Prospect Name:

Will reduce your group insurance premiums
Is more flexible
Is more powerful
Is paperless
Is more efficient
Will reduce WC premiums
And has less personal and corporate liabilities

By providing us some information on your company (this takes about 15 minutes), we will immediately start to get your Free Proposal and Analysis.

FYI, don’t worry if you can’t upload it all now, or you can’t fill out each blank.

That’s okay…

Please fill in and upload what you can so we can get started!

After we get your information, we’ll give you a call and review it all so that you’ll have the best chance of achieving your goal.

Ok let’s get started…

Tell us to which charity we should donate $25
Provide relevant information about your company
Sit back, relax and wait for some great proposals

ThePEOPeople.com will donate $25 to your favorite charity when you receive your proposals. Please fill in the website of your favorite charity below.

Date

Company Name:

Company Address:

City:

Office Phone:

Company Website:

State:

ZIP:

# Of Years of Business

EIN #:

# of Locations:

Company Web Address:

Main Contact First Name:

Main Contact Last Name:

Email Address:

Title:

Phone No:

Payroll Frequency:

If "Other," Please Specify Below

What Payroll Service Are You Currently Using:

Please Specify Other Current Payroll Service If Not Listed Above

Names of the other service providers or software--e.g. Quickbooks,401(k):

This way we can try to make sure integrate with them

45%

We need this information to get you quotes, approvals, a side-by-side comparison and a grand total ROI report.

Are you currently with any Certified 479 org or PEO?

YESNO

If you have more than one file to upload email additional files to: RFP@thepeopeople.com

If yes, who?

INSPERITY

Medical Renewal Date

MANDATE THAT RENEWAL MUST BE SUBMITTED IF WITHIN 90 DAYS OF RENEWAL

Employee Census Report & Roster (Please make sure Employee Birth Year is Unblocked)

The census report with the dependents is called the 186 report.

Full Health Plan Medical Plan Descriptions

Dependent Census

Please complete the Dependent Census and/or feel free to download the report within Insperity’s platform that includes the dependent census information for each active employee and I can populate the excel sheet for you.

Payroll Invoices: 1st of 2020, Last of 2019 & Most Recent

Schedule A

Schedule B

Most Recent Medical Invoice

Group ID Key

Payroll Invoice Report

Please provide a copy of your most recent Payroll Invoice Report which you can download from the Insperity Reporting System.

Medical Allocation Report

To show full premiums

401K Information

Please include your approximate plan assets and number of participants with a balance.

Group Identification Key

This is also called the CAR report. You may need to request this directly as you can just explain that you need an overview of your costs for the finance team.

OTHER

Employee Census Report & Roster (Please make sure Employee Birth Year is Unblocked)

The census report with the dependents is called the 186 report.

Payroll Invoices: 1st of 2020, Last of 2019 & Most Recent

Most Recent Medical Invoice

Medical Renewal Date

Full Health Plan Medical Plan Descriptions

TRINET

Most Recent Renewal

TriNet Proposal Showing Labor Cost Comparisons

Most Recent Invoice and Invoice Supporting Register- Present Report

Plan Summaries for Medical, Dental, and Vision

Medical Renewal Date

ADP

Medical Renewal Date

MANDATE THAT RENEWAL MUST BE SUBMITTED IF WITHIN 90 DAYS OF RENEWAL.

Employee Census Report & Roster (Please Make Sure Employee Birth Year is Unblocked)

Reporting Tab >Standard Benefits > HR Reports > Download PDF, Census Report & Employee Roster Report

Medical Info Overview

Dependent Census

You can access this in ADP Total Source’s portal by navigating to Standard Reporting -> HR Reports -> Employee Census (check that full birthdates are populated, default is not to include). This should show birthdates for employees and dependents.

Current Plan Benefit Summaries

This shows deductible, copays, coinsurance etc.

Most Recent Benefits Invoice

You can access this in ADP Total Source’s portal by navigating to Standard Reporting -> HR Reports -> Employee Census (check that full birthdates are populated, default is not to include). This should show birthdates for employees and dependents.

Payroll Invoices: 1st of 2020, Last of 2019 & Most Recent

Please provide a copy of your payroll invoice that was processed for the first wages paid out in the current year in January and a copy of your payroll invoice that was the most recent one run.

Total Source's 401K

If you are using Total Source’s 401K please provide your approximate plan assets and number of participants with a balance.

