The FWCJUA has created an on-line Agency application form to assist you determine whether you meet the requirements prescribed by law and adopted by the Board of Governors of the FWCJUA to obtain authorization to submit business. Each Agency must meet the minimum standards identified below in order to submit applications to the FWCJUA and directly or indirectly receive compensation in connection with business written by the FWCJUA. Please note that an Agency who receives authorization to submit applications to the FWCJUA has no authority, actual or apparent, to bind coverage on behalf of the FWCJUA or automatically assume the responsibility of issuing Certificates of Insurance without prior consent and permission from the FWCJUA or its Service Provider.
Minimum Standards:
The Agency must maintain errors and omissions insurance in an amount not less then $500,000 per occurrence.
Each location of the Agency must be duly licensed and/or registered with the Florida Department of Financial Services, Bureau of Agent and Agency Licensing.
Each Designated Producer must be an individual licensed by the Florida Department of Financial Services as a general lines resident or non-resident insurance agency authorized to solicit, negotiate and effectuate workers compensation insurance.
Each Designated Producer or the Agency must serve as an insurance agent or insurance agency, as the case may be, of an insurer actively writing workers' compensation and employer's liability insurance in the state of Florida, pursuant to a certificate of authority issued by the Florida Office of Insurance Regulation.
The Agency and each of its Designated Producers must enter into an Agency Producer Agreement with the FWCJUA.
If you meet the above requirements, and wish to continue with the Authorization Process, you will need the following information for each Agency applying for Authorization:
Each Designated Producer's Florida Department of Financial Services 2-20 Agency License Number.
Confirmation that the Designated Producer applying for the authorization has an in-force book of business for workers compensation (new or renewal) with one or more insurer listed for requirement (4.) above.
Errors & Omissions insurance policy information evidencing limits of at least $500,000.
Agency check in the amount of $100.00 for each Designated Producer listed in the Agency Producer Agreement.
Note: All locations under the same Agency FEIN must be disclosed even if the agency will not submit business through that particular location. The Designated Producer must sign the corresponding Exhibit A that will print for the location he and/or she will be submitting from. A separate Agency Producer Agreement will need to be completed and submitted for each location under a separate FEIN.
If you have read, understand, and agree that you meet all the above requirements, then you are ready to begin the on-line authorization process. To proceed, please enter the Agency's FEIN and click Continue.
FEIN Number: