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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:      
  Company Website:      
  Number of Benefit Eligible Employees:    
Require separate premium checks or bank accounts:  
  Multiple Locations:  
Number of locations:    
Are benefits administered from a central location:     
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:    
How many current participants:    
 Is a Benefits Card currently offered:     
Who is your current Flex administrator:
How many years with current administrator:  
What is the main reason for switching:
   
COBRA Administration Info
Number of current/enrolled COBRA participants:  
  Number of pending COBRA participants:  
  Average number of qualifying events per month:
* The accuracy of this information is vital to
   preparing a custom quote. The proposed
   COBRA fees will be reflective of the information
   you provide, so please make sure to include
   accurate data.
   
  Total number of qualifying events over last 24 months:
* The accuracy of this information is vital to
   preparing a custom quote. The proposed
   COBRA fees will be reflective of the information
   you provide, so please make sure to include
   accurate data.
   
  Number of COBRA eligible benefit plans:    
  Does the client use Cal Choice:
* Please Note: Igoe does not provide
   administration for Cal Choice
   
  When do insurance contracts renew annually:
RadDatePicker
Open the calendar popup.
   
  Is COBRA administration currently outsourced:      
Who is your current COBRA administrator:
How many years with current administrator:  
What is the main reason for switching:
 
  Comments (Optional):  
   
     
   
     


  Important Information