Legacy Benefit Solutions Agent Registration

To begin the onboarding process and gain access to the Gen3 Producer Portal (including contracting, quoting and application tools, etc.) please complete the registration form below. If you encounter any issues during the registration process, please email your dedicated relationship manager Ted Fravel at ted@gen3advisor.com or call (844) 300-4363 x1005

IMPORTANT: Your First and Last name must be entered exactly as it appears on your insurance license/NIPR profile. If onboarding with Gen3 as an agency, please use information of the designated agency principal.