Small Group Quote Request

Emily Batten

contact@sawtoothinsurance.com

208-841-1727
Small Group Quote Request
Company Details
Business Name*
Type of business*

LLCS-CorpC-CorpSole ProprietorshipPartnershipOther
Federal Employer Identification Number (EIN)*
Physical Address of Business*

Street Address

CityState

Zip Code
Primary Contact Name*

First NameLast Name
Title*
Primary Contact Phone Number*
Primary Contact Email*
Business Phone Number
Business E-mail
Have you applied for SHOP (Small Business Health Options Program) through Your Health Idaho?*

NoYesYes, but have not received approval
If you have received your SHOP approval letter or email, please upload a copy here

Cancelof
If you have not applied for SHOP, click the link below and follow the instructions to apply

https://www.yourhealthidaho.org/small-business-tax-credit/

Once you've received your approval letter or email, send it to contact@sawtoothinsurance.com
Employee Details
# of full time employees*
Who will you be offering coverage to?*

EmployeesSpousesDependents
Do you have full time employees outside of Idaho?*

YesNo
Employee Census
Enter full-time employee information and indiciate whether they will be adding a spouse or dependents.

If you have more than 15 employees to report, please click the following link:

Download and fill out the employee census

Enter employee first name and list each related spouse and/or dependent

The information submitted in this form is used to generate quotes. To enroll in a plan, you will need to supply additional documentation. While your quote is being compiled, please obtain the following documentation:
- Most recent Quarterly Unemployment Insurance Wage and Tax report from each state where your employees work
  - State Unemployment Tax Authority (SUTA) in Idaho
  - If unavailable, two weeks payroll OR W-4
Should be Empty:

Company Details