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Broker Forms Library

To help you work with MetLife and deliver on your commitments to your clients, this page provides convenient access to frequently requested broker and customer forms. Just click on the links provided to view and download the appropriate forms, available in pdf format. Submission instructions are also provided for each form.

 

When you have a license from a state to sell insurance and are appointed by MetLife, you need to complete and return a signed Commission Agreement in order to be paid commission. For your convenience, you may sign up for electronic funds transfer (EFT) using the Direct Deposit Authorization form below.

Contact your MetLife representative for additional information about commissions and for assistance in selecting and completing the appropriate commission agreement.

Forms
Submission Instructions
Please send completed form(s) to:
MetLife Institutional Business - Broker
Operations
PO Box 30160
Tampa FL 33630-3160
Fax #: 1-800-556-9430
 

 

When an existing MetLife customer wishes to change their broker of record designation, the request must be submitted in writing by the Customer. The Broker of Record Change Request Template may be used as a guide for the customer. It is acceptable for the original request from the customer to be forwarded by a broker.

Forms
 
Submission Instructions
 

Please send the customer letter, the producer's broker code or Social Security, and your brokerage’s broker code or Tax Identification Number to MetLife by:
Email: broker_change@metlife.com
OR
Fax: 1-800-556-9430
OR
Traditional Mail:
MetLife Sales Compensation Administration Organization
PO Box 30160
Tampa, FL 33630-3160

Best Practices for Submitting a Broker of Record Change Request

In order to expedite processing of a broker change request, the name of the producer, and his or her broker code or SSN should be provided. This is needed even if a brokerage will be paid. MetLife requires that both the producer and brokerage are appointed with MetLife. (See section "Becoming Appointed with MetLife" for instructions.)

Changing Broker Address and/or Address Information

When a broker wishes to change name or contact information, you may let MetLife know by completing the Broker Profile Change Request Form.

Forms
 
Submission Instructions
 

Please send broker profile change requests to:
Email: gbr@metlife.com
OR
Traditional Mail
MetLife Sales Compensation Administration Organization
PO Box 30160
Tampa, FL 33630-3160

 

 

Your clients can elect to give you access to their administrative information on MetLife's online benefits management system - MetLink - by completing and submitting the MetLink User Authorization Form. MetLink puts simplified administrative tools, including enrollment services, claims status and billing access, at your fingertips. Click here for a demo of MetLife's eService options or contact your MetLife representative for more information.

Forms
Submission Instructions
Please send completed form(s) to:
MetLink User Authorization
Attention: Administration
PO Box 14593
Lexington KY 40512-4593
Fax #: 1- 888-505-7446
 

 

To comply with HIPAA requirements on how MetLife may disclose "protected health information" ("PHI") to brokers and consultants concerning customers and/or the insureds, all current brokers who sell Dental or Long Term Care business who have not already signed an agreement containing the privacy and security language, must execute the HIPAA Privacy and Security Business Associate Agreement with MetLife.

By signing, brokers agree to take certain steps and procedures to protect any PHI, including PHI transmitted electronically, that MetLife may share with them. For your convenience, the form, along with a fax cover sheet for submission to MetLife, is provided below.

HIPAA OMNIBUS RULE
Forms
Submission Instructions
HIPAA Privacy and Security Business Associate Agreement Please send completed form(s) to:
HIPAA - MetLife Producer Services
FAX: 1-800-556-9430
 

 

Forms
Submission Instructions
Please send completed form(s) to:
MetLife Dental Claims
PO Box 981282
El Paso, TX 79998-1282
 

 

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When I enter a phone number in the space provided above, I consent to receive phone calls to the phone number I provided, including calls to my wireless phone. I consent to have these calls generated using an automated technology from the MetLife family of companies, or vendors on MetLife's behalf, and that voicemails may be pre-recorded messages. My consent is not required to make a purchase.

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