Independent Agent E&O Coverage

The policy period is 10/1/2024 to 10/1/2025

See the Coverage Highlights for detailed coverage information.

Please list your gross revenue for the past year and estimates for the current year and next year. Only include your revenue that is derived from your life agent business and series 6 activity, if applicable.

Fields with * are required.

		Please select an answer
*	Prior Year Revenue
*	Current Year Revenue Estimate
*	Next Year Revenue Estimate
*	Limit Option	Please provide a limit option
*	Coverage Effective Date (Must be between 10/21/2024 and 09/30/2025)	11/20/2024
	Referral Code (For referred agents only)
If you currently have E&O coverage in another program and you are joining this program as a new enrollee, you need to pick an effective date on or before your current coverage expiration date to avoid a gap in coverage.

Coverage Type

Type 1	Type 2
Life Insurance Accident & Health Insurance Long Term Care Insurance Disability Insurance Fixed Annuities Employee Benefit Plans, Individual Retirement Arrangements, IRAs and KEOGH Retirement Plans Financial Planning incidental to the sale of the above products	Life Insurance Accident & Health Insurance Long Term Care Insurance Disability Insurance Fixed Annuities Employee Benefit Plans, Individual Retirement Arrangements, IRAs and KEOGH Retirement Plans Variable Products Mutual Funds Financial Planning incidental to the sale of the above products