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Request for Quotes

ABC with XYZ Acquisition

Page

14

of

14

Requested Life/Disability Quotes

STD: Quote same as current benefits & waiting periods

Quote current waiting periods with $2,000 Weekly benefit

Quote current waiting periods with $2,500 Weekly benefit

Provide above 6 scenarios as voluntary fully insured as well as ASO, advice to pay

LTD: Quote same as current benefits, fully voluntary

Quote same as current benefits with mandatory enrollment, but no employer contribution.

(XYZ’s plan through Aetna was designed in this manner)

We will be reviewing FMLA. The client wants the Life/Disability vendor to be integrated with the

FMLA. If you’re quoting Life and Disability and have do FMLA, please provide a quote for FML

Administration.

If you have any questions regarding this request, please contact Kelly Abbott at

Kabbott@cbiz.com

or 770-858-4510.