CTR070059 2025-12-01 GL AL WC PL.pdf
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- Attached to
- Master Agreement AZ|CTR070059
- Contract number
- CTR070059
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance and Additional Remarks Schedule issued by Marsh USA LLC for the Maricopa County Special Health Care District (dba Valleywise Health) located in Phoenix, Arizona. The certificate involves multiple insurers including Sentry Insurance A Mutual Co, Copic Insurance Company, Arch Specialty Insurance Company, Capitol Specialty Insurance Corporation, and Endurance American Specialty Ins. Co., with coverage spanning Arizona and related to the Well Woman HealthCheck Program under Solicitation No. ADHS19-00008459.
The insurance coverage includes commercial general liability, automobile liability, workers' compensation, and medical professional liability, with various policy limits and effective dates from 12/01/2024 to 12/01/2025. The district has a self-insured/retained limit of $2,000,000 per occurrence for general liability, with excess insurance coverage extending up to $15,000,000 for medical professional liability and comprehensive layers of workers' compensation insurance. Specific policy details include a $500,000 deductible for workers' compensation, employers' liability limits of $1,000,000 per accident and per employee, and multiple excess insurance layers providing additional protection across different policy types.
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Text version
Valleywise Health Risk Management
2601 E Roosevelt St.
Phoenix, AZ 85008
602-344-5005
May 9, 2025
To Additional Insured Status Requester:
Maricopa County Special Health Care District is a public entity. We have made a formal decision to retain risk rather than insure it through traditional purchase of insurance. This type of decision is often made by entities with considerable assets.
Any claims for which Maricopa County Health Care District is found legally liable are paid under the Amended and Restated Maricopa County Special Health District Risk Management Insurance and Self- Insurance Plan adopted May 24, 2017.
Maricopa County Special Health Care District purchases traditional insurance in excess of our self- insured/retained limit of $2,000,000 per occurrence for general liability. Maricopa County
-insured up to and beyond the insurance limits you request.
legal right, per the Department of Insurance, to extend Additional Insured status as only insurance companies can endorse policies to extend that right.
Please contact me with any further questions.
Thank you, Trisha Farrell Risk Management Operations Manager Valleywise Health Phone: 602-344-5672
Deductible: 500,000
LOS-002496583-09
1,000,000
AZ
11860
AggregateXS of $2M/$2M Buffer XS $2M SIR
Phoenix, AZ 85016
N
X12/01/2024
12/01/2025
12/01/2024
9018935002
Medical Prof Liab Claims Made
A
N/A
Copic Insurance Company
1,000,000
X
B
12/06/2024
15,000,000
15,000,000
RE: Organization: Well Woman HealthCheck Program, SOLICITATION NO. ADHS19-00008459 The placements for Automobile policy #901893502 and Workers Compensation policies #901893501 and 901893503 were made by Lovitt-Touche. Marsh USA Inc. has only acted in the role of a consultant to the
Street Address: 150 N. 18th Ave, Suite 310 Phoenix, AZ 85007
Arizona Department of Health Services client with respect to these placements, which are indicated here for your convenience.
N/A
CN101622780-STND-AWXE-24-25
Each Incident/Occurrence
12/01/2025
1,000,000
& GL/Umbrella Occurrence
AZ
24988
1,000,000
12/01/2025
9018935001
2325 E. Camelback Road
MARSH USA LLC.
Suite 600
Attn: healthcare.accountscss@marsh.com Fax: 212-948-1307
District dba Valleywise Health Maricopa County Special Health Care
Phoenix, AZ 85008 2601 E. Roosevelt
UAZ0000127
12/01/2024
Attn: Program Director
A
Sentry Insurance A Mutual Co
Expiration Date: 12/01/25
Policy Number: UHE5000070
Expiration Date: 12/1/25
Limits: $10M xs $30M
Expiration Date: 12/01/25
States: AZ
Policy Number: 9018935003
Effective Date: 12/01/24
Additional Workers Comp:
Sentry Casualty Company
Capitol Specialty Insurance Corporation
Employers Liability Each Accident: $1,000,000
Effective Date: 12/01/24
Employers Liability Disease-Each Employee: $1,000,000
Limits: $5M part of $10M xs $40M
Excess Layer:
Effective Date: 12/01/24
Arch Specialty Insurance Company
Endurance American Specialty Ins. Co.
Limits: $5M part of $10M xs $40M
Policy Number: HX20241035
MARSH USA LLC.
District dba Valleywise Health Maricopa County Special Health Care
Phoenix, AZ 85008 2601 E. Roosevelt
Expiration Date: 12/01/25
Effective Date: 12/01/24
Policy Number: HHF30049060201
Employers Liability Disease-Policy Limit: $1,000,000
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