GeoBlue | International Travel Health Insurance

Agent Sign Up

Meet a growing market's needs with GeoBlue highly competitive products, marketing services, attractive commissions and incentive programs.
When you sign up with us, you immediately receive unique web links that track online sales via your agent account. These links can be added to your website or emailed to customers. These links will point into our individual product web site located at www.hthtravelinsurance.com (gateway to all HTH Worldwide and GeoBlue plans) or www.geobluetravelinsurance.com (gateway to GeoBlue plans only).
You will also receive a unique 6 digit Agent ID number. This number should be included on all brochures mailed from your office. This unique number allows us to accurately track all paper enrollments received via your account.
To get started, please review and accept the terms of the Worldwide Insurance Services LLC Agency Agreement below. This agreement shall commence and becomes effective upon your initial sale of an insurance product listed on the Compensation Schedule below.
Agency Agreement

        	AGENT OR AGENCY AGREEMENT

	
	This Agreement ("Agreement") between ("Agent" or “Agency”) and Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York) ("Company"), sets forth the terms and conditions under which “Agent” and “Agency” shall perform certain services for the Company.  The designations “Agent” and “Agency” shall be interchangeable based upon the contracting party designated by signature below. Agent and Company may also be referred to individually as a “party” and together as the “parties.”

1 	APPOINTMENT

1.1 	The Company hereby appoints Agent (and any of its Producers/Sub-brokers if Agent is an Agency) to solicit, at its own expense, new and renewal applications for insurance contracts ("Policy" or "Policies") as listed in Schedule A, as amended from time to time. 

2 	DUTIES OF AGENT 

2.1 	If Agent is Agency, then it shall be responsible for assuring that all of its Producers comply with the following duties as well as the Agent.

2.2 	Agent will comply with all laws and regulations which relate to this Agreement and shall indemnify and hold the Company harmless for its failure to do so.  Agent shall maintain in good standing, at its own cost, licenses required by all applicable statutes and regulations.  Agent shall provide copy(ies) of its current license(s) to the Company.  Upon Agent's loss or failure to procure and maintain such licenses as may be required by law, this Agreement shall terminate automatically in accordance with paragraph 7.3. Agent shall comply with all appointment requirements of the underwriters of any of the products set forth on Schedule A.  If Agent is a business entity, Agent shall ensure all of its employees who sell Company’s products are properly licensed and appointed, including appointments to Company’s underwriters, a State Department of Insurance, a supervising agent, or any other person or entity as required by applicable law or statute.  Agent agrees to participate in training activities as requested by Company to maintain current knowledge of Company’s products, guidelines, and administrative procedures.

2.3 	Agent may not waive any provision of the Company's underwriting standards or the insurers’ underwriting standards without the Company's express prior written authorization.  Any questions about the Company's underwriting standards shall be referred to the Company. 

2.4 	Agent will comply with the Company's rules and regulations relating to the preparation of proposals and the completion and submission of applications.  As a material part of the consideration for the making of this Agreement by the Company, Agent agrees that there will be made no representations whatsoever with respect to the nature or scope of the benefits of the Policies sold except through and by means of the written material either prepared and furnished to Agent for that purpose by the Company or approved in writing by the Company prior to its use.  Agent shall have no authority and will not make any oral or written alteration, modification, or waiver of any of the terms or conditions of any Policy whatsoever.

2.5 	Agent warrants that Agent will diligently and to the best of its ability ensure that the facts set forth by any applicant in any application it solicits are true and correct.

2.6 	Agent will conduct itself so as not to affect adversely the business, good standing, and reputation of the Company.

2.7 	BlueCross BlueShield Association (BCBSA) owns the BLUE CROSS®, BLUE SHIELD® and GeoBlue® word and design marks, among others (“Brands”).  Company is an independent licensee of BCBSA and authorized to use the Brands, working in collaboration with BCBSA’s Member Plans, subject to Company’s license agreement with BCBSA and BCBSA’s Brand Regulations (“Brand Guidelines”), attached hereto as Schedule B, and as revised from time to time by Company and made available to Agency.   

Agency warrants and represents that it will not use the Brands, or any other trademark owned by BCBSA, and shall not make any reference to BCBSA or BCBSA’s Member Plans in any way (e.g., in Agency’s advertising, letterhead, symbol or logo, business or product name, press releases, customer lists). Subject to the paragraph below, Agency shall also not use GeoBlue® word and/or design marks (trademark or service mark) without the explicit approval of Company. 

