Broker of Service letters will only be accepted on cancelled Broker or Direct accounts.

What is a Broker of Service?

The following characteristics apply to a Broker of Service:

  1. Broker does not own the policy.
  2. Broker will not be paid commission.
  3. Broker cannot negotiate pricing for the policyholder.
  4. Broker may represent the client’s interest with State Fund and may be provided with servicing information.
  5. All automated communications and documents still go directly to the employer.

What is a valid Broker of Service letter?

The Broker of Service letter received by State Fund must meet all of the following requirements in order to be considered valid. 

  • The Letter must be on employer’s letterhead.
  • The Letter must express the employer’s intention to appoint the broker as the Broker of Service.
  • State Fund must receive the letter within 30 calendar days of the date of the letter.     
  • The Letter must be specifically addressed to State Fund.
  • The Letter must specify the employer’s name and policy number.
  • The Letter must include the printed name and title of signer.
  • The Letter must specify the broker’s name and address, telephone and fax number, and if applicable, the broker’s State Fund access number.
  • The Letter must be signed and dated by the corporate officer, partner, sole proprietor, executive director (nonprofit entities only), or manager and/or managing members of Limited Liability Companies (LLCs). The signing individual must have the authority to enter the company into a contractual agreement and must be endorsed on State Fund policy records.

***Note: If the organization or corporation is a nonprofit they may provide Board Minutes as the policy records may not reflect the current members. 

What determines the effective date of the Broker of Service letter?

The effective date of the valid Broker of Service letter will be determined on the basis of the date when State Fund receives the valid Broker of Service letter. Valid Broker of Service letters received after 5:00 p.m., on a weekend, State or Federal holiday will be considered received on the next business day. State Fund’s business day begins at 8:00 a.m. and ends at 5:00 p.m. Pacific Time (PT). 

How and where can Broker of Service letters be sent?

They can be sent to the Account Management unit at or to our fax number at 888-302-3538

A Broker can be appointed as a Broker of Service only on Cancelled Brokered and Direct Accounts.

As a Broker of Service on a cancelled account, the broker is entitled to the following documents upon request.

  1. Cancellation Notices
  2. Cancellation Warning Notices
  3. Certificates (List of Issued Certificates)
  4. Claims Narratives
  5. Claims Resumes
  6. Claims Review
  7. Endorsements
  8. Experience Modification
  9. Loss Runs
  10. Payroll Reports
  11. Premium Bills: Deposit Premium and Final Bill only
  12. Rate Sheet (X-Mod Worksheet)

How does a broker/employer release Broker of Service representation on an account?

The broker/employer can submit a written request to the Broker of Record desk at The request must state: “release Broker of Service representation of this policy” or “remove as Broker of Service.”

Account Management/BOR Desk Contact Information:

Direct Phone: (888) 302-3540

Fax: (888) 302-3538