Application Process

We will contact you to learn about your company and discuss your objectives. We will then custom design a plan for your unique needs.

To begin the process of implementing a cost-effective benefit solution for your company, please complete this form.

Contact Form
Name:*
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Medical
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The basic group insurance application requirements are listed below:

  1. Company Profile (form above)
  2. Employee Census
  3. Current Plan Information
  4. Claim Reports
  5. Quoting requirements vary by carrier and employer demographics

Upon final plan selection, the carrier requires the following documents.

Of course, we will guide you through the process and provide the required documents. To ensure a smooth transition, all enrollment material should be submitted 30-days prior to the effective date.

  1. Proof of business with at least two employees
  2. Employer Application
  3. Signed carrier proposal listing plan selection
  4. Tax & Wage report (for Texas, this is the quarterly Texas Workforce Commission (TWC) report)
  5. Supplemental Employment Verification form listing anyone not on the TWC report (new hires, owners, etc.)
  6. Completion of carrier specific underwriting requirements - depending on employer size, this is either a claims experience report or individual health questionnaires. We will guide you through the underwriting process.
  7. Employee Applications (required for all eligible employees, including continuants and declinations)
  8. Premium Payment Check (check for the first month's premium payable to the insurance carrier)