Request for Proposal Checklist

If Currently with an Outsourced Provider:

Applicable questionnaires, completed and signed: Benefits, EPLI, WC 

2020 Unemployment Tax Rate and/or Q4 2019 Quarterly Return

Workers Compensation 

    • Copy of Declaration Page, with class codes & rates
    • Loss History Report, for years 2016 thru 2019
    • Premium Due Report- including hours, class codes and payroll per employee

Employment Practices Liability Declaration Page, if available

Most recent pay period’s 

    • Payroll Register/Journal – gross to net breakdown, per employee
    • Service Fee invoice

If currently offering employee benefits:

Most Recent Carrier Invoice(s)

Summary of Benefits – each plan offered

Employee Census – template attached

Copy of carrier Renewal Notice with Rates by tier (if within 60 days of renewal)

Please upload documents or email to

Cohen & Company
Attn: Outsourcing Division
(954) 302 – 3550, option 1
Mon-Fri, 9a -5p EST

Outsourcing upload docs
File Upload
Maximum upload size: 52.43MB