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• Employer Name, Address, Phone Number, Nature of Business, Effective Date

• Can include on attached census

• Census should include employee and dependent information of those to be covered.  Please include date of birth, gender, full address, type of coverage.  If more than one plan offered, need to identify who is on what plan.

• Current Rates

• Renewal Rates

• Current Summary of Benefits

• Medical Claims Data (if available).  If not available may require individual medical applications.

 

To receive a quote for group life or disability, in addition to the information listed above, we will also need:

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• Salaries

• Job Title

 

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