CCHPA Approved Broker Sign Up

Complete the form below to continue:

This level of membership is for Brokers who have been approved by UnitedHealthcare to sell Health Plan of Nevada or Sierra Health and Life Medical Insurance Plans.

Approved Brokers will be allowed to sell Clark County Association Health Plans (CCHPAs) which consist of 10 plans for small group employers with 1-50 employees in Clark County, Nevada.

Employers must be members of the Henderson Chamber of Commerce, Boulder City Chamber of Commerce or Latin Chamber of Commerce to purchase CCHPA plans.

Please call Amy Palmeri at 702.209.3968 or email APalmeri@HendersonChamber.com to verify eligibility.

Referred By:
Referral Details:
Please list name of person who referred you and their company name here, or note specifics if you answered "other."
Your Company Name:
Physical Address:
Are you currently open for business at this address?:
Mailing Address:
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Primary Contact:
Please enter in Last Name, First Name
Additional email addresses you would like to have added to our contact list:
Website (add http:// in front of address):
Is your website currently "live"?:
Number of Employees:
Business Description:
Would you like to be assigned an Ambassador?:
Ambassadors assist new members in getting involved with the Chamber, introduce them to other members and act as a contact person for any questions or concerns they may have.
Name of person who handles your marketing:
Marketing Rep Email:
Please select a password that you will use to access your Directory Page.