Benefits Evaluation

Evaluate your current benefits plan and find out how yours matches up! Complete the following questions, and we will contact you for a free consultation and review.

* Fields marked with an asterisk are required.

Current Plan

We currently offer our employees (check all that apply):

One Medical / Rx Plan

Multiple Medical plans to choose from

Dental plan

Vision plan

HSA / HRA plan

FSA plan

Section 125 plan

A Wellness program

Life insurance paid by the company

Life insurance paid by the employees

Disability insurance paid by the company

Disability insurance paid by the employees

A 401(k) plan with no company match

A 401(k) plan with a company match

An IRA with no company match

An IRA with a company match

Other

Please Specify:

New Interest

We would like to (check all that apply):

Reduce the company’s benefit costs

Reduce the employees’ individual benefit contribution costs

Offer more health benefit choices to our employees

Reduce the number of health benefit choices offered to our employees

Offer a wellness program

Offer more retirement benefits

Reduce our retirement benefits

Add Life Insurance benefits to our plan

Add Disability Income benefits to our plan

Add Long-Term Care benefits to our plan

Sponsor employee paid group voluntary benefits

Sponor employee paid group supplemental benefits

Offer Medicare & or Medicare supplemental plans

Other

Please Specify:

Additional comments:

I heard about Alliance Benefits Insurance Group from:

Contact Information

First Name: *

Last Name: *

Title: *

Company: *

Email Address: *

Phone: *

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