NCSFA Healthcare Pool Plan

Please complete the form below by March 30, 2026. Responses will help determine whether this opportunity moves forward.

NCSFA Health Care Pool Plan

NCSFA is conducting a survey to find out how many member departments with paid firefighters would be interested in a pooled health care plan.

Fire Department Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Chief's Name(Required)

First Last

Chief's Cell Phone(Required)

Chief's Email(Required)

Enter Email Confirm Email

Current Number of Paid Firefighters(Required)

Do You Currently Offer Group Health Coverage?(Required)

Yes

If You Answered Yes To The Question Above, Who Is Your Current Insurer And What Is Your Renewal Date?

If You Answered Yes To Having Group Health Coverage, How Many Firefighters Are Enrolled?