Level Funded Medical

Level Funded Request Forms

Large Group/Level Funded Request for Quote form (Excel)

1. Download and save the Large Group/Level Funded RFQ Excel file.
2. Enter the information required in the three tabs.
3. Save the final version of the Excel file.
4. Email the Excel file to your Large Group Analyst or Sales Consultant. Be sure to attach your completed form to the email before sending.

At your convenience, you may also complete this template via our user-friendly Online RFP tool. You can access this tool via your Broker Dashboard and click on the Large Group/Level Funded Request for Proposal tile. Through this tool, you may also upload files using our secure upload feature. Documents to upload: invoices, renewals, benefit summaries, census data and any other important items you wish to include.

Large Group/Level Funded Request for Proposal (Online)

1. Go to the Broker Dashboard and click on the Large Group/Level Funded Request for Proposal tile.
2. Click on Start New RFP and verify your information.
3. Enter the information required in each section.
4. Click on the Save and Complete button to submit the RFP to the Large Group Team.
5. Your dedicated Large Group Analyst will reach out with any questions.

Level Funded Request Forms

Large Group / Level Funded Request for Quote form (Excel)

1. Download and save the Large Group / Level Funded RFQ Excel file.
2. Enter the information required in the two tabs.
3. Save the Excel file.
4. Click here to email the Excel file to our Level Funded specialists.
5. Be sure to attach your completed form to the email before sending.

Level Funded Quoting Checklist (PDF)

Level Funded Carrier Matrix (PDF)

Should you have any questions or need more assistance, please contact our Level Funded Specialists:

Phone: (800) 801-2300
Email: COLargeGroup@warnerpacific.com

Team Sheet

Team Sheet (PDF)
 

Large Group Request Forms

Large Group / Level Funded Request for Quote form (Excel)

1. Download and save the Large Group / Level Funded RFQ Excel file.
2. Enter the information required in the two tabs.
3. Save the Excel file.
4. Click here to email the Excel file to our Level Funded specialists.
5. Be sure to attach your completed form to the email before sending.

Level Funded Quoting Checklist (PDF)

Level Funded Carrier Matrix (PDF)

Should you have any questions or need more assistance, please contact our Level Funded Specialists:

Phone: (800) 801-2300
Email: TXAlternateFunding@warnerpacific.com