Broker Appointment Package
Thank you for your interest in getting appointed with CCHP
To appoint your company or agency, please download the CCHP Agent/Broker & Business Associate (BAA) Agreement and provide the following materials:
- Broker & BAA Agreement
- Broker Application
- Page 14 Brokers/Agent Agreement
- Page 1, 8 & 9 Business Associate Agreement
- W9 Form
- E & O Certificate
- California States License – Department of Insurance
- Company CA License (if applicable)
- California (or State) Driver License
- AHIP Certificate (if applicable)
- Covered CA Certificate # (if applicable)
- 2026 CCHP Agent/Broker Commission Schedule
- Direct Deposit Form
For individual producing agents in your company, given that the commission is payable to the company. We would need the completed Broker Application, a copy of their State Driver License, CA License, and their E & O Certification.