Become an Agent

Become an Insurance Agent with Eagle Statewide

Unlock your full potential as an insurance agent with Eagle Statewide — where innovation, mentorship, and growth go hand in hand. Whether you’re just starting out or looking to expand your business, we provide the tools and support to help you succeed from day one.

Why Join Eagle Statewide?

• ✅ Partner with top-rated national and regional carriers
• ✅ Get comprehensive onboarding, training, and 24/7 support
• ✅ Leverage advanced CRM, quoting, and marketing tools
• ✅ Build your own book of business with full autonomy
• ✅ Enjoy industry-leading commissions and performance bonuses

🔹 Explore the insurance products you’ll be able to offer — auto, home, life, commercial, and more.

🔹 Discover our agent portal and how it automates your workflow, saves time, and tracks commissions.

🔹 New to insurance? Visit the National Association of Insurance Commissioners or read this step-by-step licensing guide.

At Eagle Statewide, we empower agents through technology, education, and opportunity — so you can focus on what truly matters: protecting clients and growing your business.

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– Step 1 of 3

Name *

First

Last

Business Name

Example: Eagle Insurance or Your Name

Date of Birth *

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Example: 00/00/0000

Legal Entity TypeSole ProprietorshipPartnershipLimited Liability Company (LLC)CorporationNon-Profit OrganizationLimited PartnershipJoint VentureCooperativeTrustGovernment Entity

Tax ID (if applicable) or Social Security

Example: 81-0000000

Social Security

Example: 000-00-000

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Business Mailing Address

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

Example: 701-111-2222

Fax

Example: 800-111-2000

Email *

Example: example@eaglestatewide.com

Website / URL

Example: https://example.com

Year Business was Formed

Example: 2001

Next

Primary Producer Name

First

Last

Date of Birth

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Example: 00/00/0000

Errors and Omissions Carrier

Example: Eagle Insurance

E&O Policy Number

Example: ES2458711252

E&O Policy Effective Date

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Example: 00/00/0000

E&O Policy Expiration Date

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Example: 00/00/0000

Next

Years of Insurance Experience?Less than 1 year1 to 3 years4 to 6 years7 to 10 yearsMore than 10 years

Is your agency a member of a Group or Aggregator?YesNoNot applicable

other and (if

Does your agency currently write business with Eagle Statewide through a broker?Yes, through a brokerYes, directlyNo, not currently

Companies RepresentedAetnaDelta DentalGuardianVSP Vision CareCigna DentalMetLife DentalBlue Cross Blue ShieldUnitedHealthcareCignaHumanaMolina HealthcareOscar HealthAmbetterPrudential FinancialMetLifeNew York LifeNorthwestern MutualAmeritasNational Life GroupTransamericaMutual of OmahaLincoln Financial GroupState FarmLiberty MutualAllstateUSAAFarmers InsuranceNationwideLemonadeChubbTravelersThe HartfordAmTrustBerkshire Hathaway GUARDEmployers InsuranceZurich InsuranceAssurantAmerican ModernForemost InsuranceHanover InsuranceCNA FinancialHiscoxProgressiveGEICOAssurance AmericaUnited Automobile InsuranceThe Responsive Auto InsuranceKemperBristol WestThe General

Annual Premium

Example: $225,500 – Enter zero (0) if you have no products.

File Upload Certificate of Errors and Omissions and License Status *

Click or drag files to this area to upload.You can upload up to 5 files.

Your message if necessary

Privacy Notice Eagle Statewide or its agents may use the information you provide together with other information we have about you to contact you, including by mail, phone, SMS, fax or email, with offers or information about Eagle Statewide products and services we provide. We may keep your information for a reasonable period for this purpose. For more information please reference our Privacy Policy. *

• I have read and understood this Privacy Notice.

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