AGENCY REGISTRATION

AFTA Plan Agency Registration Application

This is not an application for the AFTA assurance plan. If you want to purchase AFTA, please contact an agent.

We are currently offering a 30 day trial for companies who want to become Agents. Once you fill out this form, you will be able to view a presentation on the AFta Plan and all the tools to set your business up as an agency, including a banner that you can add to your website.

If you decide you do not want to continue with the application, you can cancel at any time. To become and Agent requires a payment of $79 annually. The first payment will be due after the initial trial period.

*Marked fields are Mandatory

COMPANY
NAME:

PHONE:

ADDRESS:

STATE:

MC #:

EMAIL:

FAX:

CITY:

ZIP:

CONTACT:

TERMS AND
CONDITIONS:

1.The AF Total Assurance plan (AFTA) is underwritten and administered by AF Management 
Consulting, in this agreement known as "Administrator". A person or organization selling AFTA to the end consumer should be a registered agency authorized to do so. This organization or person will be referred to in this agreement as the "Agency" 
2.This registration application serves as an agreement between AF Management Consulting, the plan Administrator and the Agent. The following terms and conditions constitute the agreement.
3.Only registered agents and/or employees will be allowed to sell AFTA.
4.AFTA will act as an additional assurance to the general insurance provided by a carrier company and will not replace said insurance.
5.Agent will receive an agency number that will act as the authorized identifier to sell AFTA. If for any reason a consumer neglects to use the correct agency number, the Administrator cannot be held liable for claims, fees or any disputes between the agency and the customer of the agency.
6.Agency will receive a reference link to a unique AFTA registration page for customers to the agency. This link should be made available to customers when they decide to purchase AFTA. No registrations can be accepted outside the registration page for an agency on the Administrators website.
7.The Administrator will use its discretion to admit and approve agencies. The approval will be based on:
a. Rating with the BBB
b. The rating on transportreviews
c. Time of operation
d. Internal rating
e. Fully bonded and insured with the USDOT
8.Agency status will be revoked upon non payment of monthly agency fees as determined annually.
9.Agencies shall have a Logo displayed on their website that will link back to their Agency Rating on the Administrator web site. No direct links that will lead customers to competitors will be active.
10.Agency claim penalties and effect on ratings.
a. (A++) Minimum membership of 2 years with no claims. No deductible on up to 2 minor and 1 major claims per 100 AFTA Plans sold.
b. (A+) Minimum membership of 12 months with no claims. No deductible on up to 2 minor and 1 major claims per 100 AFTA Plans sold.
c. (A) Regular agent less than 6 months with no claims. No deductible on up to 2 minor and 1 major claims per 100 AFTA Plans sold.
d. (B+) Regular agent where its customers submitted more than 2 minor ($400) and 1 major ($1000) claims per 100 AFTA Plans sold. Agency will be responsible for a 10% deductible on additional claims but claims should not exceed a total of 4 minor and 2 major claims per 100 AFTA plans sold.
e. (B) Regular agent where its customers submitted more than 4 minor ($400) and 2 major ($1000) claims per 100 AFTA Plans sold. Agency will be responsible for a 20% deductible on additional claims but claims should not exceed a total of 6 minor and 3 major claims per 100 AFTA plans sold.
f. (B-) Regular agent where its customers submitted more than 6 minor ($400) and 3 major ($1000) claims per 100 AFTA Plans sold. Agency will be responsible for a 40% deductible on additional claims but claims should not exceed a total of 8 minor and 4 major claims per 100 AFTA plans sold. 
g. (F) Exceeding these claims agency will be revoked.
11. The commission on each AFTA Plan will be $35.00. Commissions will be paid on the 28th calendar day of every month. 
12. Claims will be submitted directly at the Administrator's website. Agents can only refer customer via their own website, email or verbal communication to the claims page on the Administrator site. The agency number has to be submitted by the client as well as an order number.
13. Claims have to be evaluated by the agency first before recommending customers to submit it online. Agency is responsible for providing the link to the claims page.
14. Both the administrator and agency has the right to terminate this agreement without further notice. Agency will be accountable for any deductibles due to claims from customers even after the termination of the agency agreement.
15. AF management consulting cannot be held liable for any claims or disputes arising outside this agreement.

AFTA Plan Agency Registration Application

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