RFP Information Request:
Please provide the following via e-mail –

• Name of group
• Effective Date
• Date due to Broker/Client
• Broker/Client Contact Name
• Broker/Client Contact Info (phone, mailing address, e-mail address)

If the requested information is sent via e-mail, then the appropriate regional sales associate will contact you.

Submission Summary:
ABCT requires the following items in order to provide the most competitive quote.

• Benefit Plan (current and/or proposed)
• Current and Recommended PPO Network
• Current Rates and Factors (include specific deductible and contract basis)
• Most Recent 24 Months Claims Experience (shown monthly including monthly enrollments)
• Employee Census w/ coverage type (including D.O.B, zip codes, COBRA & retirees)(150 Employee minimum – exceptions considered)
• Most recent 12 Months Shock or Large claim Information (diagnosis, prognosis and amount)
• Stop-Loss Requirements for Specific Deductible
• Current and Requested contract Basis for Specific and Aggregate Coverage
• Questionnaire or Additional client Questions