Luminescent Benefits - Hassle Free Proposal Request
Manage the entire process on your terms
What kind of quote(s) are you looking for?
PEO (Professional Employer Organization)
Company Health Insurance
Key Man, Individual Life Insurance, D&O, Etc
401(k) and Retirement Plans
Other
If "Other," please specify:
Company Name:
Tax ID:
*Optional. Tax ID will be needed prior to on-boarding.
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Headquarter Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What does your business do? Industry and Description:
How many Full-Time Employees do you have?
How many Part-Time Employees do you have?
How many Employees do you anticipate adding in the next 6-12 months?
What is your average Annual Payroll?
What is your current Payroll Cycle?
Weekly
Bi-Weekly
Semi-Monthly
Monthly
N/A - We haven't run Payroll yet
Does your business have any K1 members?
Yes
No
Do you have any 1099 workers?
Yes
No
Do you have employees in foreign countries?
Yes
No
If "Yes", please list the foreign countries:
Are you currently offering Medical Coverage?
Yes
No
If "Yes," which provider(s) and when are the renewal date(s)?
Are you currently offering a Retirement Plan?
Yes
No
If "Yes," which provider(s)?
If "No," Are you interested in offering a Retirement Plan?
Yes
No
Are you currently use a PEO?
Yes
No
If "Yes", which PEO?
Are you open to evaluating Non-PEO options? i.e. solo vendors for Health Insurance, HR software, 401k.
Yes
No
Please select the areas where you would like to see improvement:
Payroll
Medical
Workers' Compensation
Human Resources
Dental, Vision, Disability, etc.
HR Software
Applicant Tracking
401k
What’s the Most Important criteria when making this decision? i.e. cost, level of service, tech platform, etc. Feel free to open up.
When are you looking to make a switch?
How many PEO’s would you like for us to evaluate? We can do up to five.
1-2
3-4
5
0 - We're interested in other options
Are there any providers that you would like for us to consider? Please list.
Are there any providers that you would NOT like for us to consider? Please list.
How would you like to work with us during the 'Quote Gathering Process?' (Often times, vendors will require additional information. There will be back and forth.)
Email Only
Call Only
Email and Call
How would you like to work with us during the 'Evaluation Process?'
Quotes Only: We will do our own independent research and work directly with the vendors
Quotes + Luminescent Analysis: We would like your side-by-side analysis and comparisons to compliment our research
Full Support: In addition to the analysis, we'd like to have a Luminescent team member by our side to consult with, discuss the proposals, and to join in on demo's and other correspondence with the vendors
Submitted By:
First Name
Last Name
Job Title:
Email:
example@example.com
How did you hear about us?
Signature:
Submit
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