To appoint your company/agency please download CCHP Agent/Broker & Business Associate Agreement and provide the following materials:
Gracias por su interés en ser nombrado con CCHP
- Broker & BAA Agreement
- Broker Application
- Page 14 Brokers/Agent Agreement
- Page 1, 8 & 9 Business Associate Agreement
- California States License
- W9 Form
- E & O Cert
- Covered CA Cert # if applicable
- 2022 CCHP Agent/Broker Commission Schedule or 2023 CCHP Agent/Broker Commission Schedule
- Direct Deposit Form pdf format or Word doc format