STATE OF ALABAMA --- DEPARTMENT OF INSURANCE
TOTAL FEES: $155
APPLICATION FOR MANAGING GENERAL AGENT (MGA) APPOINTMENT
1. Section I of this form is to be completed by an authorized representative of the insurance company and Section II is to be completed by the Managing General Agent
(MGA). Non-resident MGAs must also complete Section III. If currently licensed as an MGA in this state, the Alabama MGA license number must be shown in Section I.
If not currently licensed, the Department will assign a number upon filing.
2. Filing of this application does not give authority to the MGA. This authority does not exist until all required items are filed and a license is issued by the Alabama
Department of Insurance.
3. This application must be accompanied by a check or money order in the amount of $155.00, representing an application fee of $30.00 and a license (appointment) fee of
$125.00. [Retaliatory fees may also apply. See Section III of application.] An application will be returned without processing if not accompanied by the fees as indicated
above. Make check or money order payable to "Commissioner of Insurance, State of Alabama."
4. In addition to the fees mentioned above, the following items MUST be submitted with this application:
If applicant is a business entity, a certificate of good standing from the Alabama Secretary of State.
- Original copy of fidelity bond [in the minimum amount of $100,000].
Copy of MGA's errors and omissions policy [in the minimum amount of $1,000,000 or 25% of gross amount of direct premium, whichever is greater].
Duplicate copy of the executed contract between the MGA and the insurer. All Alabama insurers must use Form AL-MGA-2, which can be obtained from the
Alabama Department of Insurance and may be freely copied. Other insurers must also use Form AL-MGA-2, unless the insurer is domiciled in a state having a law
substantially similar to the Alabama MGA Act, in which case the insurer must file a c