The use of the Brands is subject to Agency correctly using the Brands as directed by Company and in accordance with the Brand Guidelines.  Company has the right to monitor use of the Brands, and if Company determines at any time in their sole discretion that Agency’s use is inaccurate, misleading, inappropriate for any reason, or that Agency is no longer entitled to use the Brands, Company will notify Agency, and Agency agrees that it shall immediately remove, or change in accordance with Company’s request.    

Upon request of Agency during the term of this Agreement, the Company shall make available for Agency’s use, standard advertising prepared for the Company.  Agency may add, at Agency’s expense, to the standard advertising only its business name, business address, agency number and telephone number, as provided for in the advertising, in compliance with BCBSA’s regulations.  No deletions or changes in the advertising copy are permissible.
 
Company may furnish Agent a URL link(s) to Company’s products that shall display Agent’s name and contact information, and shall be embedded with the unique identification number Company has assigned to Agent.  Agent may post this URL link(s) on its proprietary Web pages that are designed for offering, disseminating, and selling health insurance products.  Agent may not send said URL link(s) to any third party, or otherwise facilitate said URL link(s) being posted on a third party’s Web page, or post said URL link(s) on any proprietary Web page of Agent not designed for offering, disseminating, or selling health insurance products, without written consent of Company.

2.8	Agent shall act solely as an independent contractor, and as such, shall control in all matters its time and effort in the placement of the Policies offered hereunder.  Nothing herein contained shall be construed to create the relationship of employer and employee between Agent and Company.
	
2.9	Agent shall indemnify, defend and hold Company, its parents, subsidiaries, and affiliated and related companies, and the directors, officers, employees, agents and representatives of each of them (the “Indemnified Parties”) from and against any and all liabilities, obligations, demands, causes of action, claims, judgments, settlements, losses, damages, injuries, costs or expenses (“Losses”), relating either directory or indirectly to, or arising from, Agent’s business, activities,  and operations, including but not limited to any unauthorized act or transaction (including Agent’s unauthorized use or misuse of the Brands), negligent act, or omission.  Company shall, at its option, control on behalf of the Indemnified Parties the defense or settlement of any third-party claim, or have Agent control the defense or settlement, using counsel approved in writing by Company.  In either case, Agent, as the indemnifying party, shall bear all costs and expenses of the defense or settlement (including, without limitation, reasonable attorney’s fees, costs and expenses) as and when they are incurred.  In the event that Agent shall have control of the defense or settlement of a third-party claim, the Indemnified Parties shall have the right to participate in such defense or settlement with counsel of Company’s choosing.  To the extent Agent controls the defense or settlement of any third-party claim, Agent shall make no settlement without the written consent of Company.

      	COMPANY MAKES NO WARRANTIES, EXPRESS, IMPLIED OR ARISING BY CUSTOM OR TRADE USAGE HEREUNDER (INCLUDING WITH REGARD TO THE BRANDS) AND, SPECIFICALLY, MAKE NO WARRANTY OF ADEQUACY, MERCHANTABILITY, OR FITNESS FOR ANY PARTICULAR PURPOSE. COMPANY SHALL HAVE NO LIABILITY FOR CONSEQUENTIAL, SPECIAL, OR PUNITIVE DAMAGES HEREUNDER, INCLUDING BUT NOT LIMMITED TO THE COSTS OF DESIGNING, PRODUCING AND DISTRIBUTING AGENT’S ADVERTISING AND MARKETING MATERIALS.  

2.10	Agent shall maintain in force insurance coverage against wrongful acts and errors and omissions of Agent, its agents and employees with respect to the services performed hereunder. Such insurance coverage shall be in the amount of at least $100,000 for the sale of individual plans listed on Schedule A and at least $250,000 for the sale of group plans listed in Schedule A.”

2.11	Agent shall promptly prepare and transmit to the Company, in a format acceptable to the Company, such 
reports as the Company may reasonably require from time to time, including reports of all information necessary for the Company to comply with all applicable laws, rules, and regulations or to manage its business.

2.12 	Whenever any activity under this Agreement would cause a producer to be considered a “Business Associate” as defined in 45 C.F.R. section 160.103, the following restrictions in conjunction with any additional statutory requirement will apply to all uses and disclosures of all Protected Health Information:

2.12.1   Business Associate shall not use or further disclose Protected Health Information other than as permitted or required by this Agreement or as Required By Law.  Business Associate shall not sell Protected Health Information.  Business Associate shall not use or disclose Genetic Information except as permitted by 45 C.F.R. § 164.502(a)(5)(i).
2.12.2 Business Associate shall use appropriate safeguards to prevent use or disclosure of Protected Health information.
2.12.3 Business Associate shall comply with the Security Rule, including developing and implementing written information security policies and procedures.
3 	DUTIES OF THE COMPANY

3.1 		The duties of the Company shall vary depending upon the specific product being sold by Agent.  For all products, the Company will provide approved brochures and other approved marketing materials for sales campaigns.  The Company will deliver to the customer all insurance policies, certificates and related correspondence or similar documents, in accordance with Company procedures.  The Company shall respond in a reasonable and timely manner to inquiries and questions about the product.  The Company shall maintain reasonable accounting, administrative, and statistical records in accordance with prudent standards of insurance record keeping, including premium, sale or effective date, and any other records needed to verify coverage, pay claims, or underwrite the company insurance products, of any insured participant covered under the policies.


