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2022-23

This calculator for the '22-'23 academic year must be completed and submitted by a lettered officer by September 5, 2022 for semester schools and September 20, 2022 for quarter schools. Failure to submit this form by the deadline will result in a per man rate of $355.00.

The premium charged to the chapter is calculated by taking the base rate per man multiplied by the number of active members as of the Membership Deadline of June 30, 2022.

This number of active members is calculated using the following formula:

(Total Membership on Vault as of 06/30/2022) – (5% rounded to the nearest dollar.)

Each chapter will be eligible for certain discounts and surcharges based on performance and behavior. Each chapter will start off at a base rate of $310 per man and can have surcharges and discounts applied towards that amount.

The Fraternity recognizes that some groups take great measures to ensure the safety of members and guests, while likewise, some have increased the overall risk to Delta Chi.

Instructions:

Step 1: Fill out the basic information in the first five fields.

Step 2: Fill out the below components to the best of your abilities.

Step 3: Click "Calculate" under the heading "Total discounts/surcharges to be applied per man."

For explanation on a component, hold your cursor over the question mark (?) next to the relevant component for a brief description.

Your name: *

Email address: *

Phone number: *

Chapter/Provisional Chapter: *

Chapter/Provisional Chapter if not listed in the above dropdown selection:

Chapter/Colony Officer Position (If Applicable)

Reason for completing form: *

Discounts/surcharges:

Fill out the below items as accutately as possible to determine what discounts/surcharges could be applied to your per man rate.

1. Did your chapter/provisional chapter experience an incident that resulted in a claim to the Insurance Carrier or lawsuit after 7/1/2019? If unknown, contact Director of Member Safety, Davis Millard, at dmillard@deltachi.org. Please give 3 business days for response. * 🛈

2. Was your chapter/provisional chapter placed on Levels I, II, III, or IV Corrective Action at any point in time in the past two academic years? * 🛈

3. Does your chapter/provisional chapter have a Faculty Advisor as required by Delta Chi Law? *

Faculty Advisor Name & Position at Institution: *

"BB" - Alumni Advisor Name: *

Alumni Board of Trustees (ABT) President Name: *

4. Did your chapter/provisional chapter earn a Core Competency Award with Achievement, Excellence, or Excellence with Distinction in the Advance Justice category in 2022? *

5. Did your chapter/provisional chapter earn a Core Competency Award with Achievement, Excellence, or Excellence with Distinction in the Assist in the Acquisition of a Sound Education category in 2022? *

6. Did your chapter/provisional chapter send five or more members to the most recent Regional Leadership Conference? *

7. Does your chapter/provisional chapter have a house, lodge, or floor in university housing? *

7a. Is your chapter/provisional chapter house, lodge, or residence hall floor designated as alcohol-free? If answered "yes," this form below must be filled out and returned to Delta Chi Headquarters to dmillard@deltachi.org by 9/5/22 for semester schools, and by 9/20/22 for quarter schools. * 🛈

8. The chapter/provisional chapter agrees to exclusively use a licensed and insured third-party vendor for all social events where alcohol is present. This includes all chapter/colony events where alcohol is present, regardless of location. A chapter/provisional chapter who voluntarily agrees to abide by the agreement and receives the discount is unable to host an event with alcohol utilizing a BYOB system, even if all applicable recommended Delta Chi Risk Management Policies are followed.

In order to receive this discount, a chapter/provisional chapter must complete and return this form by 9/5/22 for semester schools, and by 9/20/22 for quarter schools. * 🛈

9. Is your chapter/provisional chapter currently compliant with Delta Chi's minimum Grade Point Average Requirement? * 🛈

Total discount/surcharge to be applied per man:

$0.00

Please note: All information will be verified by the Fraternity. Information that cannot be verified or that is found to be inaccurate will not count towards a chapters or colony's premium.

Recap:

Enter the total discount/surcharge to be applied per man (from previous section, be sure to include a negative sign if shown above): *

Based on the information submitted above, your insurance premium for 2022-23 could be represented by the number below. Submissions will be verified by a staff member for accuracy. The Base Rate for 2022 as set by the Board of Regents is $310 per man; discounts and surcharges submitted in this form will be factored in to this rate.

Rate-Per-Man Risk Management Bill:

$310.00

Your total bill will be calculated by using the number above (once verified) multiplied by the number of active members in your chapter or provisional chapter.