Request for Quote - ACA Support Questionnaire
Thank you for your interest in Broker Builder Solutions. This form is for ACA REQUESTS ONLY. Please submit one form per group. If you experience issues with this form please notify email@example.com.
Your Company Name
Do you have an Employee Benefits Broker that handles your company benefits? If yes, what is their name? We have robust partnerships that span across 26 states.
What is the total number of eligible employees that you will be filing for?
What benefits administration platform does the group currently use, if any? (Example: Employee Navigator, Selerix, None, etc)
To help us determine what data elements need to be collected/audited in preparation for ACA, if the group uses Employee Navigator have they used the system consistently throughout the year? *
Group does not currently use Employee Navigator platform
If the group uses Employee Navigator, check off the applicable boxes to indicate which plan year plans are already loaded into the system?
Group does not use Employee Navigator platform
By checking the box below, you acknowledge the following: BBS Services do not include the filing or filing fees associated with Nelco. Filing and filing fees are the responsibility of the Employer Group at the time of filing in accordance with Nelco.
Yes, I understand
Are you new to Broker Builder Solutions? If yes, how did you hear about us?
Please provide your name and phone number for contact purposes only.
The information contained in this form is for BBS Use Only. Your information will not be sold to a third party.
Do Not Fill This Out