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These application forms are currently available for printing. Upon completion you must either mail or FAX the application for processing. Also, we would need to receive your most recent audited financial statement, loss runs, descriptive brochures and your current policy. To become a shareholder, MHRRG common stock must be purchased (the minimum is one share of Class D stock at $2,354.58 a share). Additionally, it is required that insurance coverage be purchased from MHRRG for 3 successive years. The following PDF applications are now available from this site. They may be downloaded, filled-out and printed using Adobe Acrobat Reader. Follow the link below to download Adobe Acrobat Reader for free.
Other applications also available through underwriting manager Negley Associates.
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Welcome to The Mental Health Risk Retention Group (MHRRG) website.
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