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Online Pre-qualification

This questionnaire will help determine if you qualify for online enrollment as an individual agent or an agency. If you don't qualify for online, please submit an application for underwriter review - we want your business!

Individual Agents coverage is for you if:
  • You are the named Insured
  • You have office staff needing coverage solely for activities on your behalf
  • Your revenue (Commission income/fees) is below $500,000 annually
  • You are an agency in business less than 3 years (coverage can only be written for each agent within the agency)
1. Does your office/business produce more than 50% of its revenue from life, annuities, accident and health insurance products?
2. What date was your office/business established?
If your office/business has not been established for at least three years, you will be applying as an individual agent. Any licensed producer must apply separately as an individual agent.
3. Are you seeking coverage for two or more agents?
4. Are there two or more owners of your office/business?
5. Is the annual commission of your office/business $500,000 or greater?
6. Does your office/business have any licensed clerical staff who act as licensed agents with contracts of their own, and receive direct commissions?
7. Are you a resident of California?