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Become a Member
Renew Membership
Agent Resources
Diversity & Inclusion
Education Resources
Foundation Scholarship
Marketing Resources
Next-Gen
Starting An Agency
Technology
Tools For Your Agency
Advocacy
PAC
Product & Services
Agency Link
Business Consulting
Errors and Omissions Insurance
Insurance for Your Agency
Insurance for Your Clients
Valuation and Perpetuation
Workers’ Compensation Program
Resource Center
HR Solutions
HR Advisory Services
OIA Job Board
HR Solutions: Home
Independent Insurance Agency Careers
Summer Internship Program
News & Events
IACON24
Marketing Workshop – The Power of Connection
Amwins CIC Happy Hour – June
Amwins CIC Happy Hour – August
News & Blogs
Carrier Relations
Company Partners
Company Partners Benefits
Learning Portal
Course Schedule
About OIA
Best Workplaces in Ohio
Center of Our Universe
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Premium Indication Form
Fill out the form below to get started.
Swiss Re Corporate Solutions Capacity Insurance Corp
For Exclusive use only for Members of The Agency Collective Alliance - Premium Indication
Contact Name
Agency's Legal Entity Name
Address
City
State
Zip Code
Email
P&C new & renewal premiums written annually
Life and A&H new and renewal commissions
Annual Premium Percentage from Commercial Lines
Annual Premium Percentage from Personal Lines
Total Agency Staff
Current Carrier
Carrier Limits
Carrier Deductible
Carrier Policy Retro Date
Carrier Premium
Policy Effective Date
Comments
This form is used to provide a non-binding, premium indication based on preliminary information provided and is not intended to be a firm quote for acceptance of insurance coverage. To determine your qualification for a firm quote, we will need a fully completed Swiss Re application, along with a 5-year loss run.
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Last Name
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Email Address
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Agency/Company
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