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IT RENEWAL TIME IT RENEWAL TIME CalSurance

VIEWS: 16 PAGES: 4

									 IT’S RENEWAL
      TIME
                    E&O Coverage for
      Agents Affiliated with The Annuity Shop, LLC
             The Annuity Shoppe, LLC and
             The Life & Annuity Shop, LLC
           RENEWS ON FEBRUARY 1, 2012

                             Find out more about this valuable coverage
                                        and enroll online at:
                                www.calsurance.com/annuityshoppe

                                                        Questions?
                         Call CalSurance Customer Service Department:
                                                    R




                                         (800) 745-7189
                        Monday through Friday 7:00 a.m. to 5:00 p.m. PST




CalSurance Associates
A Division of Brown & Brown Program Insurance Services, Inc.
                                                                         CalSurance
                                                                                                R


681 South Parker Street, Suite 300, Orange, CA 92868
Phone: 800-745-7189         Email: info@calsurance.com
AnnuityShoppeFlr01052012v2
                                                                     California License # 0B02587
                                                                                 Page 1 of 4
                                                  Agents Affiliated with
                    The Annuity Shoppe, LLC, The Annuity Shoppe, LLC or The Life and Annuity Shop, LLC
                                       Agents’ E&O Program - Outline of Coverage

Policy Period:                                                                         Retroactive Date:
February 1, 2012 to February 1, 2013                                                   Date of first continuous claims made Life Insurance Agents’
                                                                                       Errors & Omissions Liability Policy

Insurer:                                                                               Coverage (Claims Made and Reported):
American Automobile Insurance Company                                                  Acts, errors or omissions arising out of the rendering of or failure
A Fireman’s Fund Insurance Company                                                     to render Professional Services
2012 A.M. Best's A (Excellent): XV                                                     Personal Injury
                                                                                       Failure to supervise, manage or train
“The information obtained from A.M. Best dated December 19,
2011 is not in any way CalSurance’s® warranty or guaranty of                           Professional Services:
the financial stability of the insurer in question, and that the                       Sales and/or servicing of:
information is current only as of the date of publication.”                              Life Insurance (other than variable)
                                                                                         Fully Insured, Group Employee Benefit Plans, but not including
                                                                                         Group or Ordinary Pension or Profit Sharing Plans, IRA Keogh
Policy Number:                                                                           Plans, 401(k), 501(b), 412(i) or 419 Plans
ME 07318467                                                                              Accident & Health Insurance
                                                                                         Medicare Supplemental Insurance
                                                                                         Disability Income Insurance
Named Insured:                                                                           Long Term Care Insurance
Agents affiliated with The Annuity Shop, LLC, The Annuity                                Annuities (Fixed), including Equity Indexed Annuities
Shoppe, LLC or The Life and Annuity Shop, LLC                                          Providing advice, consultation and administration of above
                                                                                       products, whether or not a fee is charged

Additional Insureds:                                                                   Also includes (related to covered products):
Insured Agent's Business Entity                                                          Financial Planner Activities
Partners                     Administrators                                              Notary Public
Officers                     Heirs/Executors                                           Extended Reporting Period:
Directors                    Employees of Agents                                        If an agent’s affiliation with The Annuity Shop, LLC, The
                                                                                        Annuity Shoppe, LLC or The Life and Annuity Shop, LLC
                                                                                        terminates for any reason, other than for cause, coverage
Risk Purchasing Group Membership:                                                       continues until the expiration of the policy period.
By applying for this insurance, agents are applying for
membership in the Financial Sales Professionals Risk                                     If such termination is in conjunction with retirement,
Purchasing Group, a group formed and operating pursuant to the                           disability or death, the following ERP options are available
Liability Risk Retention Act of 1986 (15 USC 3901et seq.). There                         for purchase:
is no additional charge for this membership.                                              - 1 year at 100% of expiring annual premium;
                                                                                          - 2 years at 150% of expiring annual premium;
                                                                                          - 3 years at 200% of expiring annual premium;
Limit of Liability (Inclusive of Defense Costs):                                          - 4 years at 250% of expiring annual premium;
$1,000,000 per Claim Each Agent                                                           - 5 years at 300% of expiring annual premium; or
$1,000,000 Aggregate Per Agent                                                            - 10 years at 500% of expiring annual premium.
                  or
$1,000,000 per Claim Each Agent                                                        Claims Administration:
$2,000,000 Aggregate Per Agent                                                         Lancer Claim Services
                  or                                                                   A Division of Brown & Brown Program Insurance Services, Inc.
$1,000,000 per Claim Each Agent                                                        681 S. Parker St., #300
$3,000,000 Aggregate Per Agent                                                         Orange, CA 92869
                                                                                       (800) 821-0540
                                                                                       Program Administration:
Deductible (Damages and Defense):                                                      CalSurance Associates
$1,500     Each Claim for all covered Products and Services                            A Division of Brown & Brown Program Insurance Services, Inc.
                                                                                       California License # 0B02587

        Please review the attached program materials. A complete copy of the specimen policy is available by calling 800-745-7189 or by visiting
                                                        www.calsurance.com/annuityshoppe
      AnnShoppeHL (01052012v3)                                      CalSurance Associates
                                                   A Division of Brown & Brown Program Insurance Services, Inc.



