Benefits Compliance Consultants Group Works Hard For Your Business Thank you for your interest in Benefits Compliance Consultants Inc. services. Get A Quote For Service! Fill out the form below for your quote. Your Email: (required) 1. Plan Sponsor Full Name: 2. Plan Sponsor EIN # (Federal Tax ID #) 3. Affiliated Companies and EIN #’s: (if applicable) _______________________________________________________________________________ 4. Plan Year Period: 5. Check The Benefits Offered: HealthLifeLTDSTDADDDentalVision Other Benefits: 6. Approximate # Of Employees Covered: 7. Do you have a Plan Document? YESNO 8. Is your Plan Document ERISA compliant? YESNODont' Know 9. Do you have a Summary Plan Description (SPD)? YESNO 10. Is your SPD ERISA compliant? YESNODon't Know 11. If “Yes” to #9, have you distributed this to each participant? YESNO 12. Have you ever amended your Plan Document or SPD? YESNO 13. If “Yes” to #12, did you distribute a Summary of Material Modification (SMM)? YESNO 14. Have you filed a Form 5500 in the past? YESNO 15. If “Yes” to #14, did you distribute a Summary of Annual Report? (SAR)? YESNO 16. Are you now, or have you ever been subject to a DOL audit? YESNO Leave a brief message with your quote request.