Get (small Groups) Application (pdf) - Nasw Assurance Services - Naswassurance

Filling out the (Small Groups) Application for NASW Assurance Services is an essential step for social workers seeking professional liability insurance. This guide provides step-by-step instructions to ensure you complete the form accurately and efficiently, facilitating your online application process.

Follow the steps to successfully complete your application online.

1. To obtain the (Small Groups) Application (PDF), click the ‘Get Form’ button to access the form and open it in the appropriate editor.
2. Begin filling out the 'Applicant Information' section. Provide details such as company name, contact numbers, email, and address. Ensure that the information is accurate and up-to-date.
3. Indicate your current professional liability carrier and the expiration date of your existing policy. This information is important for processing your application.
4. Indicate if you or any employees are members in good standing with NASW. If applicable, provide the membership number.
5. Choose how you prefer to receive your policy documents: via email, fax, or mail. Be sure to include your contact information accordingly.
6. If your business has a website, enter the URL. If not, check the items you will attach, like a company brochure or business plan, that describe services.
7. In the 'Professional Liability' section, fill in your current retroactive date and select your desired limits of liability. Make sure to review your selections carefully.
8. List the total number of W2 employees, including owners or principals, along with their occupations. Be mindful to designate each person only once according to their highest credential.
9. If applicable, verify compliance of licensed providers with Continuing Education requirements, answering ‘yes’ or ‘no’ as necessary.
10. Indicate if you utilize any 1099 Independent Contractors, providing their number if applicable, and take note of potential extra premiums.
11. If opting for additional coverages like State Licensing Board Defense Coverage or General Liability, fill out the appropriate sections and adjust your premium accordingly.
12. Answer the qualification questions truthfully. If any answers are ‘yes’, provide additional details on a separate sheet as instructed.
13. Read, sign, and date the declaration to confirm the accuracy of the information provided, acknowledging your understanding of the application and insurance process.
14. Finally, submit your completed application by either mailing or faxing it to the provided address. Ensure you keep a copy for your records.

Complete your application online today and secure your professional liability insurance!