Benefits Pricing

BENEFITS PRICING SUMMARY
Vendor/Firm Name:*
Proposal Date:*

MonthDayYear
Date
INSTRUCTIONS: Complete all sections below. Use blue text for your inputs. All amounts should be annual unless otherwise specified.
SECTION 1: DIRECT FEES (Fees paid directly by TWP to Broker)

SECTION 1: DIRECT FEES (Fees paid directly by TWP to Broker)*

Rows	Year 1	Year 2	Year 3	Fee Structure	Notes
Annual Consulting/Advisory Fee
Implementation/Setup Fee (one-time)
Open Enrollment Support Fee
Plan Design & Strategy Fee
Compliance Services Fee
Technology Platform Fee
Employee Communications Fee
Wellness Program Consulting Fee
Other Direct Fees (specify):
TOTAL DIRECT FEES

SECTION 2: COMMISSION STRUCTURE (Commissions paid by insurance carriers to Broker)

SECTION 2: COMMISSION STRUCTURE (Commissions paid by insurance carriers to Broker)*

Rows	Commission %	Commission Basis	Est. Annual $	Paid By	Notes
Medical Insurance
Dental Insurance
Vision Insurance
Life Insurance / AD&D
Short-Term Disability
Long-Term Disability
Other (specify):
TOTAL ESTIMATED ANNUAL COMMISSIONS

SECTION 3: BONUSES, OVERRIDES & PERFORMANCE INCENTIVES*

Rows	Source/Payor	Trigger/Criteria	Est. Annual $	Frequency	Notes
Production Bonuses
Volume Overrides
Performance Incentives
Carrier Contingent Commissions
Profit-Sharing Arrangements
Other (specify):
TOTAL ESTIMATED BONUSES/OVERRIDES

SECTION 4: INDIRECT COMPENSATION (All other compensation received)*

Rows	Source/Payor	Description	Est. Annual $	Value Type	Notes
Marketing/Advertising Funds
Conference/Event Sponsorships
Educational/Training Reimbursements
Technology/Software Subsidies
Vendor Referral Fees
Third-Party Administrator Fees
Other (specify):

DETAILED COMPENSATION BREAKDOWN
Use this sheet to provide detailed explanations of your compensation structure.
Direct Fee Methodology
How are direct fees calculated? (per employee, flat rate, percentage of premium, etc.)*
What services are included in each fee category?*
Are there any volume discounts or tiered pricing structures?*
What circumstances would trigger fee adjustments?*
Commission Structure Details
How are commission percentages determined?*
Do commission rates vary by plan type, carrier, or employee count?*
Are commissions based on premiums paid or enrolled lives?*
How are commissions affected by mid-year changes (enrollments, terminations)?*
Bonus and Override Arrangements
What specific performance metrics trigger bonuses?*
Who pays these bonuses (carriers, TWP, other parties)?*
How frequently are bonuses paid?*

BENEFITS PRICING SUMMARY