Get Benefitmall Request For Proposal 2014-2026

Filling out the BenefitMall Request For Proposal is a straightforward process that helps you obtain the necessary quotes for your business needs. This guide will take you through each component of the form to ensure that your submission is complete and accurate.

Follow the steps to successfully complete your request for proposal.

1. Press the ‘Get Form’ button to access the BenefitMall Request For Proposal and open it in your preferred document editor.
2. Enter the date in the space provided, ensuring that you use the current date.
3. Fill in the name of the broker responsible for the quote request in the specified field.
4. Indicate whether this is a new business, renewal, or re-quote by checking the corresponding box.
5. Provide the prospect’s name by filling in the blank with the relevant company or individual's name.
6. Complete the street address section with the full address of the prospect.
7. Input the city, state abbreviation, zip code, and the SIC code associated with the prospect.
8. Specify the requested effective date for the proposal.
9. Enter the name of the current insurance carrier.
10. Indicate if the ATNE is on payroll by checking ‘Yes’ or ‘No’.
11. Detail the employer contribution by selecting either a flat amount, percentage, or employee pay frequency.
12. Choose the appropriate plan type from the options for HMO, POS, PPO, and HDHP.
13. Select any ancillary benefits required, such as dental, life, LTD, STD, or vision.
14. Mark the medical carriers you would like to request quotes from.
15. If applicable, indicate if there are market favorites and choose specific deductible amounts.
16. Complete the sections for max out-of-pocket, co-insurance percentage, and ancillary carriers as relevant.
17. For dental benefits, specify the deductible, basic and major benefits, orthodontic options, and maximum annual benefits.
18. Include details for STD/LTD benefits, such as elimination period, benefit percentage, and maximum monthly benefit.
19. Determine the life amount configuration and ensure to fill out that section correctly.
20. After filling out all sections, save your changes, and utilize options to download, print, or share the completed form.

Complete your BenefitMall Request For Proposal online today to streamline your quote process!