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Questionnaire
Tell us a bit about your needs…
MGA Name
Contact Name
First
Last
Contact Email
Do you offer online workers comp rating to agents, customers or both?
Agents Only
Customers Only
Both
No
Is presenting initial rate indications to the submitting agent of value to your operation?
Yes
No
Would streamlining apps, supplements, and completed Acord form generations create value to your operation?
Yes
No
How many workers comp apps does your MGA process monthly?
How many apps for other lines of business does your MGA process monthly?
Estimated Workers Comp book size?
Number of Carriers you write Workers Comp with?
Number of Carriers that require a unique supplement app?
Do you currently use Appulate to quote any of your carriers?
Yes
No
Notes
Provide additional details or a bit more about what needs you currently have.
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