                                                                                                                                          Page 2 of 4
                                                                                              organization, including but not limited to a Product Provider, regardless of
Exclusions (including but not limited to):                                                    when the financial impairment of such organization began and whether or not
We shall not be liable to make any payment for Loss in connection with any
                                                                                              any Insured was aware or could have been aware of the financial impairment
Claim:
                                                                                              of such organization; provide, however, this exclusion shall not apply if at the
A. Based upon or arising out of any dishonest, fraudulent, criminal, malicious,
                                                                                              time of the Wrongful Act the Product Provider was;
   intentional or willful act or omission by any Insured or ay loss expected or
                                                                                              1. An admitted Property Casualty Insurance Company Rated B+ or better by
   intended by any Insured; provided, however, this exclusion shall not apply
                                                                                                  A.M. Best Company, or a Life Insurance/Accident and Health Insurance
   unless there is a judgment, final adjudication or admission adverse to such
                                                                                                  Company rated A- or better by A.M. Best Company;
   Insured establishing that such Insured committed such conduct;
                                                                                              2. A non-admitted insurance company rated A- or better by A.M. Best
B. Based upon or arising out of any Insured gaining in fact any personal profit or
                                                                                                  Company that is also authorized to conduct business in the applicable state
   advantage to which such Insured was not legally entitled;
                                                                                                  in which the Covered Product involved was sold, placed or obtained, or;
C. Based upon, arising out of or in any way involving:
                                                                                              3. The Product Provider was guaranteed by a governmental body or bodies
   1. Bodily injury, including sickness, injury, disease or death of any person;
                                                                                                  or operated by a governmental body or bodies (including but not limited to
       provided, however, this exclusion shall not apply to emotional distress or
                                                                                                  assigned risk plans, Joint Underwriting Association’s, or fair plans) or was a
       mental anguish solely based upon or arising out of the Insured’s rendering
                                                                                                  County Mutual reinsured by carriers rated B+ or better by A.M. Best
       of or failure to render Professional Services; or
                                                                                                  Company, or was part of the Iowa Communities Assurance Pools (ICAPS);
   2. Damage to or destruction of any property, including loss of use thereof;
                                                                                           N. Based upon, arising out of or in any way involving the direct or indirect
D. Based upon, arising out of or in any way involving any actual or alleged
                                                                                              placement of, or any recommendation to place, any Client’s insurance,
   infringement of copyright, patent, trademark, trade name, trade dress, service
                                                                                              coverage, funds, premium, or product with or in any Product Provider, entity or
   mark or misappropriation of ideas or trade secrets, piracy or plagiarism;
                                                                                              vehicle not licensed to transact such business in the state or jurisdiction in
E. Based upon, arising out of or in any way involving:
                                                                                              which such business was conducted; provided, however, this exclusion shall
   1. Any pension, welfare or benefit plan organized for the benefit of employees
                                                                                              not apply with respect to any Product Provider authorized or approved as a
       of the Insured; or
                                                                                              surplus lines insurer or carrier in the state or jurisdiction in which such
   2. Any Insured’s obligations or services as a fiduciary or trustee under the
                                                                                              business was conducted;
       Employee Retirement Income Security Act of 1974, the Consolidated
                                                                                           O. Based upon, arising out of or in any way involving any promissory notes,
       Omnibus Budget Reconciliation Act of 1985, the Pension Benefits Act,
                                                                                              viatical or life settlements a investments or contracts or viatical investment
       including any rules or regulations promulgated under any of the foregoing,
                                                                                              pools or any securities (as defined in the Securities Act of 1933, the Securities
       or any similar provisions of any state statutory law or common law;
                                                                                              Exchange Act of 1934, the Investment Company Act of 1940, and the
F. Based upon, arising out of or in any way involving any Insured’s actions,
                                                                                              Investment Advisers Act of 1940, and any amendments thereto) backed by
   activities, responsibilities or duties as a third party administrator of any plan,
                                                                                              viatical settlements, commodities, commodity future contracts, or option
   whether insured or self insured;
                                                                                              contracts;
G. Based upon, arising out of or in any way involving any:
                                                                                           P. Based upon, arising out of or in any way involving the offering, sale or
   1. Liability of others assumed by any Insured in a written or oral contract or
                                                                                              servicing of any structured settlement; provided, however, this exclusion shall
       agreement; or
