Licensed agencies and brokerages may register for WCIRB Connect® by completing the form below. Registration requests will be processed as soon as possible. Based on the volume of responses, it may take up to 10 business days to complete a registration. If you are an individual agent or broker, please use the WCIRB Connect for Individual Agents and Brokers registration form.The fields marked with an asterisk (*) in the form below are required.
Requirements for Registration
Principal or Officer of Business EntityBe an officer or principal of the Business Entity with the authority to agree to the WCIRB Website Access Agreement — Casualty Brokers–Agents on behalf of your company. If you are not, please ask a principal or officer to complete this registration form.
Have a valid California Casualty Broker – Agent Business Entity license.
- Have a company email address. (Free email address such as Y! Mail and Gmail cannot be accepted.)
- Designate a System Administrator to manage your users.
- Accept the WCIRB Website Access Agreement — Casualty Brokers-Agents.