online request form
RFP Submisssion
Please give us a chance to evaluate your needs and give you a no cost assessment and quote/RFP.
We’d love to show you how we can maximize your plan's benefits while reducing risk and costs.
To ensure an accurate and expeditive RFP, please submit the form below and all of the additional requested information by email.
General Required Information
Additional Info Needed:
- Census that includes zip, DOB, gender, and coverage type (active, retiree, cobra) as well as tier.
- Current Plan Document, SPD and or Schedule of Benefits.
- Any proposed plan design changes.
- If requesting aggregate coverage, provide a minimum of two years* aggregate claims reports including enrollment by month and pending claim report. *Three years is preferred for optimal pricing.
- Minimum of two years+ of large claim reports including paid/pending amounts, diagnosis, detailed prognosis, current and proposed treatment plans, an estimate of future costs, and any available LCM reports. *Three years is preferred for optimal pricing.
- Current specific rates, terms & benefits covered.
- Current aggregate factors, rates, terms & benefits covered.
