Request For Pricing or Services
Thank you for your interest in Broker Builder Solutions. Please answer the following questions, if applicable, so that we may prepare custom pricing based on your groups specific needs. Please submit one form per group.
If you experience issues with this form please contact email@example.com.
Your Agency Name
What services are you in need of?
Client Implementation Only (Case Build without EDI): Loading plans for purposes of enrollment and onboarding only
Client Implementation with EDI (Case Build with EDI): Loading plans for purposes of enrollment and onboarding WITH setup of EDI carrier feeds
EDI Implementation Only: Establishing carrier feeds via 834 File format
Carrier Key (Manually Keying of Changes): Do not complete this form, contact BBS directly
Demo Request: One hour live webinar
Other Services: Please contact BBS directly
For Client Implementation Only: Are we building this group from scratch, or have you began loading plans, rates, etc? (skip question if you are interested in EDI only)
If you have a current group in the pipeline, what are the number of benefit eligible lives for the group?
If you have a current group in the pipeline, list all benefit plans and plan type (Example: Medical - Cigna, Dental - Guardian, Vision - VSP, etc.)
In what month does the plans renew?
For Client Implementation Only/Non-EDI: Will this build be conducted "On Renewal" or "Off Renewal?"
On Renewal (We create current plan year plans, load demographic and enrollment data, then create renewing plan year plans)
Active Renewal (We create just the renewing plans and load the demographics only allowing the employees to do an active enrollment)
Passive Renewal/Off Renewal (We create current plan year plans and load enrollment data for current plan year plans only)
What are the Open Enrollment dates (if applicable)?
When is the expected Go Live Date (if applicable, for Client Implementations or OE only)?
For EDI Only: Will BBS provide Ongoing Monthly EDI Support and troubleshooting of error reports?
No (If no, your agency or the Employer group will be be responsible for troubleshooting error reports)
For Client Implementation Only: Will the group need additional components? (this question does not apply to EDI Only services)
HR Training (1 hour live demo conducted with HR Administrator)
Any additional information that would help us understand the groups needs? Do you have any questions for us?
Are you new to BBS? If yes, how did you hear about us?
What benefits administration platform do you use, if other than Employee Navigator or Selerix?
Please provide your name and phone number for contact purposes only.
Do Not Fill This Out