Insurance Companies and Groups
Insurance Companies: Please list your insurance companies and
annual premium range.
Clusters
Associations
Are
you a member of other associations or affiliations?
(Hold
down the CTRL key when selecting more than one or Write in the name of the
Association)
Keeping
in Contact
Please provide a complete listing of your primary
office contacts, titles and email addresses with your application.
In so doing, IBA West can more efficiently and effectively distribute
timely information to appropriate office contacts for legislation, education,
insurance products, financial service products and the Weekly Insider.
Principal Contacts
Branch Offices
How did you hear about IBA West?
What are your primary reasons for joining IBA West? Hold down the CTRL key when selecting more than one
PLEASE
READ THE FOLLOWING: My
firm and the producers herein submit the qualifications for membership.
I understand that: Membership in Insurance Brokers and Agents of the
West may be denied or revoked at any time if information provided on this
application is not true and complete, or as specified in the Bylaws; dues are
fully earned at the inception of membership; dues are calculated annually and
are prorated in accordance with association policies; membership in California
is co-extensive with the Independent Insurance Agents & Brokers of America
(IIABA), as well as local Big “I” associations (where membership, if any, may
be subject to that board’s approval).
Check
here to acknowledge you have read the above.
Use
the following space if you have any additional comments or questions for Member
Services.
Your
application for membership will be emailed to
IBAWestMemberUpdate@ibawest.com,the IBA West Member Services office located at:
IBA
West,
21731 Ventura Blvd, Suite #165,
Woodland Hills, CA 91364-4359
Phone
800-772-8998
Fax 818-888-1757
www.ibawest.com
You
will be contacted directly with a membership dues quote or to obtain additional
information that may be required. At
the time of acceptance, you will be requested to provide a copy of your
broker/agent license and bond.
Business Profile
Membership dues are based on all insurance and
financial service related revenue, including commissions for property and
casualty, life and health, employee benefits, financial products, contingent
commissions, interest income, fees for services, etc. for all offices in the
state, rounded to the nearest $25,000.
Providing
data on business lines, premium volume and headcount, allows IBA West to better
serve you by providing more useful products and services.
The additional data is used in order to provide you with a strong
legislative and regulatory representation.
All firm-specific demographic and operating information will always be
maintained confidentially by IBA West.