Quoting in the Mid/Large Market
When submitting a group for quote in the mid/large market (greater than 50 Average Total Number of Employees), please use the appropriate Rate Request Form below:
BNGA Rate Request Form Q2 2024
In addition to the completed rate request form, please submit:
- An Employee Count Form (Based on the average total number employees from the previous calendar year)
- Census
- Past, current, and renewal rates
- Specific plan design summaries
- Claims experience (for groups with 100 or more or who are self-insured)
- HRA funding arrangement if applicable
Please use this link to send Group rate requests securely.
Links to helpful sites:
OSHA (SIC Look Up)
Zip Express (County/Zip Code Reference)
