Skip Navigation LinksHome > Brokers > Proposals > Request For Proposal
  
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!

Brokers Info
  Company:  
  Broker Name:
  Phone:
  Email:
  Target Implementation Date:
Open the calendar popup.
 
  Date Proposal is Due:
Open the calendar popup.
 

Employer Info
Company Name:
Number of Benefit Eligible Employees:
Require multiple billing or bank accounts?
Proposed Plans ( Select all that apply )
Flexible Spending Account:
  COBRA Administration:  
  Transportation & Parking:  
  Benefits Card:  
     
Flexible Spending Account Info
Is this an Existing Plan:
  How many current participants:  
  Is a Benefits Card offered:  
     
COBRA Administration Info
Number of current/pending COBRA participants:
  Average number of qualifying events per month:  
  Does the client use Cal Choice:  
  When do insurance contracts renew annually:
Open the calendar popup.
 
  Is COBRA administration currently outsourced?  
  If so, what is the reason for moving?  
       
       
  Comments: