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How to Apply to Become a Provider

DFS-H2-464
Rule 69B-227.140 & 69B-228.180, F.A.C.
Revision: 03/2014

Florida statutes and Department rules require that individuals or entities offering Continuing Education and/or Pre-Licensing courses for insurance credit be approved by the Department. All such individuals or entities are advised that their conduct must conform to all provisions in Rule 69B-228, F.A.C. (Continuing Education) or Rule 69B-227, F.A.C. (Pre-Licensing). These rules can be found online at https://www.flrules.org.

The Department uses the information submitted in this application, including any supplemental material, to determine if your organization meets the rules of the State of Florida governing approval of Pre-Licensing or Continuing Education Provider. You must be approved as a Provider in order to apply for Course approval. You will be notified electronically when you have been approved or disapproved as a provider. If approved, you will receive a Provider ID number that will be used in all aspects of your communications with the Department.



Privacy Statement
Pursuant to the Privacy Act of 1974, 5 U.S.C. § 552a, the State is responsible for informing you whether disclosure of your social security number is mandatory or voluntary, by what statutory or other authority your social security number is solicited, and what uses will be made of your social security number. Under § 119.071(5)(a)2., F.S., a state agency may collect your social security number if the collection is specifically authorized by law or if it is imperative for the performance of the agencyʼs duties and responsibilities as prescribed by law.

Disclosure of your social security number on this form is voluntary and imperative for the performance of the agency's duties and responsibilities under § 119.071(5)(a)2.a.(II), § 626.2816, and § 626.2817, F.S.

The purposes for the requested information are to verify the identity of an applicant, to conduct criminal and disciplinary history background checks, and to determine if the applicant has the knowledge, competence, and integrity to fulfill the continuing education and prelicensing education objectives of § 626.2815, § 626.2816, § 626.2817, § 626.869, § 626.385, and § 626.386, F.S. Your social security number is confidential and exempt from the disclosure requirements of § 119.07(1), F.S., and § 24(a), Article I of the Florida Constitution and will not be used for any purpose other than the purposes provided herein, or as otherwise authorized under § 119.071(5)(a), F.S.

A copy of this Privacy Statement is provided to you as required by § 119.071(5)(a)3., F.S.