Docstoc

Blue Cross

Document Sample
Blue Cross Powered By Docstoc
					                   Blue Cross_Contracting
 (Regular Broker Contracting - Contract is set up directly with
                          an MGA)

The Following documents are required to obtain a contract with Blue
Cross

 *Review the sections below and ensure that the contracts are fully
completed. Codes will be delayed at head office if the information is
missing.

R.G. Packman & Associates Limited

1. Application for Contract
Thoroughly review the contract
The following sections must be fully completed:
Part A – Fill in all contact/personal information
Section (8.)- If you answer “yes” to any of these questions provide a full
explanation in section 10.

2. R.G. Packman & Associates Ltd. Agent/Broker Agreement
Print off 1 copy of the agreement
-Complete Page (7)
Complete The Broker Section
Have a witness print their name
Have a witness sign
Print your name
Sign
-Complete Page (9)
Print name as Guarantor
Sign as the Guarantor
Have a witness print their name
Have a witness sign

Blue Cross

1. Independent Representative Data Sheet
- Fill in all contact/personal information
- Sign as the Independent Representative
- Date
2. 1 Representative Agreement
- Print off and complete 1 copy of the agreement
- Cover Page
- Print name and address
- Page (14.)
- Sign under THE REPRESENTATIVE (Authorized Representative)
- Print name
- Date
- Page (25.)
- Sign under THE REPRESENTATIVE (Authorized Representative)
- Print name
- Date

3. Request For Transfer Form -(required if you are transferring from one
MGA to another)
- Representative section (top portion of form)
- Print name as representative
- Sign and date as representative

*Please include:

-A copy of your License and Errors and Ommission
-A void cheque
-If you are contracting in your corporate name please also
include a copy of your corporate License, Errors and
Ommission and articles of incorporation

Once contracts are completed please forward along with a new piece of
business.

If you have any questions while completing the documents please
contact our contracting department.

Fastrac Canada (905)738-7813

Wendy Burgess, wburgess@fastraccanada.ca (ext.239)

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:0
posted:5/17/2012
language:
pages:2
fanzhongqing fanzhongqing http://
About