4 	RESERVATION OF RIGHTS

4.1 	The Company reserves the right to reject any and all applications for its Policies submitted by Agent.

4.2 	The Company reserves the right to discontinue writing or offering any of the Policies which are or become subject to this Agreement upon sixty (60) days notice to Agent (or the number of days required by law in the Agent's state of domicile).

5 	MAINTENANCE OF RECORDS

5.1 	Company and Agent each shall maintain at their respective principal office, for the duration of this Agreement and for ten (10) years thereafter, a system of files containing this Agreement and books and records of all transactions relating to this Agreement, including records of transactions with individual insureds.  These books and records shall be maintained in accordance with prudent standards of insurance record keeping.

5.2 	The Company, its employees, or authorized representatives may have unrestricted access to records for the Policies, and may audit, inspect and examine at reasonable times, upon reasonable notice and during regular business hours at Agent's place of business, all books and records, and may obtain copies of such books and records at its own expense.  Company and Agent acknowledge that each shall accept automated files in lieu of hard copy files as permitted by law.

5.3 	Agent shall fully cooperate with any audit or examination by any Department of Insurance or other authorized agencies and shall allow access to books and records maintained by either of them pursuant to this Agreement.  Each shall notify the other within one [1] business day of any such audit or examination.

5.4 	All information related to Policies underwritten by Insurers and persons covered by those Policies, including, but not limited to, lists of insureds' names, addresses, other relevant information, applications, master policies, files, documents and correspondence are the property of the Company subject at all times to its control.  Sales literature, computer software and other property, tangible and intangible, which the Company furnishes to Agent, are the property of the Company subject at all times to its control.  Any materials prepared by the Company which relate to Polices underwritten by an Insurer shall be subject to the Company's control.  All property of the Company shall be returned to or provided to it upon its written request.  If Agent's ability to perform under this Agreement shall be affected by the return of such property, then it shall not be held in breach for its failure to perform resulting from such return.  Except as provided in paragraph 5.5, Agent may not duplicate the Company's materials or use them in any way other than as authorized by the Company and shall secure the Company's approval prior to releasing any information contained in this property to parties outside this Agreement.

5.5 	During the term of the Agreement, any extensions of it and for three (3) years thereafter, the Company shall keep strictly secret and confidential any Confidential Information about Agent, and Agent shall keep strictly secret and confidential any Confidential Information about the Company.  "Confidential Information" shall include information, written or unwritten, which pertains in any way to financial or accounting matters, business production, methods of business operations, marketing, strategic planning or proprietary information of any kind or nature whatsoever, including trade secrets or know-how.  Confidential Information does not include information that: (i) is already known to the recipient at the time of disclosure to it; (ii) is in the public domain or subsequently becomes publicly available; (iii) is provided to the recipient by a third party who is under no such obligation of confidentiality; or (iv) is independently developed by the recipient.  Each party shall take necessary and reasonable precautions to prevent unauthorized disclosure of Confidential Information and shall require all of its officers, employees, and other personnel to whom it is necessary to disclose the same, or to whom the same has been disclosed, to keep this Confidential Information secret and confidential.  It is understood, however, that certain "Confidential Information" may be required to be filed with State and Federal regulatory agencies in accordance with their reporting requirements.  Neither party shall make use of the name or service mark(s) of the other, including use of the name or service mark(s) of any marketing, enrollment, or other public relations material without prior written approval of the other party.

5.6 	Agent recognizes that in the performance of its obligations under this Agreement, it may be party to confidential information about individuals covered by Policies underwritten by an Insurer.  Information that identifies an individual covered by the Policy is confidential.  During the time confidential information is in Agent's custody or control, it shall take all reasonable precautions to prevent disclosure or use of the information for a purpose unrelated to administration of insurance benefits.  Agent may disclose confidential information only:

5.6.1 	in response to a court order;

5.6.2 	for an examination conducted by the Commissioner of Insurance;

5.6.3 	to the other party; or

5.6.4 	with the written consent of the identified individual or his or her legal representative.

