Vivera Insurance Solutions

Join Vivera and gain access to our comprehensive technology suite - perfect for agencies and independent agents

Quick Start: Only your name and email are required to get started! You can provide additional information now or complete it later during our onboarding process.

Personal Information

First Name *

Middle Name

Last Name *

Email *

Phone

Address

Apartment/Suite/Floor

City

State

ZIP Code

Social Security Number

Date of Birth

Professional Information

License Number

NPN#

Desired States

Business Type

Products of Interest

LifeHealthLife and Health (both)

Document Uploads (Optional)

You can submit your application now and upload documents later, or upload them with your application.

Medicare/AHIP Certification

Choose File

Voided Check

Choose File

Insurance License

Choose File

Errors and Omissions Policy

Choose File

Insurance License Expiration Date

E&O Policy Expiration Date

Account Setup (Optional)

You can set up your account credentials now or wait until your application is approved.

Password

Confirm Password

Application Agreement

I certify that all information provided in this application is true and accurate to the best of my knowledge *I agree to the Terms of Service and Privacy Policy *I consent to be contacted by Vivera regarding this application and future partnership opportunities *

Become a Partner

Personal Information

Professional Information

Document Uploads (Optional)

Account Setup (Optional)

Application Agreement