Benefits By Design (BBD) - Plan Advisors

Advisor Home

Contacts

Forms

Glossary

Resources

Request a Quote

BBD Online

BBD Online Demo

For your convenience, we have provided a way for you to electronically request a quote from BBD. Please complete and submit the following Request for Quotation form along with an Employee data sheet, to the appropriate BBD New Business department.

Request for Quotation (Note: All fields are optional)

Name of Employer:

Address of Employer:

Phone:

Fax:

Nature of Business:

Years in Business:

Present Insurer(s):

Years with Present Insurer:

Renewal Date:

Name of Advisor:

Email of Advisor:

Phone Number of Advisor:

Reason for Marketing:

Attach Data Sheet:

To use BBD's Employee Data Sheet, click HERE.

Comments:

Present Insurer(s)

#	Period	Total Premium	Paid Claims
1
2
3

Rate History

Benefit	Current Rates	Renewal Rates
Life Insurance
AD/D&D
Dependent Life
Short Term Disability
Long Term Disability
Critical Illness
Extended Health Services
Dental Care - Single
Dental Care - Couple
Dental Care - Family

Benefit: Life Insurance and AD/D&D

Benefit Amount:

Maximum Benefit:

Benefit: Dependent Life

Benefit Amount:

Benefit: Short Term Disability

Benefit Amount:

% Maximum per week

Benefit Commencement/Duration:

day Accident day Sickness weeks

Taxability of Benefits:

Optional Coverage: 1st day Hospital

STD Experience:

#	Period	Premium	Claims
1
2
3

Benefit: Long Term Disability

Benefit Amount:

% of monthly salary OR
% of monthly salary of monthly salary, plus 50% of the balance

Maximum Benefit: per month

Elimination/Benefit Period:

EP days BP

Taxability of Benefits:

Optional Coverage:

COLA % commencing after years

Benefit: Critical Illness

Benefit Amount:

Benefit: Extended Health Services

Pay-Direct Drugs Deductible: per prescription

Pay-Direct Drugs Coinsurance: %

EHS Calendar Year Deductible:

Single
Family

EHS Coinsurance: %

Paramedical Coverage: per practitioner per calendar year

Catastrophic Only: HSA Volumes:

Optional Coverage:

Individual Drug Limit
Vision Care per 24 months

Experience:

#	Period	Premium	Claims
1
2
3

Benefit: Dental Care

Calendar Year Deductible: Single Family

Coinsurance: % Basic, Endo/Perio

Calendar Year Maximum: for Basic, Endo/Perio

Recall Exams:

for 6 months
for 9 months

Options:

50% Major Restorative
50% Orthodontia

Experience:

#	Period	Premium	Claims
1
2
3

Benefit: Benaccount ®

Employers HSA Contribution:

Single
Couple
Family

Allotment Period:

Rolling Type:

Submit quote to New Business: