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Providing Agents with Specialty Health & Life since 1961.           
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Contact us at National Insurance Markets, Inc. Contact Us
915 Saxonburg Blvd, Suite 217
Pittsburgh, PA 15223

Telephone: (412)782-1979
Toll Free: (800)235-2013
Fax: (412)782-2868
eMail: info@nimbroker.com
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Download the Forms You Need

Did you find everything that you needed? Please let us know. We will continue to add new forms necessary to run your business smoothly.


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Senior Products (Medicare Supplement, Medicare Advantage, Part D, Senior Life) .
Senior Medical
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Medicare Supplement, Medicare Advantage and Part D

Medicare Supplements
AARP: :: App  :: Materials
Amer.Continental: :: App  :: Materials
Gerber Life: :: App  :: Materials
New Era Life: :: App  :: Materials
United World: :: App  :: Materials
Medicare Advantage
CIGNA:   :: Materials
Coventry:   :: Materials
HBCBS W. PA: :: App  :: Materials
HBS N.E. PA: :: App  :: Materials
HBS C. PA: :: App  :: Materials
Today’s Options: :: App  :: Materials
Medicare Part D (PDP)
AARP: :: App  :: Materials
AdvantraRx:n/a*  :: Materials
CIGNA: :: App  :: Materials
CCRx: :: App  :: Materials
HBCBS BlueRx: :: App  :: Materials
HBS BlueRx: :: App  :: Materials
Humana:n/a*  :: Materials
PrescribaRx: :: App  :: Materials
Med Adv Copay Gap Ins
GTL:                      :: App  :: Materials


*Plan not accepting PDF version of paper application.
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Dental Plans .
Dental Plans
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:: Fidelity Security Life
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Individual Disability Insurance Application Download .
Individual Disability Insurance
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:: Assurity Life
:: Mutual of Omaha
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Individual Medical .
Individual Medical
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:: HealthAmericaOne
:: Highmark BlueCross/BlueShield
:: Highmark BlueShield
:: Time/Assurant Health
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Group Medical .
Group Medical
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:: Health Americal/Health Assurance
:: Highmark BC/BS
:: Highmark BlueShield
:: UnitedHealthcare
:: UPMC
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Short Term Medical .
Short Term Medical
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:: Highmark BC/BS
:: Highmark BlueShield
:: IMG (International Medical Group)
:: Time Insurance (Fortis/Assurant)
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Student Health .
Student Health
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:: Time/Assurant Health
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Life Insurance (Whole Life, Graded Benefit Life) .
Life Insurance
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:: Assurity Life
:: Banner Life
:: Fidelity Life
:: Genworth Financial
:: ING
:: John Hancock
:: Lincoln Financial Group
:: Met Life
:: New Era Life
:: Presidential Life
:: Prudential Life
:: United Home Life
:: United of Omaha
:: West Coast Life
:: Western Southern
:: Life Insurance Quote Form
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E&O Application Download .
E&O Application
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:: Download E&O Application
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Important Insurance Links

» PA Department of Insurance
» NIPR License Registry
» Sircon
» HIPAA/HITECH Information
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