Well_Women_-_ADHS.pdf
PDF 664 KB Posted
- Attached to
- Master Agreement AZ|CTR070059
- Contract number
- CTR070059
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Maricopa County Special Health Care District, also known as Valleywise Health, located in Phoenix, Arizona. The insurance involves multiple insurers, including Sentry Insurance A Mutual Co, Copic Insurance Company, and additional workers' compensation insurers like Sentry Casualty Company and Capitol Specialty Insurance Corporation. The certificate is issued by Marsh USA LLC, acting as a consultant for the Arizona Department of Health Services, specifically referencing the Well Woman HealthCheck Program (Solicitation No. ADHS19-00008459).
The insurance coverage includes Commercial General Liability, Automobile Liability, Umbrella/Excess Liability, and Workers' Compensation policies with effective dates from 12/01/2024 to 12/01/2025. Key policy limits include $1,000,000 per occurrence for general liability and automobile coverage, with additional excess layers providing up to $15,000,000 in aggregate coverage. The Workers' Compensation policy has a $500,000 deductible and includes employers' liability with $1,000,000 limits for each accident, each disease per employee, and a $1,000,000 disease policy limit. The complex insurance structure involves multiple insurers providing layered coverage across different policy types to protect the healthcare district's operations.
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Text version
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
File details come from the government source that posted it. Updated .