Welcome to Get Benefits Insurance Services escrow form for payments that we receive!

As a rule of thumb, the “Total of Payments to Payee” field should equal the amount due on the GA’s invoice. If the client would like to pay by credit card, our standard credit card transaction fee is 3.75% of the premium. You should include this in the retail broker fee. Here is our standard retail broker fee schedule for surplus lines:

Retail Broker Fee (Surplus Lines Only)
Premium less than $5,000$100
Premium between $5,000 and $15,000$200
Premium greater than $15,000$300
Escrow
Payee
Is this policy financed?
Payment Method
$
$
$
$
$
$
$
Maximum upload size: 104.86MB