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Enabling Connections
With Ease
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DATA REQUIRED TO QUOTE
A. Client Information:
- Name of Prospect
- Address of Prospect
- Location of divisions/subsidiaries to be covered
- Nature of the business (what, specifically to be covered)
- Standard Industrial Classification Number-SIC Code
B. General Information:
- Census data showing gender, date of birth, and single/family designation
- Specific and Aggregate deductibles requested
- Date the quote is needed and the renewal date of the Plan
C. Benefit Information:
- Copy of Employee Booklet/Schedule of Benefits/ Summary Plan Description
D. Experience Information: (If Available)
- Month-by-month claims paid listing, including number of employees/dependents for the last 2 policy years, for Medical, RX, and Dental coverage.
- Current Specific and Aggregate Stop Loss levels.
E. Additional Shock Loss Information:
- Are there any individuals with a serious disease (e.g. diabetes, cancer, heart disease, AIDS, etc.)?
- Shock Loss information for each period cited in #E1 above. Claims in excess of 50% of the specific Stop-Loss Level. For Claims that exceed 50% of the Specific Stop-Loss Level the reinsurance markets need name of the claimant (employee/dependent), date(s) of loss, amount, cause, status, prognosis and diagnosis of each claim if possible. Case management reports are helpful, if they are available.
- Cobra covered persons.
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