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    First Name *

    Last Name *

    Agency

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    City *

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    Email Address *

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    Fax Number

    Have you previously done business with Midwest Life Brokerage? *

    Have you reviewed and agreed to all of the MWLB Express Terms of Use? (See Below) *

    Terms of Use

    By accessing and/or using any or all parts of the MWLB Express web site (https://mwlbexpress.com), you agree to abide by all of these terms of use. If you do not agree with any or all of these terms, please do not access any other parts of the web site.

    1. The Process: By submitting a request for a referral or application, you understand and agree that MWLB Express' process of quote, following up on and fulfillment of referrals and/or applications you submit MWLB Express, assumes the accuracy and completeness of the information you supply to the website. In addition, all quoting is only an estimate of the premium your client might pay for term life insurance and that the actual price of any policy offered to your client at the conclusion of the application and underwriting process may be higher or lower than the price quoted by MWLB Express. Any premium variance may be due to additional information that the insurer discovers in the course of underwriting the application, a change in age, tobacco usage, a change in the insurer's rates, etc.. You understand that MWLB Express does not guarantee that your client will be offered a policy at the conclusion of the application process, nor do we guarantee that it will be issued at the quoted rate. Although we believe that the quotes provided by MWLB Express are accurate, we cannot guarantee the accuracy of every quote due to the possibility of error, whether created by the user or technology.

    2. The web site: MWLBExpress.com and content is protected by one or more copyrights, patents, database rights, trademarks, service marks and/or other intellectual property or proprietary rights that are owned by MWLB Express. We may revise the web site at any time, without notice. You may not publish, broadcast, retransmit and/or reproduce all or any portion of the web site without the express prior written permission of Midwest Life Brokerage and/or MWLB Express. Any reproduction or retransmittion of our websites is strictly prohibited.

    3. Compensation: Under typical circumstances, First Year compensation will be paid out by the carrier that places the business. Only after final Activation of the policy will commissions generate to the agency. Most carriers will pay compensation on an "as earned" basis, meaning they will pay full Annual Compensation, only if the individual client pays their premium on an Annual basis. Policy Fees may or may not be commissionable, depending on the carrier, product and/or death benefit amount. By submitting a referral or application to MWLB Express, you agree to the commission or payment terms due to MWLB Express per the schedule below.

    Option 1 - Express BASIC: Current* CPS Insurance STREET Level Compensation, to be split 90% Agent/Agency & 10% MWLB Express

    Option 2 - Express PLUS: Current* CPS Insurance STREET Level Compensation, to be split 75% Agent/Agency & 25% MWLB Express

    * Current CPS Insurance STREET Level Compensation will be determined by the date of the request received by MWLBExpress.com. For more information on those

    4. Closing Ratio Minimum: We require a 75% Positive Closing Ratio (minimum of 8 cases) from all users of MWLB Express or we may terminate your UserID from further use. We may re-establish your account with a 75%+ closing ratio (minimum of 8 cases) through our typical brokerage operation at Midwest Life Brokerage without using the services of MWLB Express.

    5. Indemnification: You unconditionally agree to indemnify Midwest Life Brokerage and/or MWLB Express for any liability and/or damages suffered as a result of your use, whether authorized or unauthorized, of any of our web sites, including but not limited to www.mwlb.com or www.mwlbexpress.com.

    About MWLB Express

    MWLB Express is owned and operated by Midwest Life Brokerage of Naperville, IL. MWLB Express was established to process and fulfill life insurance tickets generated by our agency partners. Using the information you provide, MWLB Express compares the rates from several U.S. life insurance companies who offer some of the most competitive rates available . We produce an individualized pricing summary based on the criteria you enter and/or are presented by the proposed insured or policy owner.

    About Midwest Life Brokerage

    Midwest Life Brokerage is a life insurance and brokerage agency located in Naperville, Illinois. Since September of 1995, Kristopher Smith has worked with thousands of insurance agents who are in search of life insurance from quality carriers for their customers.
    As Midwest Life Brokerage continues to grow, we never lose sight that our customer’s CUSTOMER is the most important person in each specific transaction. We will work hard with our carriers and support team to obtain an expeditious and aggressive approval for each and every application.