Register as a CoMediCard Agent

We are excited to consider you as an authorized agent for CoMediCard. With Convenient Care When You Need It Most, our goal is to offer affordable healthcare options to individuals, families, groups, affiliations, employers, municipalities, colleges and other associations. Take a moment and fill out our registration form and we will be back in touch shortly. Our goal is to make it as streamlined as possible for you to enroll your clients, groups and affiliations. We have options to onboard online using your unique agent code or through ACH or credit card payments for qualifying groups.

Please fill out this form to start the process. Once your application is processed and approved to move forward, you’ll receive a DocuSign to review and sign our Authorized Agent Agreement. Your five digit enrollment code that is exclusive to you will be sent at that time. You will also receive a unique affiliate link with access to our affiliate marketing program.  We love our agency partners. Follow Cooper on our CoMediCard Facebook, Instagram, Twitter and YouTube for updated tips on staying healthy. And, you’ll receive emails with helpful information and a Cooper-Gram with your first sale! CoMediCard also offers co-branded marketing materials. Please review available products regularly as the page is constantly being updated. 

All the best,

Cooper Signature