Requesting a Proposal

Interested in obtaining a proposal from us?  Here’s what we need to get started:

  • Company name and principal location (City, state, zip)
  • Address of other locations and number of covered employees at each
  • Nature of business (industry type, SIC code)
  • Copy of current plan of benefits, and any desired changes
  • Current census information, including gender, age or date of birth, and type of coverage (single, family, etc.)
  • Current carrier name (and prior carrier information, if less than three years with current carrier)
  • Premium rate history and claims history, if known
  • Details on any large claims (over $10,000), past or present, including total amounts paid, diagnosis and prognosis, by individual
  • Requested effective date
  • If currently self-funded, please provide copies of schedule of benefits page(s) from in-force stop-loss insurance contract


paperwork picture


Mail, fax or e-mail the information to:

Attn:  Curtis Donley
Donley Benefits Consulting, Inc.
4653 Statesmen Drive
Indianapolis, IN  46250

FAX:  (317) 849-3436


Questions?  Call toll-free:  (800) 382-5220


4653 Statesmen Drive, Indianapolis, IN 46250
317-849-3282 * 800-382-5220 * Fax 317-849-3436


© 2012 Donley Benefits Consulting. All Rights Reserved.