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New Life Agency, Inc.
Lloyd's Coverholder
PO Box 5948
Fresno, CA 93755
T: 877.952.LIFE (5433)
F: 877.952.5589
LIC. 0C71042
LIC. 0F13013

New World Administrators is a New World of Administration, Inc. and committed to providing exceptional service to our providers. We pay our providers through our Claims Fund AccountsSM. This system allows all insured's to populate their deductible in full therefore leaving no lag time for our providers to be paid immediately.

New World Administrators guarantees payment to any contracted provider within 30 days.

Please contact info@newworldadministrators.com to request further information or Call 877.952.5443 for Provider and Claims Questions.

New World Administrators, Inc.
P.O. Box 5399
Fresno, CA 93755
Phone: 877.952.5443
Fax: 866.463.2451
E-mail: info@newworldadministrators.com

A New Standard of Care...
Serving Future Families Health Claims Today.

Provider Nomination Form

If you would like to participate in the NWA network, please complete the following information (all fields are required), and click "SUBMIT."

Doctor or Practitioner Name:
Doctor or Practitioner Title:
Doctor or Practitioner Address:
Doctor or Practitioner City :
Doctor or Practitioner County :
State		Zip
Doctor or Practitioner Phone :
Doctor or Practitioner Specialty:
Completion of this form is for nomination purposes and does not guarantee membership.

*HOLD HARMLESS*
The insurance broker and any other persons or agencies are held harmless from any loss or damages arising from health insurance, life insurance, indemnity or supplemental benefits on the surrogate, Intended parent or egg donor being denied or accepted for coverage. New Life Agency, Insurance Agency does not make any representations regarding the insurance policies referenced herein or otherwise and is not in any way responsible for the coverage of such insurance or loss or damages from the denial of any claims under such policies. Health insurance, life insurance, indemnity or supplemental benefits and exclusions can and may change without notice.