To be included in the resource center, please submit the following information to Kelly Kruger at: kelly.kruger@illinois.gov
Producers
Producer Name
Producer Business Address
Producer Business Telephone Address
Producer Birth date*
Producer License Number*
Name of each licensed company for which the producer sells medical professional liability insurance.
(NOTE: Misrepresentation of any information reported may be a violation of Section 215 ILCS 5/500-70 of the Illinois Insurance code and could result in disciplinary action.)
Companies
Company Name
Company Telephone Number
Hyperlink to Company’s Website (if available)
Base Rate Sample Forms:
Base Rate & Rating Relativity Factors for Hospitals
Base Rate & Rating Relativity Factors for Other Health Care Facilities
Base Rate & Rating Relativity Factors for Physicians including Surgeons and Osteopaths
Base Rate & Rating Relativity Factors for
Other Health Care Professionals, including Dentists
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