Form preview

Get the free Group Broker of Record (BOR) Changes

Get Form
BROKER OF RECORD CHANGES Group Broker of Record (FOR) Changes If a prospective client, who currently has an enforced policy, would like to make you their broker of record, they can do so by writing
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign group broker of record

Edit
Edit your group broker of record form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your group broker of record form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing group broker of record online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the steps down below to benefit from a competent PDF editor:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit group broker of record. Add and change text, add new objects, move pages, add watermarks and page numbers, and more. Then click Done when you're done editing and go to the Documents tab to merge or split the file. If you want to lock or unlock the file, click the lock or unlock button.
4
Get your file. Select your file from the documents list and pick your export method. You may save it as a PDF, email it, or upload it to the cloud.
pdfFiller makes working with documents easier than you could ever imagine. Create an account to find out for yourself how it works!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out group broker of record

Illustration

How to fill out group broker of record:

01
Obtain the necessary forms from your insurance company or broker. These forms will typically be titled "Group Broker of Record Letter" or something similar.
02
Fill out the top section of the form with your company's name, address, and contact information. Make sure to provide accurate and up-to-date information as this is what will be used to identify your company.
03
Include the effective date of the group broker of record change. This is the date when you want the new broker to take over as the broker of record for your group insurance policies.
04
Provide the name and contact information of the new broker. This should include their company name, address, phone number, and email address. It's important to double-check this information to ensure accuracy.
05
Indicate the reason for the change in broker. This could be due to a better offer from a different broker, dissatisfaction with the current broker's services, or any other valid reason.
06
Sign and date the form. Make sure to use a signature that is consistent with the official records of your company. This indicates your agreement to the change in broker.
07
Submit the completed form to your insurance company or broker. Follow their instructions for submission, whether it's via email, fax, or regular mail. Keep a copy of the form for your records.

Who needs group broker of record:

01
Companies with group insurance policies. Group broker of record is applicable to companies that have multiple insurance policies covering their employees or members.
02
Companies looking for better insurance rates or services. A group broker of record allows companies to switch brokers in search of better offers, improved customer service, or a more suitable insurance solution for their needs.
03
Companies experiencing issues with their current broker. If a company is dissatisfied with the services provided by their current broker, they may seek a new broker by filling out a group broker of record form.
In summary, anyone in need of a group broker of record should follow the necessary steps to fill out the form and choose a new broker. This can help companies find more favorable insurance rates, better customer service, or resolve any issues they may be facing with their current broker.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.1
Satisfied
39 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Yes, you can. With pdfFiller, you not only get a feature-rich PDF editor and fillable form builder but a powerful e-signature solution that you can add directly to your Chrome browser. Using our extension, you can create your legally-binding eSignature by typing, drawing, or capturing a photo of your signature using your webcam. Choose whichever method you prefer and eSign your group broker of record in minutes.
The best way to make changes to documents on a mobile device is to use pdfFiller's apps for iOS and Android. You may get them from the Apple Store and Google Play. Learn more about the apps here. To start editing group broker of record, you need to install and log in to the app.
Use the pdfFiller mobile app to complete your group broker of record on an Android device. The application makes it possible to perform all needed document management manipulations, like adding, editing, and removing text, signing, annotating, and more. All you need is your smartphone and an internet connection.
Group broker of record is a designation given to an insurance broker that has been chosen to represent and manage the insurance policies for a group of individuals.
The group administrator or the insurance broker representing the group is typically required to file the group broker of record.
To fill out the group broker of record, you will need to provide information about the group, the insurance policies being managed, and the contact information for the designated group broker of record.
The purpose of the group broker of record is to designate a specific broker to handle the insurance needs of a group and ensure that communication and management of policies are streamlined.
The group broker of record form typically requires information such as the group name, policy numbers, effective dates, and the contact information for the designated broker.
Fill out your group broker of record online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.