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AGENT/BROKER OF RECORD CHANGE Date of Request: Fax forms to: Group: PHC (Individual): Medicare: (866) 701-4991 (800) 618-2589 (540) 853-3013 If you have questions regarding group AOR s, please call

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What is agent of record?

Agent of record is a designation of an individual or entity that has the authority to act on behalf of another party in legal or business matters.

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The purpose of agent of record is to officially authorize a designated individual or entity to act on behalf of another party in specified legal or business matters.

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The information reported on agent of record typically includes the name and contact details of the designated representative or entity, along with any relevant documentation supporting the appointment.

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