                                                                                              not apply to a Claim solely based upon or arising out of the selling or servicing
   2. Actual or alleged liability of any Insured under any written or oral contract
                                                                                              of a Covered Product utilized to fund a structured settlement;
       or agreement;
                                                                                           Q. Based upon or arising out of:
       Provided, however this exclusion shall not apply to liability of any Insured
                                                                                              1. Any Wrongful Act or any fact, circumstance or situation which has been
       which would exist in the absence of such contract or agreement;
                                                                                                  the subject of any notice given under any insurance policy prior to the
H. Based upon, arising out of or in any way involving any actual or alleged
                                                                                                  Inception date of this Policy;
   warranty, promise, guarantee or representation as to the value or yield of any
                                                                                              2. Any Wrongful Act whenever occurring, which, together with a Wrongful
   Covered Products or as to non-guaranteed interest rates or future premium
                                                                                                  Act which has been the subject of such notice, would constitute
   payments;
                                                                                                  Interrelated Wrongful Acts; or
I. Based upon, arising out of or in any way involving any actual or alleged:
                                                                                              3. Any Wrongful Act of which the Insured had actual or constructive
   1. Liability for any employment-related practices, acts or omissions, whether
                                                                                                  knowledge as of the Inception of this Policy and which could have
       in violation of contract or statutory or common law, including without
                                                                                                  reasonably been expected to result in a Claim;
       limitation: refusal to employ; wrongful termination of employment;
                                                                                           R. For Personal Injury based upon or arising out of:
       discrimination or harassment of any kind; breach of employment contract;
                                                                                              1. The oral or written publication of material, if done by or at the direction of
       wrongful demotion, evaluation, reassignment or discipline; defamation,
                                                                                                  the Insured with knowledge of its falsity; or
       slander or libel; invasion of privacy, infliction of emotional distress; invasion
                                                                                              2. The oral or written publication of material whose first publication took place
       of privacy; or retaliation; or
                                                                                                  before the Retroactive Date;
   2. Discrimination or harassment of any kind, other than any discrimination or
                                                                                           S. By or on behalf of the Sponsoring Company or any Agent; provided, however,
       harassment excluded in 1. above, against any person or entity;
                                                                                              this exclusion shall not apply to a Claim brought in the form of a cross-claim or
J. Based upon, arising out of or in any way involving any services performed by
                                                                                              third-party claim arising from a Claim made against such Sponsoring
   the Insured, whether or not the Insured is licensed as such, as:
                                                                                              Company or Agent that is other wise covered under this Policy;
   1. an accountant, architect, actuary, tax prepare or advisor except for tax
                                                                                           T. Based upon, arising out of or in any way involving any actual, alleged or
       advice provided directly concerning a Covered Product, attorney, real
                                                                                              threatened discharge, dispersal, seepage, migration, release or escape of any
       estate agent or broker;
                                                                                              solid, liquid, gaseous, thermal, or aural irritant, pollutant, contaminant,
   2. engineer, a financial planner or registered investment adviser, except as to
                                                                                              including but not limited to, noise, lead, asbestos, smoke, vapors, soot, fumes,
       services directly related to a Covered Product.
                                                                                              acids, alkalis, chemicals, or waste materials (including those that are or are to
   3. securities broker or dealer;
                                                                                              be stored, recycled, reconditioned or reclaimed), into or upon land, air, water
K. Based upon, arising out:
                                                                                              or property; or
   1. The collection, payment or return of, or the failure to collect, pay or return,
                                                                                           U. Based upon, arising out of or in any way involving any nuclear reaction,
       any commission, fee, tax, or premium;
                                                                                              radiation, radioactive contamination or radioactive substance, in any form, no
   2. Any dispute with another insurance agent or broker, including, but not
                                                                                              matter how emitted.
       limited to, any dispute concerning commissions, fees, client lists or
       entitlements; or
   3. Any commingling, misappropriation or conversion of Client funds:
L. Based upon, arising out of or in any way involving any actual or alleged
   unauthorized use or release of any confidential or private information
   pertaining to any Client, any director, manager, partner, member, officer or
   employee of any Client or any family member of any such person;
M. Based upon, arising out of or in any way involving any bankruptcy,
   receivership, conservatorship, insolvency, or financial inability to pay of any
          Please review the attached program materials. A complete copy of the specimen policy is available by calling 800-745-7189 or by visiting
                                                          www.calsurance.com/annuityshoppe
TheAnnuityShopHL01052012v3