Most Recent Payroll Report

JustWorks

Medical Renewal Date

MANDATE THAT RENEWAL MUST BE SUBMITTED IF WITHIN 90 DAYS OF RENEWAL.

Employee Census Report & Roster (Please Make Sure Employee Birth Year is Unblocked)

Reporting Tab >Standard Benefits > HR Reports > Download PDF, Census Report & Employee Roster Report

Dependent Census

MANDATED IN CALIFORNIA. This report must be requested from Justworks directly.

Medical Info Overview

Current Plan Benefit Summaries

This report can be accessed in the Justworks portal by navigating to “You" on your Dashboard and clicking on “Documents” and you will see all the plan summaries available for download in PDF.

Most Recent Company Billing Invoice

This report can be accessed in the Justworks portal and you can access it by navigating to “Payments” click on the top right-hand corner where it says download invoice history.

Not Mandatory, but helpful for a complete analysis:

Workers Comp Billing Rates per Code

Please request your workers comp billing rates per code from your Justworks Account Manager. Ask them to specifically provide the “rate per code for each state” and they can email it over.

JustWorks Contract

Please provide a copy of your Justworks contract. This is to ensure I capture any clauses or issues that may occur if you decide to transition.

New Hire Packet

Please provide a copy of any New Hire Packet provided to candidates- This is to ensure I capture any additional company benefit offerings.

Are there any ineligible benefit classes?

YESNO

If yes, which class:

Thanks…for providing the information!!

30%

Is your current Plan Self-Funded?

YES

NO

Employee Welcome Packet- What we really need are the medical options you offer to your employees. We will get you apples to apples matching plans. So we need to know what you currently offer. Send this to us in any form you like. Summary Plan Descriptions.

A copy of last year's renewal

Plan contributions by plan tier

If you have over 100 employees we also need your most recent claim report

Census file upload - this was attached to the email for this form. Complete the census and upload it here.*Download Census Form if you need one.

Do you have a time attendance system?

YESNO

If Yes, which Time and Attendance System?

What is your accounting and G/L software?

If Other, please provide name of software

Do you have updated Job Descriptions for each position?

Do you have employment practices liability coverage?

YESNO

Is there an employee manual?

YESNO

When was the last update to the employee manual?

How many full-time employees do you currently have employed?

How many part-time employees do you currently have employed?

Do you have a collective bargaining agreement in place?

YESNO

What are the name of the union(s)?

66%

State

Rate

State

Rate

State

Rate

State

Rate

LAST QUARTERLY SUTA FORM:

*If You Have Additional States, Please Add To your Census or upload your SUTA file.

89%

Just a bit more!

CURRENTLY VALUED WORKERS COMP LOSS/RUN FOR LAST 5 YEARS

Sample of Loss Run:

IF YOUR WC PREMIUM IS OVER $100K

DETAILED DESCRIPTION OF LOSSES OVER $25K

LAST PAYROLL RUN

WORKERS COMP DECLARATION PAGE

Sample of Declaration Page Linked Here.

*If your MOD is over 1.2 please fill out the Workers Acord form and upload here.
*If you're staffing or other industry at the end there are additional forms, just for your industry.

Workers Acord form- Download Workers Acord Form.

Workers Acord Form Upload

(*OPTIONAL*) SAFETY MANUAL

All this information will give us the ability to do a quick workup on costs and approval to join one of our buying groups.

We will be back to you shortly with an answer.

Hopefully there is a straightforward path we can find to help reduce your current and future costs, and strengthen your compliance and systems dramatically, like 479 has done for over 140,000 other firms like yours. Then we will go on to the next steps to refine and do a complete ROI for you!

We have filled out this form to the best of our knowledge.

I authorize ThePEOPeople to sign the PEO and Carrier forms on my behalf with my information to get quotes so we do not have to fill out forms for so many vendors.

We understand that there are no fees charged by SBE479.org/ThePeoPeople’s services and no obligation to purchase a PEO/479 plan or join any buying group, however, it is understood that there are significant time and resources devoted to shop, compare and analyze the PEO quotes. If we have a PEO now and your work ends up helping us reduce the existing or renewal rates and we stay with our current PEO. Our firm will use SBE479 exclusively for this PEO shopping process and should we select a PEO – SBE479 will be our Broker of Record for the PEO – this does not obligate us to use SBE479 or ThePeoPeople for other coverages or our regular benefit plans.

Please Acknowledge That This Information Is Correct:

100%

You're all done!