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Brokers

Home /Brokers Portal

Information Last Updated: 7/29/2019

Broker Portal

Click the login button to access your Brand New Day Broker Portal

Broker Portal Login Request

Broker Support

Broker Support Department
marketing@universalcare.com
1-866-255-4795 ext 2018

Additional Benefits

Additional Benefits

Forms and Documents

Enrollment Forms (2019)
Enrollment Forms (2020)
Scope of Appointment (2019)
Scope of Appointment (2020) English | Spanish | Chinese | Korean | Vietnamese
Pre-Enrollment Qualification Assessment Tool for Cardio/Diabetes (for Embrace Plans only) (2019)
Pre-Enrollment Qualification Assessment Tool for Cardio/Diabetes (for Embrace Plans only) (2020)
Post Enrollment Continuity of Care Form (Must be submitted with all Enrollment Forms) (2019)

Post Enrollment Continuity of Care Form (Must be submitted with all Enrollment Forms) (2020)
Brand New Day Agent Manual (2019)
Over-the-Counter (OTC) Order Form (2019) English | Spanish | Chinese | Korean | Vietnamese
Over-the-Counter (OTC) Order Form (2020) English | Spanish | Chinese | Korean | Vietnamese
CMS Form 1696 Appointment of Representation English | Spanish
Online HRA Form

Brokers

Portals

Training

Broker Certification

Resources

Broker Support

1-866-255-4795 Ext. 2018
Marketing@universalcare.com