Get Broker Of Record - Blue Cross Blue Shield Of Ri

Completing the Broker Of Record form for Blue Cross Blue Shield of Rhode Island is an important step in ensuring proper representation for a group. This guide offers clear, step-by-step instructions to help you navigate the online form efficiently and accurately.

Follow the steps to complete the form with ease.

1. Press the ‘Get Form’ button to access the Broker Of Record form. This will prompt the form to open for you to begin filling out.
2. In the section labeled 'Effective Date,' enter the date when you want the Broker of Record status to take effect.
3. Fill in the 'Group Number(s)' and 'Group Name' fields with the relevant information for the group you are representing.
4. As the new broker, complete the statement indicating your acceptance of the assignment and verify that the information provided is correct.
5. Input your 'BCBSRI Broker ID Number,' 'Broker Name,' and provide your 'Broker Signature' in the specified fields.
6. Include the agency name and any percentage arrangements in the designated areas, repeating for any additional brokers as necessary.
7. If applicable, fill in the details for the general agent, including 'BCBSRI General Agent Number,' 'General Agent Name,' and provide their signature and date.
8. Complete the section for the company officer by entering their name, title, and signature along with the date.
9. Finally, review all the information provided to ensure accuracy. Once verified, you can choose to save changes, download the document, print it, or share it as required.

Complete your documents online today to ensure timely processing!