Mid-Size Group: Submit for Proposal

75-500 employees on the plan

Currently fully insured or self-funded

Securely submit to submission@myh2b.com

• Group Name / Address / SIC Code
• Effective Date
• Member level census with first and last names, gender, date of birth, full address, relationship (E, S, D), enrollment status, tier (E, ES, EC, FAM). Phone number/full address appreciated but optional.
• Current Renewal
• Annual renewal premium
• Claims data to finalize rates (if currently self-funded)