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Hagan Benefits, Inc. / Governmental Pools / SDPAA Applications

To apply for coverage:
 
1. Print and complete the desired application (from the list below) and answer all questions in full. Sign your name and date the application.
 
Liability, Property, Boiler and Machinery Application Acrobat PDF
 (With Property Coverage please complete Statement of Values Form, below)
 
Statement Of Values Form Acrobat PDF
   
If you don't have Adobe Acrobat Reader click the icon below to download for free.

 
2. Mail your completed application to:
Hagan Benefits, Inc.
Attn: SDPAA
P.O. Box 5090
Sioux Falls, SD 57117-5090
 
3. Don't send any money now; you will be billed later once your application is approved. When your application is approved, you'll receive your Certificate of Insurance. If you have any questions, please feel free to call Hagan Benefits, Inc. at number: 1-800-456-0737
 




 
 
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