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Broker Details
Client Details
Quoting Details
Enrollment Services
Attachments
Broker First Name
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Broker Last Name
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Broker Work Email Address
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Broker Contact Phone Number
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Sold Case Notification Contacts
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When the carrier sold case notification is submitted to initiate the implementation process, please specify any additional contacts (names & emails) we should include if different than than the above.
Brokerage
NFP - South Florida
The Bailey Group - NFP
NFP Corporate Services (SE) - Marietta, GA
NFP Corporate Services (SE) - Statesboro, GA
NFP - Bethesda
NFP Corporate Services (SE) - Charlotte, NC
NFP Corporate Services PA Inc - Warrington, PA
NFP Corporate Services PA Inc - Devon, PA
NFP Corporate Services (SE) - Greenville, SC
NFP Corporate Services IL Inc
NFP Indianapolis
NFP - Cambridge Consulting Group
NFP Corporate Services MN Inc.
NFP Corporate Services OK, LLC.
NFP - WPA - Benefits Network
NFP Corporate Services TX, LLC
NFP Corporate Services (NY) - Connecticut
NFP Corporate Services (NY) - Braintree
NFP Corporate Services (NY) - Norwell
NFP Corporate Services (NY) - Linwood
NFP Corporate Services(NY) - Plainview
NFP Corporate Services (NY) - Boston
NFP Corporate Services (NY) - Binghamton
NFP Corporate Services (NY) - New York
NFP Corporate Services (NY) - Northborough
NFP Corporate Services (NY) - Albany
NFP Corporate Services (NY) - Vermont
NFP CA Insurance Services
NFP Corporate Services (CO)
NFP Corporate Services (NW)
NFP Corporate Services (UT)
Brokerage
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Request quote for
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Ancillary RFP
Enrollment Services
Ancillary RFP with Enrollment Services
Current Broker Commission
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Please note that at the end of this form, we request that you attach the following documents: an updated client census, any renewal(s), incumbent carrier materials (policy certificates and rates), and claims experience, if applicable.
