Simply complete our request for proposal, send us a few documents,
and we'll have a proposal prepared for you within a few days.
1. Please complete our Request for Proposal: Click Here
2. Copy of your most recent UCT-6
3. Copy of your current payroll register and the total number of active employees.
4. Workers’ Compensation Dec page or monthly audit showing modifier, discounts, and class codes.
5. 3 Year of Workers' Comp Loss Runs and/or OSHA 300 Log, this information is needed and necessary.
6. If Medical Insurance Requested:
• Current Census completed
• Current Plan Summary i.e. co-pay, deductibles, out of pocket maximum, etc.
• Current Pricing & Renewal date i.e. employee, employee/spouse, employee/child, family, etc.