Broker of Record Letter

Current Insurance Carrier

  • Company Name:

  • Address:

  • Policy or Group Number:

To whom it may concern:

This letter will serve as notification of our appointment of Benefits Planning Service, 1200 Quail Street, Suite 105, Newport Beach, CA 92660, as our insurance representative and Broker of Record, for all matters relating to and concerning our group insurance benefits. This appointment is effective upon (month) (date) (year) and supersedes any previous broker of record and/or authorization letters.

Please furnish Benefits Planning Service with copies of policies, endorsements, amendments, and any other documents that are deemed necessary to handle and protect our benefit program interests. We appreciate your understanding and cooperation in this regard.

We understand that Benefits Planning Service will not be responsible for any deficiencies in our current benefit plans, to which this letter pertains, until it has had a reasonable opportunity to review our current policies, as well as any related endorsements and amendments, and is in a position to provide us with recommendations.

Thank you for your assistance with this request.  Please advise if you have any questions.




Cc: Benefits Planning Service, California Insurance License #0810795


Contact Benefits Planning Service today for assistance on fully insured and self-funded plans as well as ACA compliance issues. We are here to serve you.