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2016 Agent/Broker of Record Change Form Date of request: Fax forms to: Group & Individual ACA: 18667014991 Individual Legacy: 18003362429 Questions or AOR changes, call: Group: 18773046470 Individual

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What is agent/broker of record change?

An agent/broker of record change is when a policyholder decides to switch their designated insurance agent or broker for a particular insurance policy.

Who is required to file agent/broker of record change?

The policyholder or the authorized representative of the policyholder is typically required to file an agent/broker of record change.

How to fill out agent/broker of record change?

To fill out an agent/broker of record change, the policyholder usually needs to submit a specific form provided by the insurance company, indicating the details of the new agent/broker.

What is the purpose of agent/broker of record change?

The purpose of an agent/broker of record change is to officially designate a new agent or broker to handle a particular insurance policy on behalf of the policyholder.

What information must be reported on agent/broker of record change?

The agent/broker of record change form typically requires information such as the policyholder's name, policy number, current agent/broker information, and new agent/broker information.

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