Register a Company

All Users must first create a username and password prior to using the Rapid Online Submission Interface.

A Company account is limited to insurance carriers, intervenors, law firms or other representatives. A Company account requires authorization from AHB prior to access. Once a Company account is created and AHB grants access, a Company Administrator may create multiple Company general users, each with their own unique username and password.

Company Information

Company Name **
NAIC # for Company (if Insurer) **
Address1 **
Address2 *
City **
State **
Zip **
Email **

Primary Administrator

First Name **
Last Name **
Email Address ***
Phone Number *
Title *

Secondary Administrator

First Name *
Last Name *
Email Address **
Phone Number *
Title *

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