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Co-Op / 1,000 Piece Mailer Submission Form

Simply complete the below Co-Op / Lead Mailer Enrollment Verification Form and submit.

We appreciate your business and partnership.


Medicare Advantage enrollments used to qualify for Precision Senior Marketing’s AHIP reimbursement program cannot also be used to qualify for the T-65 Lead Mailer Program. For agent use only. Not for use with consumers. Not affiliated with the United States government or the federal Medicare program. Some exclusions and limitations may apply. Some products may not be available in all areas. Enrollments for this promotion must be with carriers the agent is appointed with through Precision Senior Marketing (PSM). Eligibility for this program will be determined by PSM. Only directly contracted writing agents may participate. Lead vendor and mailers for this program will be determined by PSM, and cash equivalents and reimbursements will not be offered. Agent must be trained and certified and must abide by PSM’s compliance program described at http://cdn2.hubspot.net/hub/11198/file-451466630-html/compliance/compliance-module.html to participate.