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Home
Solutions
Underwriting
Products
Claims
Administration
Resources
About
About Us
Our Team
Our History
News
Contact Us
Resources
Forms
Underwriting
Disclosure Statement and Details of Claims Form (pdf)
Disclosure Statement and Details of Claims Form (xls)
Statement of Health
Medical Information Release
UR LCM Vendor Evaluation Package
PPO Network Questionnaire
Administration
Premium submissions (xls)
Agent Appointment Form
Application for Reinstatement of Excess Loss Coverage
Monthly Aggregate Claim Reports (xls)
TPA Questionnaire
Sample ANICO Treaty
Claims
Specific Reimbursement Request
50% or Potential Claim Notification
Confirmation of Work Status/Eligibility Form
Bardon’s Trigger Diagnosis Codes
BIG Aggregate Excess Risk Form (xls)
Aggregate Accommodation Form
Final Aggregate Form
Completed Funding Questionnaire
Helpful Links
Standard Life and Accident Insurance Company
A.M. Best Company
National Insurance Commissioners
Self Insurance Institute of America
Society of Professional Benefit Administrators
