PolicyBridge — Join as an Agent or Broker

Agents & Brokers — join PolicyBridge

Sign up, pick Agent or Broker, list every state you are licensed in (Ohio first, then PA, WV, KY, IN, MI, plus any other state), add your intro video and carriers, and sign the Independent Agent Agreement online. You can claim leads only after your license is verified.

Full nameAgency EmailPhone Role

License numberNPN Licensed states (comma separated, e.g. OH, PA, IN) Intro video link (YouTube / Vimeo / Loom) Carriers you work with (comma separated)

Independent Agent Agreement v1.6

PolicyBridge Independent Agent Agreement (v1.6)
Parties and purpose: PolicyBridge is a lead and agent platform, not an insurance agency or carrier. It does not sell insurance, quote a policy, bind coverage, or underwrite anything. Agents and brokers on PolicyBridge are independent and licensed, and they are the ones who sell insurance to clients.
Split: PolicyBridge takes 20% of the PREMIUM COLLECTED, taken FIRST, before any broker/agent payout. The remaining 80% is split between broker and agent per their own agreement — PolicyBridge sets no 50/50 default. A Broker who sells keeps the whole remainder. Renewals run for the life of the policy.
Leads: first come, first served. The first verified agent to claim a lead owns it exclusively. Contact the client within 30 minutes.
Conduct: only sell where you are licensed. Do not cold-call — leads are people literally looking for life insurance.
Electronic signature: by typing your legal name below you agree to this agreement, including the split, conduct, and electronic-signature clauses. Attorney review is recommended before public launch.

I have read the full agreement above. Type your legal name to sign Drawn signature (type your name again if you cannot draw)