Broker Appointment Package

Find out the required materials to appoint your company/agency. View, or download the CCHP Agent/Broker & Business Associate Agreement to learn more.

Broker Appointment Package

Thank you for your interest on getting appointed with CCHP

To appoint your company/agency please download CCHP Agent/Broker & Business Associate Agreement and provide the following materials:

Broker & BAA Agreement

1. Broker Application

2. Page 14 Brokers/Agent Agreement

3. Page 8 Business Associate Agreement

4. California States License

5.  W9 Form

6. E & O Cert

7. Covered CA Cert # if applicable

8. CCHP Agent/Broker Commission Schedule

9. Direct Deposit Form  pdf  doc file