                                                                                                                                                         Page 3 of 4
                                            Agents A liated with the Annuity Shop, LLC, The Annuity Shoppe, LLC or
                                                                 The Life and Annuity Shop, LLC
                                                                       Enrollment Form
                                                   Claims Made & Reported Errors & Omissions Coverage
                                                     Policy Period: February 1, 2012 to February 1, 2013
 By purchasing this insurance, agents become members of the Financial Sales Professionals Risk Purchasing Group, a group formed and operating pursuant to the Liability
                                     Risk Retention Act of 1986 (15 USC 3901 et seq.). There is no additional charge for membership.
  Instructions........................ ALL sections must be completed. Incomplete forms will take additional time to process. Please allow up to ten (10) business days
                                        for processing.
                                        Return this form along with payment to: CalSurance Associates
                                         A Division of Brown & Brown Program Insurance Services, Inc., P.O. Box 7048, Orange, CA 92863-7048

  Coverage Questions............Call CalSurance Associates at (800) 745-7189 or email at info@calsurance.com
  Certificates of Insurance......Go on-line: www.calsurance.com - Certificate Reprinting - Sponsoring Group - The Annuity Shop, LLC, The Annuity Shoppe, LLC or
                                        The Life and Annuity Shop, LLC


 Section 1 - Your Information (Please Print Clearly)                                       Section 3 - Payment
First Name                                  Last Name                                            Payment in Full by Check: Check made payable to
                                                                                                 CalSurance Associates , A Division of Brown & Brown Program
Street Address                                                                                   Insurance Services, Inc. for the full premium

                                                                                             Note: Other payment options such as installments by Visa or
Mailing Address (if different than street address)
                                                                                                     Mastercard are available if enrolling online:

City                                                     State       Zip Code                     www.calsurance.com/annuityshoppe
                -            -                                   -          -                                             Billing through
Contact Phone Number                                     Birth Date (MM/DD/YY)                                        CalSurance Associates
                                                                                                   A Division of Brown & Brown Program Insurance Services, Inc.
                -            -
Fax Number


E-mail                                                                                    
                                                                                           NOTICE: I must be a currently contracted agent affiliated with The Annuity Shop, LLC, The
                                                                                           Annuity Shoppe, LLC or The Life and Annuity Shop, LLC to be eligible for this program.

 Section 2 - Limit Options, Effective Date and Amount Due                                 Otherwise, I will not be considered an Insured under this program and no claims made
                                                                                           against me will be covered.

            Please choose a Limit Option by checking the box:                              I warrant that I am currently contracted with affiliated with The Annuity Shop, LLC, The
                                                                                           Annuity Shoppe, LLC or The Life and Annuity Shop, LLC.
         Enrollment           Limit:               Limit:                Limit:
                                                                                           NOTICE: This is a claims made and reported policy. If I have knowledge of any claim or
          Month            $1MM/$1MM           $1MM/$2MM             $1MM/$3MM             incident that could give rise to a claim under the proposed policy and any claim or action
     Feb. 2012                   $495                 $540                $705             arises therefrom, it is excluded from coverage for which this form applies. A potential gap in
                                                                                           coverage may occur if I elect an effective date that is not continuous with my prior expiration
     March 2012                  $459                 $500                $652
                                                                                           date, and may result in the denial of a claim.
     April 2012                  $420                 $458                $596
     May 2012                    $382                 $416                $541             I warrant that I have no knowledge of any pending claim or incident that could give rise to a
     June 2012                   $343                 $374                $484             claim under the proposed policy.
     July 2012                   $306                 $332                $429             I acknowledge that the specimen policy and program materials have been delivered to me
     August 2012                 $267                 $289                $372             via www.calsurance.com/annuityshoppe and I have reviewed these documents prior to
     September 2012              $228                 $247                $316             enrolling in the program.
     October 2012                $190                 $205                $261
                                                                                           I warrant and represent that the above statements are true and that I have not suppressed
     November 2012               $151                 $162                $204             or misstated any material facts and I agree that this application shall be the basis of the
     December 2012               $113                 $121                $149             contract with the company issuing the policy. It is understood that completion of this
     January 2012                $ 74                 $ 78                $ 92             application does not bind the company to issue or the applicant to purchase the insurance.

                                                                                           I have read the above notices and warranties and agree.

             Effective Date of Coverage              -               -

  Notice: Effective date of coverage cannot be prior to your date of contract with         Signature (Required)
          the sponsor and cannot be backdated to a prior month.

  *Rates include an administrative/co-marketing fee of up to $70.                          Today’s Date

                                                                         CalSurance Associates
                                                     A Division of Brown & Brown Program Insurance Services, Inc.
AnnuityShop01092012v4                                                 California License # 0B02587                                                       Page 4 of 4

								
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