Name

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* 1. Name

Company

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* 2. Company

Email Address

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* 3. Email Address

Phone Number

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* 4. Phone Number

Are you satisfied with the services provided by your benefits broker?

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* 5. Are you satisfied with the services provided by your benefits broker?

Does your broker provide on-line enrollment, compliance audits and HR support at no cost?

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* 6. Does your broker provide on-line enrollment, compliance audits and HR support at no cost?

Has your broker discussed a Level Funding cost containment strategy with you?

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* 7. Has your broker discussed a Level Funding cost containment strategy with you?

Does your broker provide a concierge service platform for your employees?

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* 8. Does your broker provide a concierge service platform for your employees?

Are you provided with an annual service calendar by your broker?

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* 9. Are you provided with an annual service calendar by your broker?

Can we have a GCD representative schedule a meeting or call with you?

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* 10. Can we have a GCD representative schedule a meeting or call with you?

Guess how much money is in the bowl!

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* 11. Guess how much money is in the bowl!

T