Igoe Administrative Services, FSA & Cobra Administration

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Request For Proposal [RFP]

We created the online proposal tool to allow you to request proposals for your clients quickly and efficiently. The information provided from this questionnaire will allow us to create a proposal that is tailored towards your client’s specific administrative needs. Upon submission of your request, a detailed confirmation e-mail will be sent to the e-mail address provided in the form. A business development team member will be in contact with you upon receipt of this information. We appreciate the opportunity!

* All fields are required unless labled as Optional.

Brokers Info

Company:

Broker Name:

Phone:

Email:

Target Implementation Date:

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Date Proposal is Due:

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Employer Info

	Company Name:
	Company Contact:

	Number of Benefit Eligible Employees:
	Require multiple billing or bank accounts:	YesNo
	Multiple Locations:	YesNo

	Number of locations:
	Are benefits administered from a central location:	YesNo

Number of contacts:

Proposed Services ( Select all that apply )

	Flexible Spending Accounts
	Flexible Spending Account:
	Transportation & Parking:
	Benefits Card:

	COBRA Administration Services
	COBRA Administration:

Flexible Spending Account Info

When do insurance contracts renew annually:

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Is this an Existing Plan:

YesNo

	How many current participants:
	Is a Benefits Card currently offered:	YesNo
	Who is your current Flex administrator:
	How many years with current administrator:
	What is the main reason for switching: