Request a Proposal

If our concept makes sense to you, we would like to prepare a free objective assessment and comparison of your current costs and benefits versus costs and benefits with our program in a proposal.

Simply fill out this brief form, and we will contact you and prepare a comprehensive proposal for your consideration.

(*Required)
First Name*
Last Name*
Company Name*
Address*
City* State* Zip*
Email Address*
Phone
Industry
Gross Annual Payroll:

Are you currently doing your own... (check all that apply)
Payroll Administration? Benefits Administration? Workers' Compensation?
Human Resources Administration? Safety and Risk Management?
Compliance Administration?

We are currently using a PEO.

What employee services do you currently offer? (Check all that apply)
Health Insurance
Workers' Compensation
Dental Insurance
Vision Insurance
HR Department
Life Insurance
AD&D Insurance
Employee Assistance Program
Travel Benefits
Christmas Savings Club
Direct Deposit
Online HR Portal
   PTO Program
Safety Training
Compliance Training
Employee Handbook
Section 125 Plan
401(k)
Roth 401(k)
Individual Roth 401(k)
Online EE Handbook
Other

How long have you been in business? :

How many employees do you have?

What state(s) does your business operate in?(Check all that apply)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
   Louisiana
Maine
Maryland
Massachussetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
 Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

Are you using or have you ever used a PEO service? :


Additional comments:



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