Get Agent Of Record Letter (uahu Approved) - Selecthealth - Selecthealth

The Agent of Record Letter is a crucial document for establishing a designated agent to handle medical and/or dental insurance products. This guide will provide you with a clear, step-by-step process to effectively fill out this document online.

Follow the steps to complete the Agent of Record Letter smoothly.

1. Press the ‘Get Form’ button to access the document and open it for editing.
2. Enter the current date at the top of the letter in the appropriate format: Month/Day/Year.
3. Fill in the name of the recipient, Mrs. Janica Blackhurst, along with the address of SelectHealth as specified in the document.
4. In the section labeled 'hereby designates,' enter the Company Name that you are appointing as the Agent of Record.
5. Indicate the effective date of the designation by filling in the Month, Day, and Year.
6. Include the Agent Name whom you are designating in this letter.
7. Complete the agent's details, including the phone number, agency name, street address, city, state, and ZIP code.
8. Ensure that the employer's signature, typed or printed name, and title are provided in the designated areas.
9. Have the agent also sign and date at the bottom of the letter where indicated.
10. Ensure the letter is printed on the employer's letterhead, especially for large employers.
11. Review the document for accuracy and completeness before saving your changes, downloading, or sharing the completed form.

Complete your documents online today for seamless management of your insurance needs.