JOB AID 2 APPLICATION SUPPORT

FOR CLCA CERTIFIED PRODUCERS

11.10.16

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PURPOSE OF JOB AID

• To assist Lead Accepting Producers with CLCA

applications submitted to CAARP

• EASi system benefits

• Required Application Information

• Application documents and support

• To offer producers a Consumer Checklist

before the consumer’s first office visit.

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ELECTRONIC APPLICATION SUBMISSION INTERFACE (EASI)

• Provides immediate binding of coverage

• Generates temporary insurance identification cards for private

passenger applications

• Electronically transmits the application to the Plan.

• Allows the deposit payment to be made by electronic funds

transfer, debit card, or credit card.

Producers are required to utilize the EASi system

to expedite the application submission process.

Benefits of using EASi:

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APPLICATION REQUIREMENTS AND DOCUMENTS NEEDED

• Completed application on the EASi system

• Copy of the vehicle registration

• Copies of the drivers’ licenses for the

insured and any principle operators.

• Deposit payment

• The applicant must sign and date the

application or it will be returned void.

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REQUIRED APPLICATION INFORMATION

• Last name, First name and middle name or initial of the applicant

• Resident address and telephone number

• Mailing address if different from resident address

• Occupation and length of time at current employer

• Employer name, address and telephone number

• Vehicle year, make, model, and vehicle registration

• State where vehicle is registered and registered owner’s name

• If uninsured motorist property damage is requested, provide Information on any existing damage

to the vehicle

• Usage of the vehicle (pleasure, work, business or farm) and the number of miles driver to work

or school (one-way)

• Garaging address if vehicle not garaged at resident’s address

• Rating band and rate class for as many vehicles as listed

• Premium amounts for coverages (listed individually)

• Total policy premium amount plus gross deposit amount submitted

• Selection of payment from one of the three payment options

• Drivers licenses for the Insured and all drivers in the household

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REQUIRED APPLICATION INFORMATION CONTINUED

• Indicate years licensed of all drivers in the household and if licensed less than three years,

indicate date licensed

• Indicate individuals in the household who do not drive or are not licensed due to license

suspension or revocation

• Indicate relationship to applicant, percentage of use of vehicles, birth date, and gender of all

licensed drivers in the household

• Marital status including name of spouse or registered domestic partner if not listed as an

additional driver

• Indicate whether applicant is required to file evidence of financial responsibility with the

Department of Motor Vehicles and if so, indicate all information needed to make filling (the

name of the individual requiring the filing, the type of filing, the reason for the filing, and the

state where the filing is required)

• Name of the last automobile insurer policy number, termination date and reason for termination

if available

• Provide details about all motor vehicles convictions and accidents in the preceding three years

involving the applicant and anyone who operates the applicant’s vehicle(s)

• If the application is for non-owner policy, provide all information including rating band and rate

class

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PROOF OF INCOME DOCUMENTATION• Federal or state income tax return for the last year

• IRS form 1099

• IRS form W-2

• Payroll stub

• Medi-Cal card

• An employer verification letter

• Social Security or pension letter

• Utility company/ Lifeline verification

• Electronic Benefit Transfer (EBT) card

• Notification from California Work Opportunity and Responsibility to Kids

(CalWORKS)

• State of California Employment Development Department (EDD) Debit Card or

benefit letters

• Bank Statement as proof of deposits of Social Security payments

• CalFresh (food stamps)

• CalWORKS (welfare)

• SSI (aged, blind, disabled)

• LIHEAP (Low Income Home Energy Assistance)

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CONSUMER’S CHECK LIST

• Vehicle year, make, model, and vehicle registration

• Copies of the drivers’ licenses for the insured and any principle operators.

• Address where vehicle(s) will be garaged/parked.

• Form of payment

• Proof of income document

• Proof of vehicle ownership / registration

• Previous automobile insurer policy number, termination date and reason for

termination, if available

• Any evidence of required Financial Responsibility filing with the Department of

Motor Vehicle (SR-22), if applicable

• Consideration for optional CLCA insurance coverage (Uninsured Motorist and

Medical Payment), if applicable

Consumers are encouraged to bring these items to their office appointment when applying for CLCA insurance:

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QUESTIONS ABOUT APPLICATION

IF YOU HAVE ANY SPECIFIC QUESTIONS ABOUT THE APPLICATION NOT

COVERED IN THIS JOB AID PLEASE CONTACT:

AIPSO / CAARP

Phone: 800-622-0954

Email: caarp@aipso.com