Contracting Request

UCare AGA Contracting Request
Thank you for your interest in contracting with UCare. AGA is partnered with our Integrity Partner, IFC, for us to offer UCare to our agents. To contract with UCare you must be a MN resident. Once this request form is completed you will be sent a DocuSign from IFC to collect your information, then you will be sent information to contract with the carrier.
Agent Full Name*

First NameMiddle NameLast NameSuffix
Agent Email*
example@example.com
Agent NPN*
UCare is only available for MN residents. You will not be contracted if you reside outside of MN. Confirm you are a MN resident.*

I am a Minnesota resident
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How will your commission be paid?*
Contracting with UCare*

NEW AGENT - I have never been contracted with UCare previously.TRANSFERRING AGENT - I have a current appointment with UCare through another FMO and would like to transfer that appointment under IFC.TRANSFERRING AGENT (Direct) - I have a current appointment direct to UCare and would like to transfer that appointment under IFC.
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UCare AGA Contracting Request