FMIG NextGen LT Returns
Please use this form to submit lead returns on calls you believe fall outside your NextGen Filters.
Agent Name *
Lead Phone Number *
Your answer
Do you believe the this lead answered "NO" to the following question: Do you, or anyone on the plan, have any pre-existing conditions? *
Do you believe this lead answered "YES" to the following questions: Can you afford $150/month for an individual health insurance plan? ($200/individual + spouse, $250/family)? *
Other Reason For Return
Other Notes:
Your answer
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