Broker Materials
Broker-Agency Direct Deposit Authorization Form | |
CoPower Producer Agreement CA |
CoPower Landmark Rate Calculator (Nov 2023 to July 2024) |
Enrollment Forms
Benefit Waiver and Declination Form | |
Declaration of Disability Over-Age Dependent Child Form | |
New Group Enrollment/Waiver Form | |
New Group Enrollment/Waiver Form (Spanish) |
CoPower Census (All Carriers) | |
CoPower SELECT Employer Application with Delta Dental, VSP, UNUM, & Landmark | |
W-9 Form |
In-Force Group Materials
Existing Group Enrollment and Change Form | |
Existing Group Enrollment and Change Form (Spanish) |
CoPower Contact Sheet |
Sales Guides & Flyers
CoPower Vantage Powerful Perks Flyer | |
Discount RX Card | |
Discount RX Card - Spanish | |
Zywave CoPower Flyer |
CoPower Portfolio | |
CoPower SELECT Landmark Summary of Benefits and Rate Guide | |
Empower Group Flyer |
Summary of Benefits (SOB)