Delegation code

Delegation code

CREATE AN ACCOUNT - WITH YOUR PROVIDED DELEGATION CODE

Enter your delegation code and required information here:

* Indicates a required field.

Delegation code : *

Legal Business Name : *

Certification Number : *

Individual Email *

You must enter all required information to continue.

Label	Element Type	Description	Validation	Role
Delegation Code	Text Box	Enter delegation code	Enter alphanumeric values only Enter maximum 6 characters	Enrollment Counselors,Issuer, Employer Representative and Authorized Representative users only
Legal Business Name :	Text Box	Enter Covered California Certified Enrollment Entities name	Enter alphanumeric values and all printable special characters Enter maximum 50 characters	Covered California Certified Enrollment Counselors,Issuer and Employer Representative users only
Certification Number	Text Box	Enter certification number	Enter 10 digit numeric values only	Enrollment Counselors user only

Covered California