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BROKER OF RECORD CHANGE FORM: INDIVIDUAL/GROUP ENROLLMENTS ON & OFF MARKETPLACE Complete this form to ensure the correct broker is reflected as the Broker of Record (FOR) on new business enrollments

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How to fill out broker of record change

01

Step 1: Obtain the broker of record change form from your insurance provider.

02

Step 2: Fill out the form with accurate and up-to-date information.

03

Step 3: Provide the necessary details, such as policy number, insured party information, and contact information.

04

Step 4: Sign and date the form.

05

Step 5: Submit the completed form to your insurance provider either through fax, email, or mail.

06

Step 6: Follow up with your insurance provider to ensure that the broker of record change has been processed successfully.

Who needs broker of record change?

01

Businesses or individuals who want to change their insurance broker

02

Businesses or individuals who are unsatisfied with their current broker's services

03

Businesses or individuals who have found a better insurance deal through a different broker

04

New businesses or individuals entering the market and needing to select their first insurance broker

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What is broker of record change?

Broker of record change is a process in which a new insurance broker is designated as the official representative for an insurance policy.

Who is required to file broker of record change?

The insured party or policyholder is typically required to file a broker of record change.

How to fill out broker of record change?

To fill out a broker of record change, the insured party must complete and submit a broker of record letter to the insurance company.

What is the purpose of broker of record change?

The purpose of a broker of record change is to officially designate a new insurance broker to handle an insurance policy.

What information must be reported on broker of record change?

The broker of record change form typically requires information such as the name and contact information of the new broker, policy details, and the reason for the change.

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