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Changes Requiring an Endorsement
Agent of Record Change Procedures
Corporate Officers
Certificate of Exemption from Coverage
Partners, Sole Proprietors & Owners
Certificates of Insurance
CHANGES REQUIRING AN ENDORSEMENT
- Name Change/Address Change
- Change in Federal Employer I.D. Number
- Ownership Change (may require new application)
- Changes in Legal Entity
- Additional Locations
- Exposure Changes
AGENT OF RECORD CHANGE PROCEDURE
Please submit an ACORD 36 or have the insured request this change in writing on company letterhead (include a date and signature).
FIRST BENEFITS INSURANCE IS UNABLE TO MAKE AGENT OF RECORD CHANGES MID-TERM. WE WILL MAKE THESE CHANGES ONLY AT THE JANUARY 1ST POLICY RENEWAL.
CORPORATE OFFICERS
Executive Officers of a corporation are defined as the "President, Vice President, Secretary, Treasurer" or any other officer appointed in accordance with the by-laws of the corporation. Under North Carolina law, officers are automatically INCLUDED in workers' compensation coverage unless an Exemption Form has been filed.
CERTIFICATE OF EXEMPTION FROM COVERAGE
This form is used if you have corporate officers that choose to be EXEMPT from workers' compensation coverage. Executive officers covered under the policy have the same status as the other employees under the policy. In North Carolina, Executive Officers may elect not to be subject to coverage by signing a Certificate of Exemption From Coverage Form. This form must be processed and filed with First Benefits Insurance. Once an Exemption Form has been filed, it remains in effect until a Revocation of Exemption is filed. Please make sure that an appropriate Exemption Form is completed and returned according to your coverage request.
PARTNERS, SOLE PROPRIETORS & OWNERS
Partners, Sole Proprietors, and Owners are automatically EXCLUDED from workers' compensation coverage unless an Inclusion Form has been filed. Once covered, they will have the same status as employees under the policy. When covered partners, sole proprietors, or owners are considered employees, their payroll will be assigned to classifications and rates under the rules which apply to employees. Premium for each partner, sole proprietor, or owner treated as an employee shall be based on an annual payroll amount. Changes in status of coverage for Partners, Sole Proprietors and Owners requires the signing of a Notice of Election of Coverage Form. The Election Form once filed remains in effect until a Withdrawal of Election Form is filed.
CERTIFICATES OF INSURANCE
First Benefits Insurance agents will provide agents with Certificates of Insurance as the need arises. However, your client may contact us in your absence. Reminder: The North Carolina Department of Insurance has a longstanding position that insurance agents may not alter Certificates of Insurance.
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