Employee Benefits Request for Proposal

/ Colorado Group Health Insurance Benefits / Employee Benefits Request for Proposal

We will prepare a customized employee benefits proposal for your business.

Name*
First Last
Phone*
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Email*

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Company Name*
How many employees do you have?
Do you currently offer group health insurance to your employees?
What benefits would you like for us to include in your proposal?
- Group Health Insurance
- Dental Insurance
- Visions Insurance
- Disability Insurance
- Life Insurance
- Retirement Plan
- HSA Plan(s)
- AFLAC Supplemental Insurance
- Other (Please Specify Below)
Have you already prepared an employee and dependent census?
A census should include the names, dates of birth, gender, zip codes, desired enrollment status (employee only, employee + spouse, employee + children, family coverage) and tobacco usage (Y/N) for ALL employees AND dependents. If you want to offer life or disability insurance, we will also need annual salary amounts for all employees. Here's a template if you need it!
Excel Version
If you have your census ready, please upload it here.
Max. file size: 64 MB.
What else do we need to know before we get started?*
Name
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