WIMPERbenefits.com
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WIMPER Program = Employer FICA tax Savings + Employee Benefits through the Affordable Care Act at No Net Cost
Companies Receive an Avg. $500/Employee/Year in FICA Savings. Employees Receive Unlimited Preventative Medical/Health Care & Whole-Life Insurance with Cash Value.
Your Pre-Qualification Form
The below information will only be used to evaluate your potential FICA tax savings and employee benefits through the WIMPER Benefits program, and is not an engagement for services. There are no up-front costs for this program, and you are not obligated to enroll. So, there is zero financial risk. If you should decide to enroll, the cost of the program is funded through your FICA tax savings -- making it a no net cost opportunity. We also have no long-term contracts. Your security and privacy are our top priorities. We safeguard your information using state-of-the-art servers, data encryption, and robust protection measures for both storage and transmission. Rest assured, we will never sell your data. Your confidentiality is our commitment, and you can trust us to uphold the highest level of security throughout all your interactions with our services. Beyond security, we are dedicated to delivering exceptional service and ensuring a personalized experience at every stage. Your satisfaction is our goal, and we're here to provide you with a world-class experience. Visit us at WIMPERbenefits.com or email us at Info@WIMPERbenefits.com, and we are happy to answer any of your questions.
Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Legal Business Name
*
Date of Incorporation
Employer Entity Type:
*
C Corp
S Corp (Taxed as S Corp-passthru, partnership, or sole proprietor)
S Corp (Taxed as C Corp)
LLC (Taxed as S Corp-passthru, partnership, or sole proprietor)
LLC (Taxed as C Corp)
LLP
Partnership
Sole Proprietorship
Not-For-Profit
Government Agency
Church or Religious Affiliate
Other
Employer's State of Organization
*
Contact Person (If Different)
Employer Fiscal Year End
*
Calendar Year
Other
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business EIN / Tax ID#
*
How many W2 employees do you currently have?
*
How often are your employees paid?
*
12 - Monthly
24 - Semi-Monthly
26 - Bi-Weekly
52 - Weekly
Do you currently have a section 125 cafeteria plan implemented in your company?
*
Yes
No
Do you have any affiliated companies that you own?
*
Yes
No
Please describe your trade or business.
Do you use a third-party payroll processor?
*
Yes
No
Who is your Payroll Provider?
*
What's the percentage of employee turnover per year?
Do you pay a portion of your employees health benefits?
*
Yes
No
Who are all the owners of the company (please list names and percentages of ownership)?
*
Owner Name
Percentage
Owner #1
Owner #2
Owner #3
Owner #4
Owner #5
Owner #6
Owner #7
Owner #8
Do you offer your employees major medical coverage?
*
Yes
No
Please provide Company Officers Names and Titles.
*
Officer Name
Title
Officer #1
Officer #2
Officer #3
Officer #4
Officer #5
Officer #6
Officer #7
Officer #8
Please provide the benefits sponsored by the Employer. (Select ALL that apply)
Wellness
Medical
Dental
Vision
Cancer
Critical Illness
Hospital Indemnity
Life
Accident
Short-Term Disability
Long-Term Disability
I.R.C. Code Section 125 Plan
Flexible Spending Account
Dependent Care
HRA
HSA
Other
Do you have any of the following Employees?
Union
Part-Time
Other
What is the best way(s) to contact you?
*
Phone
Email
Text Message
Submit
FLORIDA DEPARTMENT OF FINANCIAL SERVICES Resident Insurance - LIFE INCL VAR ANNUITY & HEALTH License Number : G061576
CONTACT US AT INFO@WIMPERBENEFITS.COM WIMPERBENEFITS.COM ©2024
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