.
 
 
  Your Health Benefits
403(b)/401(k) Balance
Manage Subscriptions
Secure Message Center



 
  Home > Employee Health & Welfare Benefits > Employee Benefit Trust > Request A Quote
   
 

Eligibility

   
 
EBT Request for Proposal pdf

Request for Proposal
Please complete the Request for Proposal form as well as attach available supplemental documents outlined in the Request for Proposal Instructions section of the form.

Excel file



EBT Census Info pdf
Pdf file

 



Census
To provide coverage, we will need a complete census of all eligible employees. Census must include date of birth (or age), gender, occupation, salary/wage, and type of current coverage (single, spouse, child(ren), family, or waived). If part-time or non-eligible employees are included, please indicate them as such. Individual identifiable information is not necessary.

If possible please submit the information electronically in any format it can easily be extracted. If census information is not available electronically, you may use the pdf form to the left of this text.


Get Adobe ReaderTo view these pdf's in your browser, you may need to download and install
Adobe Reader. Adobe Reader is a free download.


If you would like to receive a quotation to join the Employee Benefit Trust and obtain coverage, please print, complete, and submit the request for proposal forms to:

Christian Brothers Employee Benefit Services
Attn: Underwriting Department

1205 Windham Parkway
Romeoville, IL 60446
Fax: 630.226.2186

If you would like to speak with a representative or need assistance in completing these forms, please contact any of the following:

John Airola
Managing Director
1205 Windham Parkway
Romeoville , IL 60446.1694
Phone: 800.807.0100 Ext. 2450
Fax: 630.226.2169
John_Airola@cbservices.org

Jim Adam
Senior Benefit Consultant (Western US)
Phone 800.807.0100 Ext. 3011
Fax 630.679.5118
Jim_Adam@cbservices.org

Susanne Anderson
Senior Benefit Consultant (Central US)
Phone 800.807.0100 Ext. 3043
Fax 630.679.5159
Susanne_Anderson@cbservices.org

Kristine Walker
Senior Benefit Consultant (Eastern US)
Phone 800.807.0100 Ext. 3044
Fax: 630.679.5142
Kristine_Walker@cbservices.org

 


© Copyright 2005 - Christian Brothers Services - All Rights Reserved
Web development, design, and hosting by Christian Brothers Service
s