To receive a quote from Lifestyle Health Plans:
PRELIMINARY RATES PROPOSAL
- Company Profile Form
- Lifestyle Group Census with participant tiers (EE, ES, EC, Family)
- Copy of Current Plan Design
- Copy of Current Carrier Invoice / Rates
FIRM RATES PROPOSAL
Under 100 Employees:
- Company Profile Form
- Lifestyle Group Census with participant tiers (EE, ES, EC, Family)
- Copy of Current Plan Design
- Copy of Current Carrier Invoice / Rates
- Completed Employee Health Applications
Groups 100 Employees * or More:
- Company Profile Form
- Lifestyle Group Census with participant tiers (EE, ES, EC, Family)
- Copy of Current Plan Design
- Copy of Current Carrier Invoice / Rates
- Employer Disclosure Statement
- 2 Year Detailed Claims History
- Large Claims Report
* For groups 100 Employees or more, Employee Health Applications are not required if detailed claims history is available.
Send all completed data to your Lifestyle Health Plans sales representative or e-mail to our quoting queue at: quotes@medova.com.