You are here > Quote Requests > Information Needed To Quote

Quoting Requirements

The following is a minimum list of information that we require to create a quote for each coverage we carry. If you have any additional information not listed here, please include that as well so we may provide you with the most accurate quote possible.

Stop Loss / Self Insured

1.  Group Details, Locations, and Nature of Business

2.  Effective and Quote By Date

3.  Commission Level

4.  Current/Proposed Contract Type

5.  Specific and Aggregate Deductibles (Minimum Spec Level $20,000)

6.  Current/Renewal Rates (if available)
Min Group Size:  50
Required Documentation:  1.   A Current Census containing the following:
  • Name or Employee identifier
  • Gender
  • Date of Birth
  • Single or Family coverage
  • ZIP Code (if applicable)
2.   3 years of Specific/Aggregate reporting.

3.   Current Large Claims Information:
  • Pending report
  • LCM notes
  • Trigger
  • DX. Report
4.   Current schedule of benefits and/or any changes to the plan document in the last policy year or new SPD if applicable.

Life, ADD, STD and LTD

1.  Group Details, Locations, and Nature of Business

2.  Commission Level

3.  Current Booklet/Contract or Schedule of Benefits

4.  Rate History

5.  Contribution Levels
Min Group Size:  50
Required Documentation:  1.   A Current Census containing the following:
  • Name or Employee identifier
  • Gender
  • Date of Birth
  • Benefit Amount or Current Salary (If based on income)
  • ZIP Code (if applicable)
2.   3 years of Experience Including::
  • For Life - Include Waiver Of Permission Listing
  • For LTD - Include Disabled Lives Listing, Reserving, Open Claims Listing, Dx Indication of Claimant
  • For STD - Include Premium and Claims Paid

Organ Transplant

1.  Group Details, Locations, and Nature of Business

2.  Stop Loss Deductible

3.  Stop Loss Carrier

4.  Stop Loss discount (% of discount carrier will offer on annual premium if program is put into place)

5.  S/F counts

6.  S/F Rates

7.  Domicile State / Addt'l States - Please supply ee count to each

8.  Current Lasers
Min Group Size:  10
Required Documentation:  None

Limited Medical Benefits

1.  Group Details and Domicile Location

2.  Commission Level
Min Group Size:  10
Required Documentation:  None

Medical Tourism

Group Name
Min Group Size:  1
Required Documentation:  None

Group Retiree Coverage

1.  Group Details and Domicile Location

2.  Commission Level
Min Group Size:  10
Required Documentation:  None
  
Corporate Offices
Commercial Group Intermediaries
16 Executive Court
Suite 4
South Barrington, IL  60010

Main Number:  (847) 713-4700
Fax:  (847) 713-4701

Contact Via The Internet