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AEP 2022 Reporting
*
Indicates required field
Name
*
First
Last
MAPD
*
PDP plans
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Medicare Supplements
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Hospital Indemnity Plans
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AOR
*
Total Medicare Applications
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Did you participate in ACA?
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Yes
No
Referred to other party
ACA applications
*
ACA referrals
*
Life insurance or the other products
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ex: 5/ $2125 AP
Primary marketing source ? Store, etc
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Store? Mail? Events? Past clients?
Years or Selling Medicare?
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1 Year
2 Years
3 Years
4 Years
5+ Years
Did you hit your AEP goals?
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Yes
No
Did not have a goal
What would you change for next AEP?
*
How can SBC help you for 2021?
*
Submit
