Submit Business Using eApp

When your client says yes to a Nassau product, our eApp helps you get the policy issued quickly and painlessly. It’s an easy, fast, and smart way to submit your business!

To ensure a smooth process, the applicant should have the following information readily available prior to beginning the eApp.

  • Applicant email address
  • Medicare ID card
  • Applicant’s bank name
  • Account number and routing number
  • Plan: A, F, G, or N (also plan B in PA)
  • Primary care physician’s name, city, and state
  • Existing policy number and name of carrier (if replacing)
  • Proof of Guaranteed Issue eligibility (if applicable)
Start an eAPP

Note: Login/Registration will be required on Nassau’s portal.

Outline of Coverage

Click on your state to reveal the Outline of Coverage


Key Contacts

A useful guide to ensure a seamless process for your applications

View Contact List

Why Nassau?

Why your Clients should choose Nassau Medicare Supplement?

Why Nassau?

State, Plan & HHD Availability

List of available plans and household discounts by state

View State Availability

For more resources, including Rates and User Guides, please visit our Agent Portal

Frequently Asked Questions


A checking account must be provided at the time of application. Monthly EFT is the only option. The initial premium is deducted from the account the day after the policy is issued. Recurring deductions start on or about the first of the month following the effective date. If a payment date falls on a weekend or holiday, the bank draft will occur on the next business day.

Yes, the premium deduction date can be changed to any day between the 1st and 28th of the month. After the policy is issued, the client can request changes to the draft date and mode by calling Policyholder Services at 1-800-999-2224.

In general, a household discount is available when an applicant has resided with another individual for at least 12 months. Certain requirements and state variations may apply. For details, refer to the State Availability & Household Discount Requirements document accessible from the Nassau Med Supp landing page on SalesNet:


Tele-Sign/Voice Signature is not available in South Carolina. The eSign process will need to be used for this state.

Yes, it is very important to enter the full name into the signature prompt as it will populate as written into the application signature.

Yes. The eSign and Tele-Sign/Voice Signature processes require the applicant to have a valid email address at the time of application so that forms can be received and signed electronically. The agent is responsible for reviewing the application and other forms with the applicant prior to signing.

Every applicant will need a device that will provide email access, allow the applicant to click on the link within the email, and view the documents that generate upon portal access. The eSign process also requires the applicant to be able to acknowledge receipt of each document and provide a signature online.

In addition to the application, the client will receive a variety of forms that are part of the eApp process. These include the Outline of Coverage, Medicare Guide, Health Information Authorization, MIB and Fair Credit Disclosure, Consent to Sign Electronically, replacement forms (if applicable), plus other required state-specific forms. Please review the completed application and other forms with your client prior to submitting the application.


Nassau does not currently support an application to be submitted by a POA on behalf of an applicant.

The applicant must provide a valid primary residential address, which will determine the State of policy issuance. If the applicant wishes to have their documents mailed to a P.O. Box, that information should be entered in the mailing address fields.

All policies are effective the 1st of the month. The applicant can choose the month up to 90 days in the future.

While the guide must be provided to the applicant prior to submitting the application, it is not necessary to review every page with the applicant. You can click on the OPEN chevron in the upper left corner of the screen to move to the next form. (Please inform the applicant that they will receive the Guide as part of the enrollment and that it is an excellent educational resource You should also be familiar with the content of this guide, particularly the information concerning illegal practices.)

The agent can contact the New Business department (1.800.541.0171) to withdraw the application prior to the policy issue, which typically occurs within 2 business days of the application submission.

General Information

Nassau offers plans A, F, G, and N, (also plan B in PA). Note, Plan F is only available to those eligible for Medicare prior to 2020. Visit the Nassau Medicare Supplement landing page on SalesNet for the current state and plan availability information:

MACRA is legislation that became effective on April 16, 2015, which, among other things, eliminated the Plan C and Plan F options for individuals newly eligible for Medicare. Nassau offers a very competitively priced Plan F option, but this plan is only available to individuals eligible for Medicare prior to January 1, 2020.

Nassau currently has telephone scripts approved for use with consumers. We anticipate having additional marketing materials available for use in the near future. Check the Nassau Medicare Supplement page on SalesNet for current information, including state-specific materials. NOTE: Nassau’s Compliance Department must approve any materials which use the Nassau name or logo. Agents must be appropriately licensed to sell Medicare Supplement insurance and appointed by Nassau Life Insurance Company of Kansas prior to solicitation and submission of an application.

Unless an applicant qualifies for Open Enrollment or Guaranteed Issue, the applicant will be underwritten for coverage. For more information on the underwriting process, reference the Nassau Medicare Supplement Underwriting Guide on SalesNet: For more information regarding Open Enrollment and Guaranteed Issue guidelines, reference the “Choosing a Medigap Policy” CMS Guide.

It is typically not suitable to sell a Medicare Supplement insurance policy to an individual on Medicaid, except in certain situations. If an applicant answers “Yes” to Question 7 under Section 4 (General Questions) of the application, the answers to the subsequent questions are required and Nassau may request additional information to determine if the application can be accepted.

Download FAQs

Important Disclosures



Nassau Medicare Supplement insurance policies are underwritten by Nassau Life Insurance Company of Kansas (“Nassau”), a subsidiary of Nassau Financial Group. Nassau currently offers Medicare Supplement insurance in AL, CO, DE, IL, IN, IA, KS, KY, LA, MD, MI, MS, MT, NE, NM, NV, NC, ND, OH, OK, PA, SC, SD, TN, TX, UT, and WY, but that is subject to change. Nassau offers Plans: A, F, G, N except in Pennsylvania where Plans A, B, F, G, N are offered. Nassau is not authorized to market Medicare Supplement insurance in AK, AR, AZ, CA, CT, DC, FL, GA, HI, ID, MA, ME, MN, MO, NH, NJ, NY, OR, RI, VA, VT, WA, WI, WV. BPD 40467