Welcome, Bob Broker
View Dashboard
Account Settings
Log Out
Advanced Search
Case Name
Case Name
Dashboard
Activities
»
Recent
New Quote
New Enrollment
New Case
Work Queue
Tools
»
Home
Compensation
Forms
Network Information
News and Rate Alerts
Product Information
Provider & Network
Summary of Benefits and Coverage (SBC)
News and Rate Alerts
XYZ Enterprises
Status:
Prospect
Case Information
New Business
Case Notes & Messages
Case History
SG Quote
ID
Type
Date Created
Created By
Effective Date
Status
8388
ENR
06/09/2015
Broker, Bob
06/15/2015
Enrollment Review
View
8387
PQ
06/09/2015
Broker, Bob
06/15/2015
Enrollment
View
Copy
SG Quote
Add Employee
Close
Employee Information:
First Name
Last Name
Birth Date
*
Age (As of Effective Date)
*
Smoker
Yes
No
Smoking Cessation
Yes
No
*
Gender
Female
Male
*
Employment Status
Active
COBRA
Out Of Area
Yes
No
Coverage Type
Employee Only
Employee + Spouse
Employee + Child
Family
No Coverage
Email Address
Date of Hire
# Hours Worked
Commissions Employee
No
Yes
1099
No
Yes
Employee Dependent Information
Birth Date
Age (As of Effective Date)
*
Smoker
Yes
No
Smoking Cessation
Yes
No
*
Gender
Female
Male
*
Relationship
Spouse
Child
remove
Add Dependent
I want to change coverage types for each product.
Add Another Employee
Cancel
Save
XYZ Enterprises
Status: Prospect
All information is kept safe and secure.
View our