Enrollment
Information:
REQUEST FOR PROPOSAL CHECKLIST
Pacific Northwest Consulting Engineers require
certain information before we can provide a quote:
1.
A census in an electronic format
(preferably Excel) including:
a.
Name
b.
Date of birth
c.
Gender
d.
City
e.
State
f.
Zip code
g.
Title
h.
Main business office location (full address)
i.
Branch location(s)
j.
Current medical election (employee only, employee + spouse, employee
+ family, employee + child(ren), waived, ineligible, etc.)
2.
Current Plan Information
a.
Current insurance carrier
b.
Benefits summary (current and proposed renewal)
c.
Current rates
d.
Renewal rates
e. Is the
current plan through an Association?
If so, please advise the name of the Association.
Please complete
in electronic format and e-mail to Engineers Trust Admin., Inc. at
administrator@engtrust.com ;
fax printed format to
503-222-9517,
Or mail to:
Engineers
Trust Admin., Inc.
PO Box 1029
Portland, OR 97207-1029
Alternate
Contact:
Woodruff-Sawyer & Co.
Brad Erickson
503-416-7901
berickson@wsandco.com