Request For Proposals

Individual Long Term Disability/ Business Overhead

This form is for all Individual Long Term Proposals and all Business Overhead Expense cases.

Buy Sell Proposal Request

This form is for Buy / Sell monthly, down payment, or lump sum benefit amount proposals.

Multi-Life Offer Request Form

Use this form for cases with three or more lives and for which you would like to propose an executive carve out program, a retirement completion program, a group supplement program, or other type of multi-life disability income benefit program. This form will allow us to negotiate/request Guarantee Issue or Simplified offers from the insurance carriers. Additionally, a census in an Excel Spreadsheet is required including:

• Company Name and Address
• Employee Name (First, Last)
• Sex
• DOB
• Resident State
• Occupation
• Salary
• Bonus/ Commission

Download our pre-formatted Excel spreadsheet census form

Once completed, you may attach the census to the web form, or you can e-mail census to [email protected].