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What is the Number One Business Anxiety Today?
Once again, the cost of health insurance is the top problem worrying small-business owners, according to the latest problems and priorities survey by the National Federation of Independent Business.
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Please take a few minutes to complete the information below so we can have a better understanding of your situation and your needs. Once completed a representative will call you shortly to discuss your needs in greater detail and to prepare a quote for you. We need the following information:

* Indicates Required

Name: *
Address: *
City: *
State: *Zip *
Phone:

Day Time Phone:
*

Fax: Fax:
Email: Email Address:
*
  Which service or services would you like us to prepare a quote for you:
(check all that apply to your needs)
Payroll
PEO (Employee Leasing)
Health Insurance
Associations
Business Services
  Are you currently using a PEO? Yes    No
 

How are you handling your current payroll?

 

What type of business?


  How many years have you been in business?
Startup?
  Number Of Employees?
  Do You have an annual payroll? Yes    No
  When would you like to start receiving PEO Services?
  What is your worker's compensation mod rate?
  Are loss runs available? Yes    No
 

What additional employee benefits (if any) would you like to provide through the PEO? **

Group Medical
Dental
Vision
Short Term Disability
Long Term Disability
401K
Flex Spending Account
Other:

  Comments:
 

**Note: An employee census will be required for employee benefit quotes.

Contact us directly at (770) 919-0462 for more information.
Or e-mail us at
info@yourhrsolution.com

 



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