[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-278821-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-278821-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","exc-brk-broker-of-record-letter-template","EXC-BRK-Broker of Record Letter Template","","Broker of record designation letter template for Excellus BCBS group business. The template is formatted for submission on company group letterhead and includes recipient details for Broker Administration, group number fields, broker agency name and address, and an effective-date placeholder. It states the broker agency as the sole insurance representative for Excellus BlueCross BlueShield coverage, clarifies possible base and/or bonus compensation eligibility if coverage is purchased, and specifies that the designation remains until written notice of change. 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is the recipient for this broker of record letter template?","Question",{"text":63,"@type":64},"The letter is addressed to Excellus BCBS, Attn: Broker Administration, with the provided street address in Rochester, New York.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What does the template designate the broker to be?",{"text":68,"@type":64},"It designates the named broker agency as the organization’s sole insurance representative regarding all coverage provided by Excellus BlueCross BlueShield.",{"name":70,"@type":61,"acceptedAnswer":71},"How long does the designation remain in effect?",{"text":72,"@type":64},"The designation remains effective until the company notifies Excellus BlueCross BlueShield in writing to the contrary.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},278821,1790720390,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,114,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social 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Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":115,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":4},1099514068365,"https://ap-avatar.wpscdn.com/avatar/10000253d8d9f28188e?_k=1776742907772140068","(TO BE SUBMITTED ON GROUP LETTERHEAD)  \nExcellus BCBS  \nAttn: Broker Administration  \n165 Court Street  \nRochester, New York 14647  \nGroup Number(s):  \nBroker Agency Name:  \nBroker Agency Address: City, State, Zip Code  \nDear Broker Administration Team:  \nEffective (effective date), Our company hereby designates the above named Broker as our sole insurance representative with respect to All  \ncoverage provided to this organization by Excellus BlueCross BlueShield.  \nI understand that ifour company elects to purchase coverage from your company that  \nthe named Broker Agency may be entitled to base and/or bonus compensation for our business.  \nThis designation will remain in effect until we notify Excellus BlueCross BlueShield in writing to the contrary.  \nSincerely,  \nSignature of Company Officer  (e-signatures accepted if authenticated)  \nPlease print (Officer Name)  \nTitle of Company Officer","cbCaiebP4iIqNRWb","https://ap.wps.com/l/cbCaiebP4iIqNRWb","pdf",78596,"English","# Broker of Record Letter Template\n## Recipient and Submission Details\n## Designation Statement and Effective Date\n## Compensation Notice and Ongoing Validity\n## Signature and Officer Information","[{\"question\":\"Who is the recipient for this broker of record letter template?\",\"answer\":\"The letter is addressed to Excellus BCBS, Attn: Broker Administration, with the provided street address in Rochester, New York.\"},{\"question\":\"What does the template designate the broker to be?\",\"answer\":\"It designates the named broker agency as the organization’s sole insurance representative regarding all coverage provided by Excellus BlueCross BlueShield.\"},{\"question\":\"How long does the designation remain in effect?\",\"answer\":\"The designation remains effective until the company notifies Excellus BlueCross BlueShield in writing to the contrary.\"}]","EXC-BRK-Broker of Record Letter Template | PDF",1789512749]