6 	COMPENSATION

6.1 	Compensation for each policy written hereunder shall be made by the Company to Agent in accordance with Schedule A, attached hereto and incorporated herein by reference.  The Company shall not be liable for any payments due to agents of Agent during the term of this Agreement or thereafter.

6.2 	Compensation due under this Agreement shall be paid to Agent within 30 days from the end of each calendar month in which the Company receives premium with respect to its Policies or as may otherwise be agreed upon in writing.  Company has the right to adjust Compensation during the term of this Agreement.  

6.3 	A party shall have a lien and right of offset on all sums payable hereunder or otherwise for any debt due from the other party or the other party's agents.  Indebtedness under this Agreement or under any other agreement between the parties shall constitute a general indebtedness survive the termination of this Agreement.  A party shall not be limited to recovery of payment of this indebtedness from sums payable under this Agreement.

6.4 	Under all circumstances, the Company shall have the right to offset overpayments to Agent against amounts due to Agent.

6.5         In case of breach of this Agreement, including breach through  misuse of Brands as stated herein, Company reserves the right, upon notice to Agent, to withhold any compensation due to Agent, until Company determines that such breach has been rectified.  

7 	EFFECTIVE DATE, TERM AND TERMINATION

7.1 	This Agreement shall commence on the effective date first stated above and shall continue in force until terminated pursuant to this Article.

7.2 	Except as otherwise provided herein, this Agreement will begin on the effective date and terminate twelve (12) months thereafter, at which time it will automatically renew for subsequent one (1) year periods unless either party gives written notice a least sixty (60) days prior to termination date or unless otherwise terminated as provided herein.  The parties expressly agree that subject to the provisions of paragraph 7.3 and 7.4, any termination of this Agreement will not in any fashion terminate the obligations of the parties with respect to business written during the term of this Agreement.  Subject to the above, the obligations of the parties with respect to such business shall remain in full force and effect until the cancellation or termination date of any such Policy.	

		

		Notice, as provided herein, is to be sent to:

			If to the Company:

Worldwide Insurance Services, LLC
				933 First Ave
				King of Prussia, PA 19406

			If to the Agent (Midwest Insurance Brokerage Service Inc.):
			
				Agent or Agency Name
				Address
				City, State, ZIP
				Contact Name
				Phone Number
				Fax Number
				Email
				Website (if applicable)

	
	All notices given under this Agreement must be in writing and sent via a verifiable method to the party receiving notice at the address indicated above or such address as may have been communicated most recently in writing to the sending party.

7.3 	This Agreement will terminate automatically upon the occurrence of any of the following events, and upon such occurrence the parties shall be obligated to make only those payments the right to which accrued to the date of termination:

7.3.1 	Suspension or revocation of a party's license(s) in any state(s) in which both parties are working together;

7.3.2 	Conviction of a felony by Agent and/or its employees;

7.3.3 	Sale or transfer, or other substantial changes are made in the ownership of Agent's Agency;

7.3.4 	Cancellation or expiration of Errors and Omissions insurance required of Agent by this Agreement;

7.3.5 	Misappropriation (or failure to remit) any funds or property due the Company from Agent;

7.3.6 	Determination that Agent is not in compliance with Company underwriting guidelines or the terms of this Agreement and Agent has failed to correct the problem within 10 days of the Company providing written notice of same;

7.3.7     The filing of a petition in bankruptcy by a party or commencement of any voluntary insolvency proceeding;

7.3.8      The filing of an involuntary petition in bankruptcy or commencement of any involuntary 
 		insolvency proceeding not cured by dismissal by the party within sixty (60) days of filing.
     
7.4	In the event of a breach by Agent of this Agreement, Company may terminate the Agreement immediately without liability upon notice to Agent.  Agent will immediately cease all use of the Brands.  Agent acknowledges that a breach of Section 2.7 could have a material and adverse effect upon Company, that damages arising from such breach may be difficult to ascertain and, without limiting any other right or remedy, at law or in equity, to apply for immediate injunctive relief and specific performance without any requirement to post a bond or other security.  Unless otherwise stated in this Agreement, upon such occurrence, Company is obligated to make only those payments the right which accrued to the date of termination. 

8	GENERAL PROVISIONS

8.1	Failure of either party to insist upon the performance of any of the terms of this Agreement or to declare a  
forfeiture or termination in the event of non-performance by the other party shall not constitute a waiver   of performance required hereunder.

8.2	No assignment, transfer or disposal of any interest that a party may have pursuant to this Agreement shall    be made at any time without prior written approval of the other party. Notwithstanding the foregoing, Company may assign any and all interests under this Agreement to a parent or affiliate, or due to merger or acquisition without the consent of Agent.

