EMPLOYER WORKSITE PROFILE FORM
Filling out the Form

"Employer Information" Section
Step 1	Complete the "Employer Information Section." Please answer all questions. Also please provide the requested information in the sections entitled "Current Payroll Frequency" and "Key Company Personnel," where shown.
"Employer-Paid Plans" Section
Step 2	To request a comparative quote for a specific product, please place a check mark in the appropriate block on the Employer Profile form, next to the product(s) for which you wish to request a quote. IMPORTANT: In order to quote certain products, it may be necessary to provide additional information about your organization, and/or your existing coverage. Once we receive the profile and determine the specific products in which you are interested, we will provide an exact list of additional information that may be needed to obtain your customized quote. Please note: If this product-specific information is not provided, it will not be possible to provide a quote.
"Voluntary Plans" Section
Step 3	Similarly to what you did in the Employer Paid Section, please place a check mark by any voluntary product for which you would like to obtain a quote. Remember, these products are employer-sponsored, but 100% employee-paid. This is a great opportunity for your employees to obtain quality products at a reduced rate. IMPORTANT: Just as with the group plans, if you have any existing voluntary plans in place, it is important to identify who the current carrier is.
Step 4	Please provide a complete employee census. You may utilize the enclosed form, or provide a printout in your own format, so long as all the requested information is provided. (See the "Census Information" section for an itemized listing.)
Step 5	Please return all information to the NCCED at 1030 15th Street, N.W., Suite 325, Washington, DC 20005 or via fax (202) 289-9031. (Attn: Susan Shorters). For your convenience (and to obtain priority processing), you may request to receive both forms in an Excel document format via email at: sshorters@ncced.org. The forms can then be downloaded, completed electronically, and returned via email. This will ensure the quickest turnaround.
After receipt and processing of your request, you will be contacted by an NCCED Service Representative, confirming receipt of your package and verifying the coverages for which you have requested quotes. A customized proposal will then be created for your review.