Quote Form..
Company Information:
Company *
Enter the LEGAL NAME of your company.
Mailing Address *
Website URL
Your Plan Administrator:
List the contact information for the person that will be responsible for gathering employee information and handling the administration of your plan once it is in place. This may be the owner in a smaller company and is often an administrative person in larger companies. It would be ideal for the person filling out this form to be that person.
First Name *
Last Name *
Email *
Ensure that this is a valid email that is checked frequently. Create a rule that allows all email from abundancecanada.ca to be accepted by this email.
Phone *
- Enter the phone number that your Plan Administrator can be reached at to answer questions.
Employee Information:
Q1 - Number of full time employees one year ago? *
Q2 - Number of full time employees now? *
Q3 - Number of employees related to the owner(s)? *
Q4 - Are any employees involved in hazardous occupations? *
- if YES add details in the next box.
Q4 Notes
Q5 - Are any employees not actively at work? *
- If YES, please provide details in the next box. Include items such as date of disability, nature of disability, prognosis, if Life Waiver was approved.
Q5 Notes
Q6 - Are any employees not covered by WCB? *
- if YES list the employees not covered in the next box.
Q6 Notes
Submit: What Will Happen Next?
This form will generate a customized spreadsheet that will allow you to enter the additional employee data that is needed to request a quote.

After pressing the Submit button you will receive an email with a link to this spreadsheet. However, it takes a bit of time for us to flip the switch on the document to give you access.

So, please WAIT until we get that done for you. If you are submitting this outside our office hours we will do that when we open the next business day.
Submit
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This form was created inside of Abundance Employee Benefits.