2010 Start-Up Instructions. Fax all completed forms to: Barbara Thompson at

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1 11551 Forest Central Ste. 200 Dallas, TX Toll Free (800) Fax (214) Start-Up Instructions Please complete, sign, and return ALL the attached forms: Marketing Agreement Credit Card Authorization Cooperative Agreement Start Up Fee Options Lead Deduction Authorizations (4) Americo Royal Neighbors United Home Life American Amicable Agent Territories EFES ID Badge Request Business Card Order Form PPL Agent Guidelines CC Decline Procedures EFES Hotline Numbers Texas Tax Exempt Form Marketing Authorization Fax all completed forms to: Barbara Thompson at Urgent: Please do not fax contracting papers to and do not fax this start up kit to the contracting office. This will create timely delays in the process. Page 1 of 19

2 EFES Start Up Fee Options I, (agent name), authorize EFES to charge the credit card listed on credit card authorization form $ for start up package (circle one) 2-Star 3-Star 4-Star Signature: Date: 2-Star Package - 15 Direct Mail Leads at $24 each $360 Photo ID Badge & Business Cards $ 35 Total Package $395 3-Star Package - 35 Direct Mail Leads at $18 each $630 Photo ID Badge & Business Cards $ 35 Total Package $665 4-Star Package - Best Value! 80 Direct Mail Leads at $16 each $1,280 Photo ID Badge & Business Cards $ 35 Total Package $1,315 Page 2 of 19

3 Marketing Agreement This Agent Agreement (this Agreement ) is entered into as of the date specified herein by and between EQUITA FINAL EXPENSE SERVICES ( Equita ), and the undersigned (herein sometimes You or Agent ). 1. Agent Responsibilities. You agree to: 1.1 Agent agrees to purchase leads from Equita at a cost determined by agent s PPL See attached scale for details. 1.2 Agent authorizes Equita to charge a credit card for the cost of the leads and agrees to provide sufficient credit card information in order to facilitate that charge, such as credit card account number, expiration date, credit card mailing address, etc. Lead charges will be processed every Wednesday for all leads provided to Agent during the previous calendar week. 1.3 Agent agrees that he/she will not receive any future leads if credit card charges are declined or credit card transaction is not approved for any reason. If card declines, Agent must pay balance before he/she receives more leads. 1.4 Agent agrees to write all insurance business generated from Equita leads with carriers contracted through Equita. 1.5 Agent agrees to 15 lead a week minimum for at least 4 weeks. Max of 30 leads a week. I, agent agree to leads for 4 weeks. 1.6 Agent must provide 2 weeks notice in writing if they wish to discontinue the lead program. Upon termination by Agent, all leads returning from mail sent specifically for Agent must be purchased by Agent at a cost of $34 per lead. 2. To take advantage of this program, Agent must complete all pages of the start up kit and return to EFES. 2.1 Start up fee and any leads assigned are nonrefundable. Agent Approval: Print Agent Name Agent Signature Date Page 3 of 19

4 Start Up Kit Credit Card Authorization Form I hereby authorize Equita Final Expense Services to charge my card for Final Expense Leads distributed to (agent name). This authorization is for: Recurring unless I notify EFES to discontinue using my card for above mentioned leads Cards accepted by EFES: Visa, Master Card, American Express Card Type (please circle one) Visa Master Card American Express Card Number CVV Number* Expiration Date: * The CVV must be provided for fraud protection. On MasterCard or Visa, the CVV is a 3-digit number above the signature line, following the credit card number on the back of the card. For American Express use the 4-digit number printed on the front of the card above the credit card number. PRINT Name as it reads on the credit card: Company (if any) as it reads on the credit card: Current Billing address (including phone number and zip code) for this card: Street Address: City, State, Zip: Billing Phone: address for receipt: I am an authorized signer on this credit card account. I understand that the payment is non-refundable. Printed Name of Signer Authorized Signature Date Please include a copy of the front and back of the card for signature verification and fax along with this completed credit card authorization form Forest Central, Ste. 200 Dallas, TX Phone: Fax: Page 4 of 19

