ShelterPoint Life Insurance – Formerly First Rehab Life 1972 Located at
1225 Franklin Avenue, Ste. 475, Garden City, NY.
Phone: 516-82908100

What ShelterPoint needs for Quotes:

All policies are administered by ShelterPoint Life and underwritten by either ShelterPoint Life, a NY-domiciled carrier, or ShelterPoint Insurance, a FL-domiciled carrier depending on the state. Contact Underwriting for details.
  • Not all products are available in all states and from each entity in the family of ShelterPoint companies.Click here to view availability by state.
  • For information about which company is licensed in your state, please visit our "Geographic & Jurisdiction Notice".

Statutory Insurance

NY DBL/PFL (1 - 49 lives)
  • Quote now!
  • Submit Application now!
  • For an application, have the following information ready:
    • valid business name & address
    • nature of business
    • effective date
    • Federal Tax ID and unemployment insurance number
    • number of male employees/number of female employees
    • previous DBL carrier
    • current workers' comp carrier
  • View Rate Card pdf icon
NJ TDB (25+ lives)
  • number of male employees/number of female employees
  • If group is currently covered by NJ Dept. of Labor:
    • Notice of Employer Contribution Rates (3 consecutive AC174.1 forms required)
  • if group is currently covered by private carrier:
    • three years premium & claims experience
  • E-mail RFP
NY DBL/PFL (50 +lives)

Other Group Benefits

24-Hour Accident
  • Company name and address
  • Nature of business
  • SIC Code
  • Dependent status: 
    • single [s] 
    • employee/spouse [ES] 
    • employee/child(ren) [EC] 
    • family [FF]
  • Plan design (number of requested units)
  • Quote now!
Hospital Cash (2+ participating employees)
  • desired plan design
  • participation level
  • dependent status:
    • single [s]
    • employee/spouse [ES]
    • employee/child(ren) [EC]
    • family [FF]
Non-Statutory Short-Term Disability (5+ lives) *
  • name
  • date of birth/age
  • gender
  • date of employment
  • job title
  • salary
  • E-mail RFP
Vision Indemnity (5+ lives)
  • desired plan number
  • number of singles
  • number of families
  • Quote now!
Dental (2+ participating employees)
  • Desired plan design
  • Participation level
  • Desired funding option
  • dependent status:
    • single [s]
    • employee/spouse [ES]
    • employee/child(ren) [EC]
    • family [FF]
  • Quote now!
Medical Gap
Underlying Major Medical Information1: 
  • Major Medical enrolled census  
    • Employee ages
    • Tier structure
  • Major Medical plan design2 – minimally:
    • Major Medical in-network out-of-pocket maximum     
    • Major Medical employee deductible
  • Major Medical rates by tier2
Gap Medical Information1: 
  • Employer contribution %
  • Number of full-time eligible employees
  • Number of participants in major medical plan
  • Number of eligible participants for Medical Gap (not enrolled in HSA)
  • Number of eligible participants for Medical Gap (enrolled in HSA)
  • If existing Medical Gap plan – current participating census and plan design
Required benefits 
  • Family Benefit (2x, 3x) individual benefit
  • Inpatient benefits 
 Optional benefits 
  • Outpatient benefits
  • Medical Gap deductible amount or Medical Gap co-insurance percentages
  • Ambulance benefit upgrade
  • Number of annual office visits
  • Number of annual refills for prescription drugs
  •  

1. Please provide all information by class if benefits will vary by class.

2. Please provide, as part of census file, if the medical plan design is not the same for all enrolled employees

Term Life and AD&D (10+ lives) *
  • name
  • date of birth/age
  • gender
  • date of employment
  • job title
  • salary
  • E-mail RFP
Vision with network option (2+ participating employees)
  • desired plan design
  • participation level
  • desired funding option
  • dependent status:
    • single [s]
    • employee/spouse [ES]
    • employee/child(ren) [EC]
    • family [FF]
  • Quote now!

* For groups of 100 or more employees, we require premium, claims, rate history, most recently paid bill and in-force plan booklet, if applicable.

For further information, please contact our underwriting staff at 800-365-4999. or underwriting@shelterpoint.com