Individual Client Referral

Please fill out the fields below and click the “Submit” button at the bottom to refer an individual client. A licensed representative at CAI will contact them directly and assist in enrolling into a health plan. If the client is written, enrolled, and stays enrolled for 3 months, CAI will issue a one time $25 referral fee at the end of the 5th month or 60 days after the qualification period.

    Referral Details

    By typing your signature in the box below and submitting this form, you are waiving BOR status for this client. CAI will be the broker of record for all clients referred, and will issue a one time $25 finder fee to you, the referring broker, if the client is successfully enrolled and remains enrolled for at least 3 months.

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