Big "I" Alliance Pre-application

Big "I" Alliance Pre-application
Does your agency belong to a Network or Alliance?*

YesNo
Which Network/Alliance do you belong to? (Optional)
Is your agency a member of the Big "I"?

YesNo
How many employees does your agency have?*
In which state is your agency is located?*
Estimated 2024 Agency Premium Volume ($)*
Commercial (%)*
Personal (%)*
(*Commercial and personal must add up to 100%.)
Carrier Partners
Select the carrier partners below you have a direct appointment with.

AcuityAmerican ModernAmTrustAuto OwnersBerkely AspireBerkley ManagementBranchCincinnatiCNAContinental WesternCowbell CyberEMCEmployers Work CompEnvocaForemost SignatureForemost SpecialtyGainscoGeicoGoldleafGrangeHanover CLHartford CLLiberty MutualMercuryNational GeneralNationwide CLNationwide PLNationwide FarmOld Republic SuretyOpenlyOpenRoadPie InsuranceProgressivePropeller BondsSafecoSelectiveTravelers AgribusinessTravelers Commercial LinesTravelers Personal LinesUS AssureWest BendWeSure
Based on selections above, please include 2024 rolling 12 estimated premium volume for the carriers you have business with.
Acuity*
2024 rolling 12 estimated premium volume
American Modern*
2024 rolling 12 estimated premium volume
AmTrust*
2024 rolling 12 estimated premium volume
Auto Owners*
2024 rolling 12 estimated premium volume
Berkley Aspire*
2024 rolling 12 estimated premium volume
Berkley Management*
2024 rolling 12 estimated premium volume
Branch*
2024 rolling 12 estimated premium volume
Cincinnati
2024 rolling 12 estimated premium volume
CNA*
2024 rolling 12 estimated premium volume
Continental Western*
2024 rolling 12 estimated premium volume
Cowbell Cyber*
2024 rolling 12 estimated premium volume
EMC*
2024 rolling 12 estimated premium volume
Employers Work Comp*
2024 rolling 12 estimated premium volume
Envoca*
2024 rolling 12 estimated premium volume
Foremost Signature*
2024 rolling 12 estimated premium volume
Foremost Specialty*
2024 rolling 12 estimated premium volume
Gainsco*
2024 rolling 12 estimated premium volume
Geico*
2024 rolling 12 estimated premium volume
Goldleaf*
2024 rolling 12 estimated premium volume
Grange*
2024 rolling 12 estimated premium volume
Hanover CL*
2024 rolling 12 estimated premium volume
Hartford CL*
2024 rolling 12 estimated premium volume
Liberty Mutual*
2024 rolling 12 estimated premium volume
Mercury*
2024 rolling 12 estimated premium volume
National General*
2024 rolling 12 estimated premium volume
Nationwide CL*
2024 rolling 12 estimated premium volume
Nationwide PL*
2024 rolling 12 estimated premium volume
Nationwide Farm*
2024 rolling 12 estimated premium volume
Old Republic Surety*
2024 rolling 12 estimated premium volume
Openly*
2024 rolling 12 estimated premium volume
OpenRoad*
2024 rolling 12 estimated premium volume
Pie Insurance*
2024 rolling 12 estimated premium volume
Progressive*
2024 rolling 12 estimated premium volume
Propeller Bonds*
2024 rolling 12 estimated premium volume
Safeco*
2024 rolling 12 estimated premium volume
Selective*
2024 rolling 12 estimated premium volume
Travelers Agribusiness*
2024 rolling 12 estimated premium volume
Travelers Personal Lines*
2024 rolling 12 estimated premium volume
Travelers Commercial Lines*
2024 rolling 12 estimated premium volume
US Assure*
2024 rolling 12 estimated premium volume
West Bend*
2024 rolling 12 estimated premium volume
WeSure*
2024 rolling 12 estimated premium volume
Select the wholesalers you are currently working with.

AmWinsArlington RoeBrown and BrownBurns & WilcoxCRCJenCapJohnson & JohnsonRPSRT Specialty
AmWins*
Please provide estimated written premium
Arlington Roe*
Please provide estimated written premium
Brown and Brown*
Please provide estimated written premium
Burns & Wilcox*
Please provide estimated written premium
CRC*
Please provide estimated written premium
JenCap*
Please provide estimated written premium
Johnson & Johnson*
Please provide estimated written premium
RPS*
Please provide estimated written premium
RT Specialty*
Please provide estimated written premium
Select the premium finance companies you are working with.

AfcoBank DirectBGA FinanceBrokers Financial ServicesCapital Premium FinancingETI FinancialImperial PFSHonor CapitalU.S. Premium FinanceOther
Afco*
Estimated annual premium financed
Bank Direct*
Estimated annual premium financed
BGA Finance*
Estimated annual premium financed
Brokers Financial Services*
Estimated annual premium financed
Capital Premium Finance*
Estimated annual premium financed
ETI Financial*
Estimated annual premium financed
Imperial PFS*
Estimated annual premium financed
Honor Capital*
Estimated annual premium financed
U.S. Premium Finance*
Estimated annual premium financed
Other
Estimated annual premium financed
Additional Agency Information
Are you currently working with any of these raters? (Check all that apply.)*

EZLynxPL RaterSemseeTarmikaTalageOther
Are you working with a virtual assistant company?*

YesNo
Which virtual assistant company are you working with?*
Which agency management system do you use?*
What are the top 1-3 markets you wish you could access?
Who is your agency's E&O carrier?*
Who is your agency's Cyber carrier?*
Contact Information
Agency Name*
Principal Agent Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
How did you hear about Big “I” Alliance Gold?*

Big "I" Alliance websiteState association websiteNewsletter article (Two for Tuesday, News & Views, State newsletter)Postcard/mailingVendor/carrier newsletterEmail from state executiveGeneral emailBig "I" meeting/eventState association meeting/eventInternet searchPersonal recommendation from a fellow agentOther
Should be Empty:

Big "I" Alliance Pre-application

Carrier Partners

Additional Agency Information

Contact Information