy three-step process.

NOTE:
To gain access to myEmblemHealth you will need to be a licensed EmblemHealth selling agent and you will need to register. Brokers who are licensed and appointed with EmblemHealth may register immediately. If you are not currently working with EmblemHealth, please contact an EmblemHealth GA representative in your area to get started.

Please enter the following information in order for EmblemHealth to correctly identify you. You will only have to enter this information once.


License Number:   -
Firm Tax ID Number:   -
Social Security Number*:   - -
ZIP code of your primary business address**:  
 

*   required if your firm does not have a Tax ID
**   ZIP code used on EmblemHealth Commission Statement




Please note that EmblemHealth, at its sole discretion, may limit access to this site and the information contained therein. Furthermore, you, as an EmblemHealth Agent, agree to indemnify and hold EmblemHealth harmless for any claims arising out of or relating to the release or modification of information obtained or contained at this site. You agree that access and use of this site is controlled by the terms and conditions set forth in your Agent Contract with EmblemHealth, including but not limited to the Confidentiality of Information provision as well as the terms and conditions of your business associate agreement with EmblemHealth.