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AGENCY REVIEW
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Authorization Eligibility Requirements
The questions presented below represent minimum eligibility requirements to become authorized.
The Agency must have an Agency license as Resident (21-05) or Non-Resident (21-05) in Florida.
Each Producer to be designated must have a General Lines license as Resident (2-20) or Non-Resident (9-20) in Florida.
The Agency must provide a Certificate of Insurance evidencing Errors & Omissions (E&O) or Professional Liability insurance.
Each Producer to be designated must have an active Florida Workers Comp insurer appointment in Florida.
In order to apply for authorization to submit business to the FWCJUA, please complete the following for verification:
Enter the Agency's license number in Florida (Resident or Non-Resident).
Yes
No
Enter the license number in FL (Resident or Non-Resident) for one of the producers you wish to designate.
Yes
No
Does each producer you wish to designate hold an active workers comp carrier appointment in Florida?
Yes
No
Can you provide proof of Agency's E&O or Professional Liability coverage?
Fill Out Agency/Producer Agreement
