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Agent of Records Letters

PW_M008262
An Agent of Record (AOR) form or letter is needed to change, add or delete an agent. 
The Agent of Record change request should be submitted on the AOR form whenever possible. If this form is not available, a letter from the group on the group's letterhead, which includes the group name, group number, agent's name and agent's Anthem ID number will be accepted. The form or letter must be signed by an officer of the group and letters must include all information that is requested on the form
If the Agent of Record letter represents a change for life, or dental as well as health, it must be checked on the form, or the changes may not be made. 
Agent of Record commission changes will become effective on the 1st day of the second month following receipt of the AOR form. Example: If an Agent of Record form or letter is received in Broker Administration on June 29, the commission would become effective for the new agent on August 1. Agent of Record forms or letters received in Broker Administration July 3; commission would become effective for the new agent September 1. 
The current agent will be notified of the requested change. The existing agent has 10 calendar days to send a rescinding letter from the group to Broker Administration. If a rescinding letter is not received, the commission change will take place as previously indicated. 
Anthem Blue Cross and Blue Shield will recognize the new agent as accountable for the group once we receive an Agent of Record change form or letter; however, it will not show in your on-line book of business until the actual effective date of the change. 
When an agent is deleted per a group's request, the effective date of the deletion is the 1st of the month following receipt of the letter in Broker Administration. 
Agent of Record changes are not accepted on direct-sold cases. 
Questions regarding the Agent of Record changes should be directed to: 
Anthem Blue Cross and Blue Shield 
ATTN: Broker Administration, VA4002-R275 
P. O. Box 27401 
Richmond, VA 23279 
Phone: (804) 354-3983 
Fax: (866) 701-4991 
 
©2005-2014 copyright of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use