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Mark E. Snapp & Associates

Group Insurance Request

Contact Information

Once we receive your (RFP) Request for Proposal, we will contact you to obtain some additional information.

We will need current census to include the following information for all groups with 5 or more enrolled lives.

Employee Last Name; DOB; Gender; Tobacco Y/N; Spouse's DOB; Tobacco Y/N; Each Child DOB; Gender; Tobacco Y/N; Employee Hire Date; Zip Code; Enrolling or Waiver; Over Age 65 and COBRA Eligible Yes/No

For Self-Insured Plans with 10 or more Employees enrolling we can still use paper or telephone enrollment to obtain rates and offers of coverage.

For Guaranteed Issue Rates we have Enrollment forms with NO HEALTH QUESTIONS - rates will be higher than previous years that where allowed to ask Health questions for underwriting purposes.
                             
For Mid-size 51 & above size Employer Groups a current census and a blend of either applications or claims history is all that is needed to obtain offers for coverage. 

For Large Employer Groups with 100 or more we will need current census on an excel spreadsheet with waivers, plan design, claims & rate history for two years. This information will help us in doing the best possible job for you and your employees in obtaining offers for Group Insurance.

Group Name:
Contact Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Office Phone:
Fax:
Email:
Renewal Date & Current Insurer Here!

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MANY SATISFIED CLIENTS SINCE 1995


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