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PRISM - Health Net is Now Available Through Claremont!

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Lowest rates in the market – Affordable options without compromising quality.
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Flexible HMO options – Networks to fit nearly every group statewide and every budget.
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Agent Agreement

Agent contract: Do we need to maintain a min. book of business in Covered California for Small Business to keep contract?

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No.

Has the agent contract been approved or is it still in draft?

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The agent agreement has been approved.

My agency’s E&O policy doesn’t list the agents. It’s written in the name of the agency. During training class, I was told that this would be acceptable to submit, however on the Agent Certification Checklist it says the following: “Errors & omissions declaration page demonstrating minimum required coverage levels in the Agent’s name.

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It is acceptable to submit the declarations page from the agency’s policy as evidence of the agent’s coverage, provided that the agency’s policy does actually cover the agent.

Standard Agreement (Std 213) Section 1 – What do I list as the “Contractor’s Name”, my own name or my agency’s?

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Use the certified agent’s name, NOT the agency name.

Standard Agreement (Std 213) Contractor Section – Do I use my information or the agency’s?

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Use the certified agent’s name and signature and it is OK to use the agency’s address.

Exhibit A – P.1 Scope of Work Do I enter the agency’s FEIN or do I put my own SSN. I don’t want to put my own SSN if payments will go to me.

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For those agents who want their commissions to go to an agency, they should put the agency’s FEIN.

Exhibit D – P.1 Business Associate Agreement Do I list the agency name or my name in the second blank?

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Use the certified agent’s name.

Exhibit G – P.1 Darfur Contracting Act Certification Form. Do I list the agency’s FEIN or do I list my own SSN?

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List the agency’s FEIN.

Payee Data Record (Std 204). Section 3 – Do I enter the agency’s FEIN? I want all payments to go to the agency, not me.

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If the agency is to be paid, put the agency’s FEIN.

Payee Data Record (Std 204). Section 5 – Do I put my information and signature here, or can the owner of the agency put his information and signature?

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If the agency is to be paid, the agency should fill out the form and the agency’s authorized payee representative should sign it.

In our library, you’ll find carrier forms, applications, enrollment kits, broker bonuses, marketing resources, and more (video tutorial). However, not all carrier forms are available online.

If you don’t find what you are looking for, contact our team for help at 800.696.4543 or materialsrequest@claremontcompanies.com.