Thank you for your interest in selling Humana

Are you a licensed insurance agent looking to contract directly with Humana? Please take a moment to fill out this simple form to help us get to know you.

This form is for agents. If you are a consumer looking for answers, get help here . 

Required fields

1. Tell us about yourself

First name
Last name
Email
Phone number
City
Zip code
State
County
Agency name
Number of agents
1 - 2425+
Languages spoken
English
Spanish
Cantonese
Mandarin
Korean
Tagalog
Vietnamese
Other
Do you currently have an active health/life license?
YesNo
Are you a Veteran?
YesNo

2. Tell us what you're interested in

I'd like to know more about:
Individual Dental and/or Vision
Medicare
Group
Other/Additional questions (please tell us more below)
Other comments

3. What brings you to Humana?

Enter response here
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