Get Travelers Erisa Bond Application

The Travelers Erisa Bond Application is an important document for plan sponsors seeking fidelity coverage under the Employee Retirement Income Security Act. This guide provides clear, step-by-step instructions to help you complete the application efficiently and accurately.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to download the Travelers Erisa Bond Application and open it in your preferred editing tool.
2. Fill out the agency information section, including the agency name, address, code, producer name, contact information, and phone/fax numbers.
3. Provide the sponsor information by entering the name of the plan sponsor (business name) and their address, including city, state, and ZIP code.
4. In the coverage/rating information section, indicate the proposed policy period, ensuring it starts at 12:01 a.m. on the desired date and is set within 90 days from when you're completing the application.
5. Select your desired billing method (either agency bill or direct bill) and provide a phone number for the sponsor if you choose direct billing.
6. Answer the fidelity loss question by checking 'yes' or 'no'. If you select 'yes', ensure to forward any details to your underwriter.
7. Indicate whether the sponsor is a union and if any plans contain non-qualifying assets or employer securities, checking 'yes' or 'no' as applicable.
8. Decide if you want to list the individual plan names on the policy. If 'yes', provide the names or attach an additional sheet if necessary.
9. Complete the section regarding any prior applications being declined by other insurance companies. If applicable, name the plan and calculate its asset details as required.
10. Review all sections for accuracy and completeness before proceeding to the signature section. Ensure that an authorized representative signs and provides their printed name, title, and date.
11. If applicable, complete the producer information section for Florida, Iowa, and New Hampshire, including the producer signature, name, agency details, and license number.
12. Once all sections are complete, you may save your changes, download, print, or share the application as needed.

Complete your Travelers Erisa Bond Application online today.