8.3       This Agreement shall be binding upon the administrators and executors, successors and permitted   
            assignees of the parties hereto.

8.4	No Amendment or modification of this Agreement shall be valid, or of any force or effect, unless the
same be in writing and acknowledged and signed by the Company and Agent subject to the Notice provisions as set out in paragraph 7.2.  Notwithstanding the preceding sentence, Company reservices the right to unilaterally modify its Brand Guidelines and Compensation, pursuant to Sections 2.7 and 6.2 of this Agreement.

8.5 	Any disputes, claims or counterclaims arising from or relating to this Agreement shall be subject to and 
shall finally and exclusively be resolved by a single arbitrator in binding arbitration administered in accordance with the rules of conciliation and arbitration of the American Arbitration Association in force as of the date hereof (the “AAA Rules”). The place of arbitration shall be Philadelphia, Pennsylvania.   The costs of arbitration shall be borne equally by the parties.

8.6	This Agreement shall be construed for all purposes and shall be interpreted and enforced in accordance 
with the laws of the Commonwealth of Pennsylvania, without regard to principles of conflict of law that would require a different result. The parties agree the site of this contract is the Commonwealth of Pennsylvania. 
  
8.7     If any provision in this Agreement shall be invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby.  

8.8      If applicable, the requirements of 41 CFR §§ 60-1.4(a), 60-250.5 (a), 60-300.5(a), 60-741.5(a), 
           and 29 CFR Part 471, Appendix A to Subpart A, are incorporated herein by reference.


This Agreement constitutes the entire agreement between the parties with respect to its matter.

IN WITNESS WHEREOF, intending to be legally bound hereby, the parties hereto have executed this Agreement.

WORLDWIDE INSURANCE SERVICES, LLC	_______________________________
			(Name of Agent or Agency)

By:      _________________________      By:  _________________________

Name:    _________________________	Name: _________________________

Title:   _________________________	Title: _________________________

Date:    _________________________      Date:   _________________________

AGENT OR AGENCY AGREEMENT

SCHEDULE A

	Product Compensation Schedule
Requirements

Agent will also be required to furnish upon Company’s request copies of State licenses for those States where products are to be marketed, negotiated and sold.

Compensation

The compensation stated below will be paid on Gross Collected Premium received from or through the Agent:

Travel and Expatriate Medical Programs-Individual Plans


Single trip health and accident insurance for international travel for individuals on leisure, educational, missionary or business travel 


Commission 15%

Annual,multi-trip health and accident insurance for frequent international travelers on leisure, educational, missionary, or business travel

Commission 
15% 

Single trip health and accident insurance for groups of individuals on leisure, educational, missionary, or business travel

Commission 15%

Comprehensive travel insurance to protect your vacation investment (classic plan)


Commission 15% 

Comprehensive travel insurance to protect your vacation investment (preferred plan)

Commission 15% 


Comprehensive travel insurance to protect your vacation investment (economy plan)


Commission 15%


Primary medical insurance for expatriates


Commission 15% for the first policy year 7.5% after the first policy year (renewal)


Primary medical insurance for missionaries; maritime crew; students and faculty


Commission 15% for the first policy year 7.5% after the initial policy period (renewal)



Business Programs1-Mandatory Group Plans


Blanket accident and health insurance for business traveler

Commission 15%

Major medical insurance for expatriates
Commission 10%
 

Student Programs2- Mandatory Group Plans 


Coverage designed exclusively for international students who reside outside of their home country while engaged in educational activities

Commission 
10%


1 If the commission rate for Business Programs deviates from 15% for the Traveler plan or 10% for the Expatriate plan, the commission rate reflected in the proposal will supersede the above amounts.

2 If the commission rate for Student Programs deviates from 10% for a student plan, a signed addendum is required.


Agent Agency Agreement Template rev. 1.21.2021
Check this box to indicate that you have read, understand and agree to the above terms and conditions of the Agency Agreement.
Compensation Schedule(A) - Agent, Producer, Individual Insurance Products

Commission is paid on collected premium. All premiums are required at time of enrollment for all plans, except for the expatriate health plans. GeoBlue offers modal billing for the expatriate health plan customers on a monthly, quarterly, semi annual and annual basis.
Referred by: Midwest Insurance Brokerage Service Inc.

Commission Schedule	Commission (%) in 1* Year
GeoBlue Long Term	15
GeoBlue Multi Trip	15
GeoBlue Single Trip	15
GeoBlue Single Trip Group	15
TravelGap Excursion	15
TravelGap Voyager	15
Check this box to indicate that you have read, understand and agree to the commission schedule listed above.