Who Are We?

FCSRMC is a program authorized by the Florida Legislature, which allows the Florida College System in the state of Florida to join together to develop and implement a statewide cooperative system of risk management under one comprehensive plan.

Property Insurance Question?
Workers’ Compensation Question?
Liability Insurance Question?
Employee Benefit Question?
Student/Athlete Injury Question?

Hurricane Season Preparation

The best time to prepare for a Hurricane is before hurricane season begins on June 1. It is vital to understand your college’s vulnerability to storm surge, flooding, and wind. The Hurricane Preparation Packet can be downloaded by clicking the button, below. 

2024 Hurricane Preparation Packet

Risk Management Forms

Certificate of Insurance Request Form

This Form is used to request Certificates of Insurance for your business partners.
Email Completed form to COI@fcsrmc.com

Accident-Incident Form

This form is used to report Property & Casualty claims to FCSRMC.
Email Completed form to Claims@fcsrmc.com

Student Accident Form

This form is used to report claims when a student is injured while participating in a covered curriculum.
Email Completed form to BGilliam@fcsrmc.com 

Allied Health Form

Click the icon above to view instructions related to filing allied health/student professional liability claims. Email Questions to BGilliam@fcsrmc.com

Athletics Injury Form

Click the icon above to view instructions related to filing athletic injury claims. Email Questions to BGilliam@fcsrmc.com 

Property Coverage Request Form

This form is used to request insurance coverage, or to make changes to coverage for college-owned properties.
Email completed form to BGilliam@fcsrmc.com

Vehicle Coverage Request Form

This form is used to request insurance coverage, or to make changes to coverage for  college-owned vehicles.
Email completed form to BGilliam@fcsrmc.com

Art Coverage Request Form

This form is used to request insurance coverage, or to make changes to coverage for college-owned artwork.
Email request to BGilliam@fcsrmc.com

Watercraft Coverage Request Form

This form is used to request insurance coverage, or to make changes to coverage for college-owned watercraft.
Email completed form to BGilliam@fcsrmc.com

Workers’ Compensation Form Packet

Click the button above to download a workers’ compensation form packet, including the First Report of Injury, Referral for Medical Services, and Wage Statement.

Builder’s Risk Quote Application

Click the button to download the Builder’s Risk application to obtain a builders risk quote. 
Email completed form to mhackathorn@fcsrmc.com

FCSRMC HIPAA Materials

This packet containes useful documents to aid in your HIPAA educational activities.

Employee Benefit Plan Forms

This file contains commonly-used Employee Benefit Plan Forms.

Risk Management Program Brochures

2024-25 Property & Casualty Brochure

Click to Download

2024-2025 Optional Program Brochure

Click to Download

FCSRMC Team – Click Pic for Bio

Chauncey Fagler

Executive Director & CRO
Email

– FCSRMC Oversight
– Annual Operating Budget
– Audit Coordination

Tony Ganstine 

Associate Director
Email

– Workers’ Compensation
– General Liability

– Educators Legal Liability
– Auto Liability
– SREF Inspections
– Employee Benefits
– International Travel
– Stewardship Reports
– Financials
– Crime

Brandon Gilliam

Enterprise Risk Manager
Email

– Individual & Optional Insurance Policies
– Student Accident, Allied Health, Athletics
– Environmental Pollution
– Certifcate of Insurance (COI)
– Employee Benefit Billing

Natalie Dyksterhouse

Enterprise Risk Manager
Email

– Employee Benefits
– Meeting Facilitation
– Wellness Program
– Health & Benefit Fairs

Selina Ohlson

Executive Assistant
Email

– Staff Support
– Travel
– Invoice Processing
– Meeting Facilitation

Contact Us:

Address:

4500 N.W. 27th Avenue, Suite B-2, Gainesville, Fl 32606

Phone:
FAX:

352.955.2190

352.955.2069