Order Supplies

If you are currently an appointed and licensed Agent/Broker of 5Star Life Insurance Company's and would like marketing supplies or application forms, please complete the form below.

If you are not currently appointed and licensed to represent 5Star Life Insurance's Worksite and Group Marketing Division, click here to receive a marketing kit and agent contracting information.

Supply Order Form

Date needed
*Name
Email
Agent Code #
Group Name
Address
Address
City		State Zip
*Phone
*Required Fields		Quantity
#FPP-CI Employee Brochures / Weekly Rates
#FPP-CI Employee Brochures / Monthly Rates
#FPP-TI Employee Brochures
#-Spanish Employee brochures
#Group and Voluntary Group Applications
#-FPP-CI applications		w/ Accelerated Benefit Disclosures
#-Spanish FPP-CI applications		w/ Accelerated Benefit Disclosures
#-Free $1,000 Group Life Applications
#-Employer FPP Payroll Deduction Agrmt
#-Case Information Worksheet
#-Employer Participation Request Form		(For Free Group Life)
#-Employer Group Life and Voluntary Group Life Agreement
#-FPP-CI Paycheck Stuffers
#FPP-TI Paycheck Stuffers
#-FPP-CI Posters
#-FPP-TI Posters
#-FPP Interest Cards (FPP-Int Card)
#-Executive Plan Applications
#-Preferred Rate Check List
#-Executive Level Plan Rate Book
#FPP-CI Employer Presentation
#FPP-TI Employer Presentation

5Star Insurance Company, Phone (877) 940-7200, Email: info@5starima.com