Communication & Enrollment
Solutions for the Workplace

Client Information
Total number of employees
Number of employees paying Health Prem.
Average/approximate Premium Amount
Number of employees paying Dental Prem.
Average/approximate Premium Amount
Number of employees paying Vision Prem.
Average/approximate Premium Amount
Workers Comp. Factor

Premium Only Plan Savings
Insurance Type	Employee Paid Premium	Number of Employees	Total Monthly Premium	Payroll Taxes Saved
Medical Insurance
Dental
Vision
Cancer
Disability Accident
Critical Care
Heart and Stroke
Hospital Indemnity
$50,000 Term Life Insurance
Monthly Payroll Tax Savings
Annual Payroll Tax Savings
Monthly Workers Comp. Premium Savings
Annual Workers Comp. Premium Savings
Annual Payroll Tax & W. C. Premium Savings