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Amfam Split Case Form – Testing

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  2. Amfam Split Case Form – Testing

Captive Agent Client Referral_AmericanFamily

  • Please fill out the form below to complete your Client Referral.




  • Agent Information




  • Client Information


  • Email Requirement: In cases where we are not able to reach the client by phone, an email will be sent to the client with the assigned OCI representative's contact information. If your client does not have email or a valid email is not provided, we will not be able to assist your client due to compliance reasons of needing electronic signatures for consent and policy completion.

  • Due to a number of insurance carriers no longer working with agents to solicit their products we are unable to help your client secure Prescription Drug coverage. If they would like to review their options and enroll please forward this self service link to them click here
  • DISABILITY NOTE: Based on the information you have provided, please use the link on your webpage to refer to full details on Disability.

  • OTHER PRODUCTS: For all other products to refer go to American Family's web page: https://www.ociservices.com/amfam-products/. Thank you!


About Us

OCI

Headquartered in Elkhorn, Nebraska, OCI Insurance & Financial Services, Inc., is an insurance field marketing organization providing support to thousands of agents nationwide in the placement of these products and services.

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OCI Insurance & Financial Services, Insurance Agency, Elkhorn, NE

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Contact Us

402.330.8700
Toll free: 866.320.8700
Fax: 402.330.8706

4221 N. 203rd St, Ste 200
Elkhorn, NE 68022

Hours:
Monday – Thursday: 8:00 am – 5:00 pm
Friday: 8:00 am – 4:30 pm

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