5 Lead Program Cooperative Agreement The undersigned agent hereby agrees to comply with all terms and conditions of Lead Program Cooperation Agreement with Equita Final Expense Services (EFES). I understand that this is a cooperative agreement that allows me to purchase leads at a discounted price. For and in consideration of such discount, I agree to place all business generated from EFES leads with companies with which I am contracted through EFES, and with insurance company agent writing numbers affiliated with EFES. In further consideration for the discounted price for leads from EFES, I agree not to contact any prospects or clients provided to me by EFES for two years from the date of initial contact, other than to service such clients if I am noted as agent of record; and I agree not to solicit such clients to terminate any policy which was sold to them. I also agree that I am fully responsible for all business I submit to all insurance companies and I indemnify and hold EFES harmless from and against any and all losses, liabilities, damages, costs, fees, and expenses which EFES may suffer or incur arising or resulting from any claim, action or proceeding involving my activities. The undersigned agent agrees that if I violate any of the terms or conditions of the EFES Lead Program I will be retroactively charged, to the date of this agreement, a retail price of $34.00 per lead for all leads purchased at the discounted price. This retroactive charge will be due immediately, and I could be terminated with cause from the Lead Program Co-op. Printed Name of Agent X Agent s Signature DATE: X Eric Brennan, CMO DATE: /SP/14698/0107/ Page 5 of 19

6 11551 Forest Central Ste. 200 Dallas, TX Toll Free (800) Fax (214) Credit Card Declines Outstanding Lead Debt Procedures Weekly lead charges are automatically charged to the credit card on file each Wednesday Bonus leads are always prepaid Start up fees, bonus leads, and A lead charges can be made any day of the week Credit Card Declines Agent is notified immediately, via system generated , of credit card decline In the event that the weekly charge is declined or you have a past due amount, you authorize EFES to charge a partial payment amount at any time Agent should contact Debt Management at extension 222 to receive an EFES Payment Arrangement form Agent is locked out of EFES website/lead Center until payment arrangement form has been completed, received by EFES, and approved by EFES Management Access will not be reinstated until payment has been received New A Leads will not be assigned until payment is received for outstanding balance If payment is not received within 2 weeks (from initial charge decline) agent will be sent over to Carriers to have their commissions redirected to EFES until the lead debt is satisfied If a payment arrangement is not followed properly, agent will be immediately turned over to Carriers and their commissions will be redirected to EFES until the lead debt is satisfied. Agent Signature: Date: Page 6 of 19

7 Lead Program Authorization Americo Financial Life and Annuity Insurance Company Administrative Office: P.O. Box Kansas City.M Home Office: Dallas. Texas The Undersigned (Agent) duly licensed to solicit insurance sales on behalf of Americo Financial Life and Annuity Insurance Company (hereinafter, the "Company"), does hereby state as follows: 1. That the Undersigned hereby transfers, sets over and assigns, subject to acknowledgement by the Company, unto (hereinafter, "Assignee") an amount equal to % of commissions earned and payable per pay cycle for the purchase of mailings for mortgage reply leads and lead mail order drops. The Undersigned understands and agrees that this Assignment, and the rights assigned hereunder, shall be subject and subordinate to (i) any present indebtedness or any which may hereafter accrue or be due and owing the Company, and (ii) all the terms and conditions of his/her agent agreement with the Company. This Assignment relates only to Agents Number(s). 2. That the Undersigned hereby represents and warrants that said commissions and allowances are not subject to any other assignment, and the Undersigned will forever warrant and defend his/her right to receive same, this instrument to remain in full force and effect until released by an instrument in writing signed by Agent and an authorized representative of his/her Independent Marketing Organization (IMO), and acknowledged in writing by the Company. 3. That the Undersigned acknowledges that this Assignment is strictly voluntary, and authorizes and directs the Company to pay over such commissions and allowances to said Assignee subject to the conditions hereof, and it is agreed that any payment so made will be a full and complete discharge of the Company's obligation to the agent to the extent of any payment so made. The Undersigned hereby waives any and all rights to claim from the Company any amounts paid by the Company to Assignee hereunder. 4. This Assignment shall be binding upon the heirs, successors, and subsequent assigns of, or any other party claiming through or under, the Undersigned. 5. This Assignment will not be effective until signed by an authorized representative of the Undersigned's IMO and approved and processed by the Company. This Assignment will terminate upon the termination of the Undersigned's agent agreement with the Company. 6. That the Undersigned holds the Company harmless for any unintended use of the commissions hereby assigned after such commissions have left the Company's control. 7. The tax consequences pursuant to this Assignment shall be coded to the Undersigned. IN WITNESS WHEREOF, this Assignment was made effective this day of,. Agent Signature Date IMO Signature Date Authorized Americo Signature Date Page 7 of 19

