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.