Blue MedicareRxSM Referral Program PRODUCER PARTICIPATION AGREEMENTProducer Participation Agreement • September 8th, 2009
Contract Type FiledSeptember 8th, 2009This form is to be completed by licensed producers who are contracted and appointed with Blue Cross and Blue Shield of Texas. If you are a subagent wanting to participate in the Producer Referral Program, the principal of your Agency must complete this form first and you, the subagent, must complete the participation form specifically for subagents. Your participation will not be active until the Agency principal completes this form and identifies you as a subagent.
Blue MedicareRxSM Referral Program PRODUCER PARTICIPATION AGREEMENTProducer Participation Agreement • September 8th, 2009
Contract Type FiledSeptember 8th, 2009This form is to be completed by licensed producers who are contracted and appointed with Blue Cross and Blue Shield of New Mexico. If you are a subagent wanting to participate in the Producer Referral Program, the principal of your Agency must complete this form first and you, the subagent, must complete the participation form specifically for subagents.
Blue MedicareRxSM Referral Program PRODUCER PARTICIPATION AGREEMENTProducer Participation Agreement • September 8th, 2009
Contract Type FiledSeptember 8th, 2009This form is to be completed by licensed producers who are contracted and appointed with Blue Cross and Blue Shield of Illinois. If you are a subagent wanting to participate in the Producer Referral Program, the principal of your Agency must complete this form first and you, the subagent, must complete the participation form specifically for subagents. Your participation will not be active until the Agency principal completes this form and identifies you as a subagent.