Quote Request Checklist

When do you need the quote back from us?

Current Rates

Plan 1

Plan 2

Plan 3

Plan 4

Renewal Rates

Plan 1

Plan 2

Plan 3

Plan 4


The following is a list of all data needed to supply a quote. CBG will follow up regarding the items needed.

1) Census - Include date of brith, gender, type of coverage (EE, EC, ES, EF), zip code, plan election (if multiple plans). Please provide in Microsoft Excel format.

2) Benefits - Current and/or proposed benefit schedule(s) - Please provide copy with submission.

3) Claims Data (if available) - Please note that we can provide manual quotes for groups up to 150 lives without claims data. If the state where the group is domiciled requires claims disclosure by the carrier, we will need claims data in order to quote. Claims data is also required for groups that are currently self-funded.

4) Applications - if claims data is not available, individual applications will be required to bind coverage.

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