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MEMBER INSURANCE PROGRAM

Ancillary Insurance Product Quote Request Form          


Please complete and submit the following form to request a variety of Coshare member insurance quotes.  because we firmly believe that you (Coshare members) are only protected if your organization's members/clients are also covered, please share this form so that your organization's members/clients can also request and secure adaquate insurance protection.

Once submitted, a member of our Coshare member insurance benefit team will contact you to discuss your specific needs and provide a custom quote.

  • Property Coverage
  • Employment Practices Liability Insurance (EPLI) - insurance against lawsuits arising from: wrongful termination, sexual harassment, gender discrimination, sexual discrimination, etc...
  • Directors & Officers Liability (D&O)
  • Data Breach - sensitive data loss
  • Commercial Auto Liability
  • Valuable Papers
  • Event Cancellation
  • Special Event Liability
  • Liquor Liability
  • Health/Medical Insurance
  • Disability Income Protection
  • Life Insurance
  • Business Owners Policy (BOP)

Type the words you see above separated by a space.
Letters ARE case-sensitive.

Quotes are provided by licensed agents with the Nicholas Hill Group, Inc.  Quotes are subject to full underwriting and include certain exclusions and limitations.  Not all products are available in all states.  Please contact the Nicholas Hill Group, Inc. with any coverage questions or concerns by calling 1-877-303-2050 or emailing info@nicholashillgroup.com.