Agent of record & release of information checklists
Agent of record checklist
Please provide all of the following information:
- Group name
- Group number
- Name of newly appointed agent
- Name of newly appointed agency
- Date Agent of Record should be effective
- Specific date information can be released to new agent
- Signature of decision maker
- Request must be submitted on employer group letterhead
Release of information checklist
Please provide all of the following information:
- Group name
- Group number
- Name of agent to receive information
- Date Release of Information should be effective
- Signature of decision maker
- Request must be submitted on employer group letterhead
Note: We do not allow for agent changes on our individual products.
