Quote Requirements for Fast, Simple Pricing
Instant quotes for qualified groups
Streamlined inputs for faster results
No underwriting for qualified groups
Review the Requirements below to keep your quote fast and seamless.
Paid Family & Medical Leave Quote Requirements
- Census File
- DOB - Date of Birth (MM/DD/YYYY)
- Gender (U or Unidentified / M or Male / F or Female)
- Annualized Wages
- Work State (For example, CO or Colorado)
- Business Name and Address
- SIC Code
- Total EE Population
Groups over 100 nationwide lives require underwriting review.
Submit your request here
New York DBL / PFL Quote Requirements
1-49 lives:
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
50+ Lives: - claims experience
- Third-Party Sick Pay reports or
- most recent paid premium bill
- evidence of any rate adjustment
New Jersey TDB Quote Requirements
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
- Include census with wages and Gender
Other Group Benefits Quote Requirements
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]
For further information, please contact our sales department at sales@shelterpoint.com.