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210 W. Hamilton Avenue State College, PA 16801 800-211-7819 (Toll-Free) 234-1419 (Local Area) shildtfs@aol.com
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HEALTH/MEDICAL, DENTAL, AND VISION PROPOSAL REQUESTS
PLEASE PROVIDE: (1) Gender.
(2) Date Of Birth.
(3) Zip Code.
(4) Coverage Status--Single, Employee/Spouse, Employee/Child, Employee/Children, or Family.
(5) Present Carrier and benefits or desired benefits.
(6) COBRA Information: employees on Cobra with their benefits termination date.
(7) Groups with 50 or more employees--please call us as we may need additional information.
We will meet with you to help you attain this information or you can fax or e-mail it to us. We can also fax you a census form to compile the above information.
If you already have this information on your computer, or wish to compile it on your computer, you may also choose to upload it to us. Please click on our E-Mail Address in the top left corner of the page if you wish to do this.
THANK YOU!! |
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SHILDT FINANCIAL SERVICES "CHART A COURSE FOR YOUR EMPLOYEE BENEFITS INSURANCE" Health/Medical**Dental**Vision**Legal**Life Disability**Pensions & 401(k)**Long Term Care  "THANK YOU FOR CONSIDERING SHILDT FINANCIAL SERVICES WHERE WE ALWAYS STRIVE TO EXCEED YOUR EXPECTATIONS" |
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