Coverage Applications—Risk Retention Group (RRG)

Below are medical professional liability insurance applications for COPIC's Risk Retention Group (RRG). Please complete the applications listed in the appropriate section and then submit them to COPIC:

  • Email:
  • Fax: 877.263.6665
  • Mail: Attn: COPIC Sales Department, 7351 E. Lowry Blvd., Ste. 400, Denver, CO 80230

COPIC, a Risk Retention Group (RRG)

An RRG is a liability insurance company that is owned by its members. The COPIC RRG provides flexible coverage options under one policy for multi-state exposure. There are several benefits to forming an RRG:

  • Nationwide reach and protection—An RRG can insure members throughout the country by registering in all states where coverage needs to be written.
  • Return on investment—Members may benefit when there are favorable loss conditions that allow for the distribution of dividends or reductions in premiums.
  • Ownership in business decisions—Because members are owners, they participate in the oversight of operations and have a voice in how the RRG is managed.
  • Rate stability—Increased emphasis on risk management and careful selection of members allows for improved loss experience, and this often translates into lower costs.

Download the following applications as they pertain to your needs for COPIC RRG coverage. For more information, please contact our Sales Department at, or 800.421.1834, ext. 6186.

PLEASE NOTE: Additional supplemental applications may be required based on your specialty. Our staff will contact you about this information. To see a list of the allied health professionals that require an application, please click on the "read more" button.

Allied health professionals who are required to submit an application for coverage:

  • Acupunturist
  • Advanced Practice Nurse
  • Aesthetician
  • Child Health Associate
  • Clinical Nurse-Specialist
  • CRNA/Nurse Anesthetist
  • Cytotechnologist
  • Electrologist
  • Embryologist
  • Emergency Medical Technician
  • Endermologist
  • Laser Technician
  • Microdermabrasionist
  • Nurse Clinician
  • Nurse Midwife
  • Nurse Practioner
  • Optometrist
  • Orthopaedic Physician Assistant
  • Perfusionist
  • Pharmacist
  • Physician Assistant
  • Physicist
  • Physiologist
  • Psychologist
  • Psychotherapist
  • Radiology Practitioner Assistant
  • Surgical Assistant
  • Surgical Technician

Contact Us

Contact our staff with questions or to get started. Looking for an agent? We can help with that too.
800.421.1834, ext. 6186 or 720.858.6186

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