Affiliate Insurance Limits and Costs

We are surveying to gather affiliate data regarding insurance coverage limits and costs. Upon completion we will send the survey results back to you. National will evaluate the data and based on the results determine if there is anything they can do to help lower future costs such as group negotiations and/or a captive plan.

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* 1. Affiliate Name:

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* 2. Your Name:

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* 3. What is the name of the carriers used?

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* 4. Please provide the coverage limits:

Property Coverage Limits:

Building Coverage Limits:

General/Professional Liability Coverage Limits:

Umbrella Liability Limits:

Cyber Liability Limits:

D&O Limits:

Employment Practices Limits:

Third-Party Discrimination Limits:

Auto Insurance Limits:

Affiliate Insurance Limits and Costs

Question Title

* 1. Affiliate Name:

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* 2. Your Name:

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* 3. What is the name of the carriers used?

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* 4. Please provide the coverage limits:

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* 5. What is the cost of the above insurance coverage?

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* 6. What does your workers comp cost?