Paquete de Citas para Agentes

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

8a. 2022 CCHP Agent/Broker Commission Schedule

8b. 2023 CCHP Agent/Broker Commission Schedule

9. Direct Deposit Form  pdf  doc file