8 LEAD GENERATION LIEN AGREEMENT The agreement is entered into between Equita Final Expense Services (EFES) and (Agent) is entered into this day of,. EFES and Agent have entered into an arrangement where EFES sells to Agent insurance sales leads in exchange for payment by credit card or check. The parties agree that there may occasionally be circumstances where there exists an outstanding balance owed by Agent to EFES. In consideration of EFES agreeing to permit Agent to purchase leads from EFES, EFES and Agent agree as follows: 1. Agents pledges and assigns all of his right title and interest in and to any commissions, fees, bonuses or other forms of payment Agent is or may be entitled to receive from any insurance company or fraternal benefit society ( Company ) that Agent currently is or may at any time in the future be appointed under the EFES hierarchy. 2. Agent authorizes EFES to notify any Company from which Agent is currently receiving or may become eligible or entitled to receive commissions or other payments of the amount of any outstanding obligation Agent owes EFES for sales leads. 3. Agent authorizes EFES to collect all commissions or other payments due from any Company until such time as EFES is reimbursed for all obligations Agent owes EFES for sales leads. 4. EFES agrees to immediately notify Company as soon as any outstanding obligation is satisfied. 5. Agent agrees that any Company owing Agent money may rely on representations by EFES as to the amount owed by Agent. Agent agrees to hold such Company harmless from any claims Agent might have to any moneys owed from Company if Company makes payment to EFES in reliance on representations made by EFES. Agent further agrees to indemnify Company from any claims by any third party claiming a right to any funds paid by Company to EFES pursuant to this agreement. 6. Agent may immediately terminate this agreement at any time by notifying EFES of Agent s intent to terminate in writing and delivery the same to EFES by certified mail or facsimile transmission as to the effect date of such termination. The termination will be effective only as to any future leads provided by EFES and will not affect the validity of the lien as to any outstanding obligations for leads previously provided by EFES to Agent. Company will not be obligated to honor such termination unless and until 10 days after written notice has been delivered by Agent to Company, such notice to be sent by certified mail or by facsimile transmission. By Date EFES AGENT Page 8 of 19

9 American Amicable Group of Companies Lead Deduction Authorization Please fax completed form to Equita Final Expense I agree that I am liable to Equita Group for the cost of leads provided to me by their lead source. I authorize the American Amicable Group of Companies to debit my account(s) for the cost of these leads and deduct that amount from my advances and/or commissions. Any dispute involving particular invoices must be resolved with Equita Group and not American Amicable Group of Companies. Please hold % of my advances and/or commissions and forward to Equita on a weekly basis. This authorization will remain in force until written notification is sent to Equita and American Amicable Group of Companies. Agent code # Agent Signature Date Page 9 of 19

10 P.O. Box 7192 Indianapolis, Indiana Phone Agent Commission Deduction Agreement I agree that I am liable to Equita Final Expense Services for the cost of leads provided to me by their leads source. I understand that United Home Life Insurance Company is not responsible for lead generation and any disputes that may arise must be resolved with Equita Final Expense Services and not through United Home Life Insurance Company. I agree to allow United Home Life Insurance Company to deduct % of my commissions as they are generated and forward them to Equita Final Expense Services. I understand that United Home Life Insurance Company will only deduct commissions when my lead payments have become delinquent and once notification from Equita Final Expense Services is received. This authorization will remain in force until written notification is sent to Equita Final Expense Services and United Home Life Insurance Company. Agent Code: Agent Signature: Date: Fax Page 10 of 19

11 11551 Forest Central Ste. 200 Dallas, TX Toll Free (800) Fax (214) Agent Territories Agent Name: address: Contact phone: Mailing address: Field Manager s name: # of Leads committed to weekly (please circle): National Sales Marketer (please circle): Ryan Caras Chase Urich Pam Godoy Robert Bridges Counties in order of mailing preference: 1) 9) 2) 10) 3) 11) 4) 12) 5) 13) 6) 14) 7) 15) 8) 16) EXCLUDE specific zips: 1) 11) 2) 12) 3) 13) 4) 14) 5) 15) 6) 16) 7) 17) 8) 18) 9) 19) 10) 20) Page 11 of 19

12 example: Equita Final Expense Services Business Card Order Form Please PRINT your information below to receive your file: Name: as you want it to appear on your card (Print Legibly) Title: Suggestions: Final Expense Representative, Senior Life Specialist, Senior Planner Address: Use EFES Address (11551 Forest Central Dr. Ste 200, Dallas, TX 75243) OR Provide your own below Address1: Address2: Address3: (City, State, Zip) CA Agents Only Insurance License # Local Phone Number: Is this Office (O) or Cell (C)? Corporate: Ext. Our toll free number is required. You do NOT need to have an extension. If a client calls for you we will take a message and contact you. Do you want Cell Number on your card? Y / N If yes include number Fax Number: Include address on your card? Y / N If yes, please provide: Website address included on card: Y / N Page 12 of 19

