Trustpoint New Business Marketing Profile Step 1 of 5 20% Preliminary QuestionsIs the prospect entered in AMS360?* Yes No STOP You must enter in the system before proceeding.Has Trustpoint previously written or quoted?* Yes No Producer*Belcher, KrisBucher, RoyCuddy, EricEstes, MattGreear, CarlLanier, AndrewLongshore, JeremyPowers, EdRender, SergioRittenhouse, ScottRobertson, BradleySalazar, SebastianStanton, RobStrong, ReeceSwindell, BobWarner, MarcoNot ListedEnter Producer Name* Enter Producer Email* General InformationProspect Name* Prospect Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Prospect NAICS Code* Please use ZYWAVE's Broker Briefcase to confirm this code. Have you completed a "pain questionnaire"?* Yes No Good for you! Your chances of winning are significantly improved as a result of this work. Please upload a copy of the pain questionnaire with this web form to share with the team.What are you waiting for? Your chances of winning are significantly improved when you go through a pain questionnaire with your prospect. Please talk to your sales manager about making this part of your process.Number of Employees* List States With Employees* Expiration Date (or first up if multiple)* MM slash DD slash YYYY At least 45 days lead time is recommended.Need by Date* MM slash DD slash YYYY Proposals will be delivered a minimum of 3 days prior to expiration and maximum of 30 days prior to expiration.Select Line of Business Opportunities* Property & Casualty Life & Health Personal Lines Select all that Apply to Current Marketing NeedsIdentify the type of buyer.*EconomicUserCheerleaderProbability of Winning*Please enter a number from 0 to 100.Enter the percentage chance that you will close this opportunity.What are the primary P&C lines of coverage being marketed?* Property General Liability Automobile Workers' Compensation Umbrella Professional Liability Other Describe Other P&C Lines* What are the primary L&H lines of coverage being marketed?* Medical Dental Vision Life Disability Other Describe Other L&H Lines* Competitor/Incumbent InformationProperty & Casualty LinesCurrent Insurance Company - Primary P&C Lines* Current Insurance Company - WC Line* Current Agency - P&C Lines* Years with current P&C agency?Please enter a number from 0 to 100.Satisfaction with current P&C agency?*Please enter a number from 1 to 10.Use scale of 1 - 10. 1 = Not at all / 10 = ExtremelyExplain why satisfied or dissatisfied. Is the prospect using outside consultant?* Yes No Are other outside agents involved?* Yes No Has the prospect assigned markets?* Yes No Consultant Name* Other Agent Name(s)* 1st - Market Assignment*Auto OwnersC N AHanoverSelectiveTravelersUticaEastern AlliacneKey RiskOther2nd - Market Assignment*Auto OwnersC N AHanoverSelectiveTravelersUticaEastern AlliacneKey RiskOtherNone3rd - Market Assignment*Auto OwnersC N AHanoverSelectiveTravelersUticaEastern AlliacneKey RiskOtherNone1st - Market Selection*Auto OwnersC N AHanoverSelectiveTravelersUticaEastern AlliacneKey RiskOther2nd - Market Selection*Auto OwnersC N AHanoverSelectiveTravelersUticaEastern AlliacneKey RiskOtherNone3rd - Market Selection*Auto OwnersC N AHanoverSelectiveTravelersUticaEastern AlliacneKey RiskOtherNone1st - Other Market* 2nd - Other Market* 3rd - Other Market* Life & Health LinesCurrent Insurance Company - Primary L&H Lines* Current Agency - L&H Lines* Years with current L&H agency?Please enter a number from 0 to 100.Satisfaction with current L&H agency?*Please enter a number from 1 to 10.Use scale of 1 - 10. 1 = Not at all / 10 = ExtremelyExplain why satisfied or dissatisfied. Is the prospect using outside consultant?* Yes No Are other outside agents involved?* Yes No Has the prospect assigned markets?* Yes No Consultant Name* Other Agent Name(s)* 1st - Market Assignment*AetnaAnthem BlueCross BlueShieldBlueCross BlueShield of TennesseeOptima HealthUnited HealthcareOther2nd - Market Assignment*AetnaAnthem BlueCross BlueShieldBlueCross BlueShield of TennesseeOptima HealthUnited HealthcareOtherNone3rd - Market Assignment*AetnaAnthem BlueCross BlueShieldBlueCross BlueShield of TennesseeOptima HealthUnited HealthcareOtherNone1st - Market Selection*AetnaAnthem BlueCross BlueShieldBlueCross BlueShield of TennesseeOptima HealthUnited HealthcareOther2nd - Market Selection*AetnaAnthem BlueCross BlueShieldBlueCross BlueShield of TennesseeOptima HealthUnited HealthcareOtherNone3rd - Market Selection*AetnaAnthem BlueCross BlueShieldBlueCross BlueShield of TennesseeOptima HealthUnited HealthcareOtherNone1st - Other Market* 2nd - Other Market* 3rd - Other Market* Marketing NarrativeExecutive Summary*Describe the operations, history and leadership. Include prospect's attitude towards loss control/risk management.Why is the prospect out to market?*Describe the prospects motivation for looking at options this year.With regards to the P&C what can we do that the current agent is not and the prospect is under-served as a result.* Loss Control / Risk Management Claims Management Policy Management Coverage / Exposure Gaps Premium Savings Other Nothing Describe what we can do in more detail.With regards to the L&H what can we do that the current agent is not and the prospect is under-served as a result.* Technology/Enrollment platform Compliance Support HR Support Alternative funding strategies (level, self, etc.) Open Enrollment/Communication Support Other Nothing Describe what we can do in more detail.Target Premium for Property*Please enter a number greater than or equal to 0.Target Premium for General Liability*Please enter a number greater than or equal to 0.Target Premium for Auto*Please enter a number greater than or equal to 0.Target Premium for Workers' Compensation*Please enter a number greater than or equal to 0.Target Premium for Umbrella*Please enter a number greater than or equal to 0.Target Premium for Professional Liability*Please enter a number greater than or equal to 0.Estimated P&C Revenue*Please enter a number greater than or equal to 0.Estimated L&H Revenue*Please enter a number greater than or equal to 0.Minimum of a 3 year loss summary must completed and attached in the upload section on next page. Documents and Additional CommentsPlease create a shared folder to collect documents such as exposure schedules, pictures, loss runs, ect. Share the folder with Will Faddis.Additional Comments
