Request a Proposal

Please fill out the form below to request a proposal from BASIC to serve your HR needs. Once submitted, you will be contacted by a consultant with suggestions to help you save money, manage risk and improve your services. If you need a proposal for your client please use the form at this link.

Your Information

First Name: *
Last Name: *
Company Name: *
Primary Address Street:
Primary Address City:
Primary Address State: *
Zip code: *
Phone Number: *
Email Address: *
Number of employees: *
Total number of employees on health plans:

BASIC Services

Below are BASIC's Full Circle Service offering, select each service you would like a proposed. Please review each section to maximize your savings and efficiency.

Hold down the shift key to select more than one service.

HR Services:
HR Management:
HR Benefits:
How did you hear about BASIC's services?: *
Insurance Agent's Name:
Comments:

If you are requesting this proposal on behalf of you client please complete the information below.

Company Name: /span>
Company Contact:
Company Contact Email Address:

By providing your contact information, including email, you may receive promotional emails from BASIC regarding products and services, webinars, important legal and industry updates, and other pertinent information. You may at any time opt out of receiving future mailings by using the unsubscribe link provided on those mailings.

All information and material provided in our proposal are subject to copyrights owned by BASIC. Any reproduction, retransmission, republication, or other use of all or part of any document found on this site is expressly prohibited, unless prior written permission has been granted by BASIC copyright owner. All other rights reserved.