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Applications / Forms
To apply for participation in the CHSA Workers' Compensation program, please read carefully and complete the below CHSA Workers' Compensation Insurance Application and Participation Agreement and immediately return to Marc Goodwin Insurance Services via:
Fax: (831) 626-4562
or
Email: CHSA@mg-ins.com
or
US Mail to:
Marc Goodwin Insurance Services
27875 Berwick Drive, Suite C
Carmel, CA 93923
All questions concerning the CHSA Workers' Compensation insurance program should be directed to
Marc Goodwin at (831) 626-4561
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