From the quoting tool, click Enroll on any United plan.

You'll land on the enrollment form – newly designed and built by HealthSherpa. It's a single page with all of the enrollment questions – applicant details, Medicare details, eligibility period, coverage selections, optional questions, etc.

Here's what the form looks like (click for detail):

A few things to know as you fill it out:

When you're done, continue to the Review page.

When entering a Primary Care Provider (PCP), United is unique – they don't want you to enter the provider's NPI, they want you to enter their United-specific Provider ID.

Note: When you click "How to find your PCP's Provider ID" in our form, you'll see this pop-up, with a link to the portal and the info you'll need over there, so it's handy:
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The Review page is a read-only summary of everything you entered. Give it a scan to double check things. This is also what your client will see, if you send the form using Remote Signature.

Here's what the Review page looks like (click for detail):

On the Review page, the agent information you see here is what will be submitted to United to identify you as the enrolling agent.

For United enrollments, you have three signature options:

If you're on a recorded call with your client, you can compliantly choose this option and submit the enrollment form yourself.

Send your client a link to review and sign the application themselves. Once sent, you'll see a confirmation and options to resend or edit the email/phone.

You can choose "Signature pad" where the client can draw their signature or "In-person beneficiary signature" where the client can type in their signature.

If you use Remote beneficiary signature, your client receives an email or a text message with a link to their application. The subject line of the email will be "Sign & submit your Medicare application"

When they click the link, they'll verify their date of birth to access the application.

They'll then see the same Review page that you saw (with your name/logo at the) with their application details. They can review that page, scroll down, type their name as signature, and click Submit.

You can check whether your client has submitted from the enrollment on their Contact Profile – look for when the status changes from "Remote signature sent" to "Submitted."

Once the enrollment is submitted (by you via Voice Signature, or by your client via Remote Signature):

A permanent PDF record of the application is generated at the time of submission – a snapshot of exactly what was submitted.

The enrollment record on the Contact Profile updates automatically with the submit date, confirmation number, SEP, and PDF link.

The enrollment submits directly into United's enrollment system at the moment of submission. It will appear in your United broker portal in 3–7 business days. To check on it sooner, call United broker support.

Unlike our standard enrollment forms, the United form supports resubmission. If you need to submit again for the same client and plan – for example, with a corrected SEP or fixed typo – just start a new enrollment from their quote.

To complete United’s HRAs for D-SNP and C-SNP plans, use our legacy (Connecture-powered) enrollment flow. When you enroll a client in a United D-SNP or C-SNP, you’ll see this pop-up where you can choose:

My client isn't receiving the Remote Signature email. Ask them to check spam for a message from no_reply@healthsherpa.com. Verify their email is spelled correctly on the Review page – you can edit it and resend from the same screen. Sending by text as well is a good backup.

My client's date of birth isn't working on the verification page. The DOB must match what was entered on the enrollment form. Check the DOB on the Review page (or the Contact Profile)

Can I still use In-person signature for United? Not yet – it's coming soon. For now, choose Remote Signature or Voice Signature.

Why does this form look different from my other enrollments? United enrollments now use a form designed and built by HealthSherpa. Other carriers still use our standard form – that's why the experience differs.

Who do I contact with questions about the form's questions or requirements? Since this is a HealthSherpa-built form, contact us – not United – with questions about the form itself. Call (855) 521-4984 or email medicare-agents@healthsherpa.com. For questions about the plan or a submitted enrollment's status, contact United broker support.

Do I need to fill anything out differently for D-SNP or C-SNP plans? These plans include additional questions on the form. For C-SNP plans, at least one chronic condition must be marked Yes to submit.

Does a partially completed application get saved?

Yes. Anything on the Contact record pre-fills into the application automatically. To make sure that additional details you add in the application itself are saved, continue to the second page, Review, before leaving.

Can I go back to make edits?

Yes, you can press back to make edits, using the back buttons or your browser's back button. The information you entered will still be there for you to update.

If this version of your form used only by United?

No. Community Health Choice (CHC) and McLaren also use this version of the form.