Broker Registration - Axel Workforce Solutions

Broker Registrationmaster2025-10-05T21:14:01-04:00

WELCOME TO AXEL

WORKFORCE SOLUTIONS, SIMPLIFIED

Our Workforce Solutions Marketplace empowers agents to quote submissions instantly within our platform. You’ll gain access to competitive workers’ compensation programs and advanced human capital management solutions like PEO, payroll, HR, and benefits administration — all in one platform.

ONLINE SUBMISSION

FAST TURNAROUND

IINSTANT PRICING

COMPARATIVE RATER

EXCLUSIVE PRODUCTS

30 YEARS+ EXPERIENCE

"(Required)" indicates required fields

Step 1 of 2

50%

Get registered in minutes.

Before you jump into getting registered, please be sure to have the following on-hand:

• Business Tax ID Number
• E&O Documents
• Agency License

License Number(Required)

Licensed State(Required)

Legal Agency Name

Contact Title

Contact First Name

Contact Last Name

Contact Phone(Required)

Contact Email(Required)

Agency Information

Principal First Name

Principal Last Name

Business Address(Required)

Street Address

Address Line 2

City

State

Zip

Business Type

Has the agency, shareholder, partner or principal thereof ever declared bankruptcy?(Required)

Yes

Has the agency, shareholder, partner or principal thereof ever been convicted of a felony?(Required)

Yes

Has the agency, shareholder, partner or principal thereof ever been refused a license?(Required)

Yes

Has the agency, shareholder, partner or principal thereof ever been subject to discipline and/or investigated by the DOI?(Required)

Yes

Is there any pending or threatened litigation or judgments within the past five years exceeding $10,000 against the broker or any principals of the organization?(Required)

Yes

Errors & Ommissions Information

E&O Expiration Date

MM slash DD slash YYYY

E&O Policy Number

E&O Carrier

Has agency had any E&O claims or complaints filed with regulatory authorities or license revocations in the past 5 years?(Required)

Yes

Upload Documents

Upload your Broker’s License, E & O Policy Declaration Page, by clicking the Select Files below. You may upload multiple files at once.

Drop files here or

Max. file size: 256 MB, Max. files: 10.

Page load link

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Products & Services
631-920-5761
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Contact Info

41 Avada Avenue, Florida, 98765

403-904-3623

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