2025 Walmart / Sam’s Club Program Store Request

Hi [memb_contact fields=_PreferredName]! This will be an exciting AEP with many plan changes. Working a kiosk is a great way to get in front of Medicare recipients and help educate them on their options for 2025.

This year we are working with Humana and Market Point to facilitate this opportunity. Keep in mind, there will be a limited number of stores available. If you are interested in staffing a store this AEP, please complete and submit the form below.

A list of potential stores is available below. You will be asked to list up to three stores (in order of priority).

* Please note, we cannot guarantee any agent will be awarded any specific store.

Program Cost:

Store fee: $600
Revenue Share: $2500.00
- guaranteed minimum 25 MA/MAPD/Med Sup apps @ $100 per app = $2500.00
- plus $100 per additional MA/MAPD/Med Sup app
- PDP apps: $25 each
- ACA apps: $23 each
Renewals
- $50 per MA/MAPD/Med Sup
- $6 per PDP
- $23 per ACA

Kellogg Insurance will cover half of the amount or up to $1550 ($600+$2500=$3100)-1550 = $1550

- The agent is responsible for additional apps written over the guaranteed minimum. The agent is also responsible for any renewal fees.

If multiple agents plan to share a store, one designated “Primary Agent” must be assigned to take full responsibility for the payment. Any cost-sharing arrangements between agents are private agreements and must be coordinated between the agents involved. Split payments or multiple payments will not be accepted.

Requirements:

Multiple Medicare Advantage contracts with Kellogg.
Submit Check-In and Check-Out times and applications through Humana’s SunFire app. The link will be provided closer to AEP.
Commit to and be in the store for at least 30 hours each week during AEP, worked across a minimum of 3 days.

When you submit the Request Form, you will be directed to the payment form. Your request will not be completed until payment is received.
You will also need to designate whether you will be participating in the kiosk during OEP. Keeping the store for OEP improves your chances of getting the store next year. If you choose to work the store during OEP, we will invoice you the Store Fee of $600 before the selling season begins.
*If none of your store choices are awarded, you will be refunded the full amount.

Available Stores

Quick Search options: search by County narrow the results.

Enter the Store Numbers in the form below in order preference.

[table id=10 /]

Please complete the information below to submit your store request.

[memb_contact fields=FirstName] [memb_contact fields=LastName]

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KEAP ID(Required)

KEAP ID

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FMO

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Name

First Last

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Cell Phone(Required)

Cell Phone

Agent NPN(Required)

AGENT NPN

Store numbers(Required)

Enter Store Number - Choice #1

Store numbers(Required)

Enter Store Number - Choice #2

Store numbers(Required)

Enter Store Number - Choice #3

I would like to have a store for OEP also.(Required)

I would like to have a store for OEP also.

YES

Undecided

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Agreement Acknowledgement(Required)

By signing up for this opportunity, I hereby acknowledge that I have read, understood, and agree to be bound by the terms and conditions set forth in the associated aggreement, including but not limited to the subsidy provisions and agent obligations. I further acknowledge and accept full responsibility for meeting the required enrollment targets and understand that failure to do so may result in applicable penalties as outlined in the agreement.

Name

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Your store choices have been submitted. Please contact chelsea@kelloggins.com if you need to pay or have any questions.