Request For Proposals

Please click on the appropriate form listed below. Once completed, hit SUBMIT and it will be sent directly to us.

Individual Long Term Disability/ Business Overhead

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

Launch Form

Buy Sell Proposal Request

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

Launch Form

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].

Download Excel Census Form Launch Form

Please feel free to contact us at 800-945-9719 to discuss the case, underwriting concerns, program design, and competition and carrier selection.

General turn around time is within 24 hours for most Individual / Business Overhead and Buy-Sell requests.

Please allow additional time for Multi-Life requests.