This government document is issued by California Health Benefit Exchange for use in California
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https://www.google.com/url?client=internal-element-cse&cx=009854164935538441977:yzlo2be1knm&q=https://hbex.coveredca.com/toolkit/forsmallbusiness/downloads/AGT-001_Agent_Transfer_Book_of_Businss%2520Form-CCSB.pdf&sa=U&ved=2ahUKEwiEsaSVrqPyAhUMt4sKHdJIAP04HhAWMAJ6BAgHEAE&usg=AOvVaw1MC1kSFeIy-0JN7J919svD