Human Services Benefits Company Header Image 1 Header Image 2 Programs Designed Exclusively for Human Service Agencies
Human Serives Benefits Company

Property and Casualty Insurance

Designed Exclusively for Human Service Agencies

PROPERTY
   Blanket Building & Personal Property
   Blanket Business Income/Extra Expense
   Agreed Value
   Boiler & Machinery within Policy Limits
   Property Deluxe Endorsement
PROFESSIONAL
   Limit $1,000,000/$3,000,000
   Insures Organization, Employees & Volunteers
INLAND MARINE
   Mobile Equipment
   Electronic Data Equipment
ABUSE & MOLESTATION
   Limit $1,000,000/$3,000,000
CRIME
   Employee Dishonesty
   Forgery
   Money & Securities
   ERISA
AUTOMOBILE
   Liability Limit $1,000,000
   $50 Towing
   Hired & Non-Owned Physical Damage $25,000
GENERAL LIABILITY
   Limits $1,000,000/$3,000,000
   Aggregate Per Location
   Medical Payments $15,000
   Fire Damage Liability $100,000
   Volunteers as Additional Insured
   Employee Benefits Liability
DIRECTORS & OFFICERS LIABILITY
   Limits Available Up to $5,000,000
   Covers Directors, Officers & Entity
UMBRELLA
   Limits Available Up to $10,000,000
   Retention Limit $10,000

Forms

You may submit the forms below to HSBC in any of the following ways. Submitting an application does not make you insured or guarantee insurance coverage.

Online: Use the appropriate "Submit Online" link below

Fax: 410-290-2939

Mail:
HSBC
6750 Alexander Bell Dr.
Suite 100
Columbia, MD 21046

Please contact us by phone at 1-800-530-7088 with any questions while completing the forms.

Submission requirements:

  • Completed and signed ACORD Insurance Applications and Supplemental Applications as required
  • Brochures and/or Website describing operations and services provided
  • Currently valued Loss Runs for the current and prior four policy years
  • Latest Audited Annual Financial Statement

Philadelphia Supplemental Applications
provided by Philadelphia Insurance Companies

Social Services Organization Supplemental Application   PDF Submit Online     PDF Download (138 KB)
Abuse and Molestation Supplemental Application   PDF Submit Online     PDF Download (72 KB)
Employee Benefits Liability on a Claims-made Basis Supplemental Application   PDF Submit Online     PDF Download (67 KB)
Non-Profit Directors and Officers Liability Insurance   PDF Submit Online     PDF Download (106 KB)
Mental Health Organization Supplemental Application   PDF Submit Online     PDF Download (169 KB)
Day Care Center Supplemental Application   PDF Submit Online     PDF Download (106 KB)

Other Supplemental Applications
provided by First Nonprofit Insurance Company

Social Services Organization (Complete)   PDF Submit Online     PDF Download (395 KB)
Residential Questionnaire   PDF Submit Online     PDF Download (125 KB)
Child Care Facility Questionnaire   PDF Submit Online     PDF Download (127 KB)
Builder's Risk Questionnaire   PDF Submit Online     PDF Download (131 KB)
Recreation Questionnaire   PDF Submit Online     PDF Download (138 KB)
Foster Care/Adoption Questionnaire   PDF Submit Online     PDF Download (157 KB)
Workers' Compensation Questionnaire   PDF Submit Online     PDF Download (135 KB)
Directors and Officers Application for a Claims-made and Reported Policy        PDF Download (124 KB)

ACORD Applications

Property Section   PDF Submit Online     PDF Download (39 KB)
Statement of Values   PDF Submit Online     PDF Download (30 KB)
Crime Section   PDF Submit Online     PDF Download (46 KB)
Commercial General Liability Section   PDF Submit Online     PDF Download (41 KB)
Commercial Insurance Application   PDF Submit Online     PDF Download (48 KB)
Maryland Commercial Auto Coverages/Limits Section  
(for other states, please submit appropriate commercial auto coverages/limits section)  
PDF Submit Online     PDF Download (42 KB)
Vehicle Schedule   PDF Submit Online     PDF Download (39 KB)
Business Auto Section   PDF Submit Online     PDF Download (45 KB)
Business Income Worksheet for Non-Profits   PDF Submit Online     PDF Download (76 KB)

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