13 11551 Forest Central Ste. 200 Dallas, TX Toll Free (800) Fax (214) EFES ID Badge Request (included in start up fee) Name: Title: (Recommended Title: Final Expense Specialist, Senior Planner) State(s) you are licensed in: Insurance license number: Yes, I want to include my photo [recommended] Please photo in.jpg format to s.spence@equita1.com If your photo is not received we will process your badge request without a photo. No, I do not wish to include a photo Page 13 of 19

14 PPL Agent Guidelines ** Premium Per Lead Forest Central Suite 200 Dallas, TX Toll Free (800) Fax (214) Premium Per Lead Lead Cost $200 + $11 $180 $199 $13 $160 $179 $14 $140 $159 $15 $120 $139 $16 $110 $119 $18 $100 $109 $20 $90 $99 $22 $80 - $89 $24 $70 - $79 $26 $0 - $69 $28 Based on a 3 month rolling average and 80% placement Minimum 15 leads per week $3000 maximum credit per application To qualify for $11, $13, $14, $15, $16, and $18 leads agents must have a minimum of 80 leads within the 3 month running average Applies to internet and direct mail leads Platinum, Gold, Silver, and Bronze Leads do not count towards your PPL (great way to increase your PPL) Monthly-Direct billing mode does not count towards your premium ** At any time this program may be discontinued and EQUITA FINAL EXPENSE SERVICES reserves the right to modify the terms and conditions of this program including, but not limited to, the standards and levels of eligibility, and rates of lead costs. Page 14 of 19

15 11551 Forest Central Ste. 200 Dallas, TX Toll Free (800) Hotline Numbers or Marketing Staff Eric Brennan Fax: x 212 President Ryan Caras Fax: Chase Urich Fax: Pam Godoy Fax: Robert Bridges Fax: John Patton Fax: Barbara Thompson Fax: Jessica Schulz Fax: x 264 x 251 x 214 x 306 x 235 x 222 x 256 Marketing Director - EFES Marketing or product related questions, lead distribution, and bonus leads National Sales Manager Marketing or product related questions, lead distribution, and bonus leads EFES Marketer Marketing or product related questions, lead distribution, and bonus leads EFES Marketer Marketing or product related questions, lead distribution, and bonus leads Project Manager & Agent Mentor General questions, blasts, marketing communications New Agent Processing / Debt Management Lead accounting, lead balances, lead credits, collections, Start Up Kits Lead and Territory Manager Agent Territory or Lead Questions Administrative Staff Tony Micheletti Fax: t.micheletti@efesonline.com Tammy Johnson Fax: t.johnson@efesonline.com Michele Piper Fax: m.piper@efesonline.com Nicki Hiesler Fax: n.hiesler@efesonline.com x 211 x 215 x 251 x 248 Director of Staff Operations Manager of New Business, Contracting, Commissions, Supplies, IT, Print Shop New Business Final Expense Underwriting and new business questions New Business Final Expense Underwriting and new business questions New Business Final Expense Underwriting and new business questions Page 15 of 19

16 Melissa Prentice Fax: Nicole Martin Fax: Sharon Spence Fax: x 254 x 297 x 213 Commission/Licensing/Contracting Contracting and commission questions Administrative Assistant Contracting and commission questions Supply Coordinator Writing supplies, business card, and ID badge request Page 16 of 19

17 11551 Forest Central Ste. 200 Dallas, TX Toll Free (800) Fax (214) Texas Tax Exempt Form Under Texas laws, Equita Final Expense Services must collect Texas state and local sales taxes on lead sales unless the purchaser provides a valid Texas Sales Tax Exemption Certificate by January 1, The Exemption only applies to agents in one of the following: - Any agent with an address outside of Texas and does not work leads in the state of Texas. - Any agent with a Texas address and works leads outside of Texas. Be advised, however, that if you do not return this form prior to your first invoice, you will be charged Texas Sales Tax on all leads purchased from Equita Final Expense Services. The form can be located at: If you have any questions regarding this form, please consult with your own tax adviser. Page 17 of 19

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19 I,, authorize EFES Print Agent Name to send me marketing and other promotional materials electronically. These methods may include: Direct EFES communication, 3 rd party Marketing companies on behalf of EFES, Text Messaging, and Blasts. My contact information is (Please PRINT): Address: Mobile Number: ( ) Agent Signature: Date: Forest Central Dr. Suite 200 Dallas, TX x Page 19 of 19