ProgramBusiness
 
Browse Directory
Storefront Community

Sloan Mason Insurance Services

     Fill out the form below if you are interested in this program.
Program Details -

Sloan Mason WC Questionnaire Insurance

 

SLOAN MASON INSURANCE SERVICES
WC including USL&H-Questionnaire

  1. How many years has the Senior Officer, Partner or Proprietor operated this or a similar business?

  2. Does the applicant have evidence of continuous WC coverage over the past 3 years?

  3. In how many years of the last 5 years (including the current year) has at least 1% of the applicant's work (by payroll) been subject to the USL&H law?

  4. Does the applicant operate from a home or residential office?

  5. Have payrolls fluctuated more than 50% between any two of the last five years?

  1. What is the approximate prospective annual premium for the applicant?

  2. How many states does the applicant operate in? (Maximum number of states permitted = 5)

  3. Are the USL&H payrolls more than 1% of total payroll (excluding Clerical, Outside Sales and Drivers)?

  4. Is the current or prospective Experience Mod greater than 1.15 or less than .60?

  5. How many compensable losses have occurred in past 3 years, per $10,000 of Earned Premium?

  6. Is the applicant in Chapter 11 Bankruptcy proceedings?

  7. Has the applicant ever filed for voluntary or involuntary bankruptcy proceedings?

  8. Has the applicant's insurance been cancelled or lapsed in the last 2 years due to non-payment of premium?
  1. Does the applicant use independent contractors in the conduct of its business?
  2. If the applicant uses independent contractors, does the applicant obtain and retain Certificates of WC insurance?
  3. Does the applicant provide a group health plan for its employees?
  4. Does the applicant have an operating safety program?
  5. Does the applicant own, operate or lease any aircraft to fly its employees?
  6. Do employees travel out of rated states or beyond contiguous states on the applicant's business?
  7. Do part time or seasonal employees make up more than 25% of the work force?
  8. Is there any exposure to employee leasing, alternative staffing, temporary, volunteer, or donated labor?
  9. Does the applicant employ any captain or crew members of vessels not covered for injury by a P&I policy?
  10. Do any employees work predominantly at home?
  11. Any otherwise uninsured maritime construction or maintenance work on or from vessels used as work platforms?

Please do contact us for your clients’ USL&H insurance needs.

Sloan Mason Insurance Services
License No. 0D78351

402 W. Broadway, Suite 400
San Diego, CA 92101

Phone- 619-595-4831
Fax- 619-330-4512

Locations Served : Alaska, Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Washington,D.C., Delaware, Florida, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, Mississippi, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, New Jersey, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Vermont, Washington, Wisconsin, West Virginia, Wyoming