SPECIALTY BENEFITS

K. B. (Ken) Wheeler

Independent Associate-Benefits Consultant

BENEFIT INFORMATION REQUEST FORM

EMPLOYER PRODUCTS, SERVICES AND BENEFITS FOR EMPLOYEES & INDIVIDUALS

Please take a few minutes to complete the following information. 

Your feedback will help ensure that the information you receive is tailored to your unique needs.

 

                                                               For a Group or Individual Quote or More Information Please Complete

 I would like information concerning: My company's number of employees:
Benefit Plan Review and Analysis 2-10
NEW Iowa Long Term Care Medicaid Asset Protection Plan 11-25
NEW College Savings Plans (529) 26-50
(STD) Short Term Disability Plans 51-75
(LTD) Long Term Disability Plans 76-100
NEW (LTC) Long Term Care-Income Plans-Catastrophic Disability 101-300
Life-Dental-Vision Plans Over 300
401k, 403b and Other Retirement Plans Over 1,000
Financial Advisor Assistance for Retirement Plan Employees Myself and/or My Spouse are the Only Employees
NEW 401k Individual Plans (for Employers with only owner employees or with employees with LESS than 1,000 annual hours)  My time table is:
Retirement Plan Rollovers Immediate or as soon as possible
Estate Planning-Trusts-Wills-Living Wills-Financial Power of Atty. The next year
A Financial Plan and/or Tax Savings and Estate Planning for Retiring Business Owners The next two years
Traditional IRA to Roth IRA Conversion or Retirement Plan Rollover Other
NEW National Funeral Plans Special Information:
View a Composite of My Portfolio & Accounts on Request (PEO) Professional Employer Organizations
Legal Service Plans by Pre-Paid Legal Services, Inc.  Other
Speaker Information for an Organization meeting
How can we improve this web site for you? Comments: Enter Below
Name:
Company:
Address:
City: State/Prov.
Phone: Zip/Post Code:
Fax:
E-Mail:
Birth Date  *(If Applicable)
Male-Female *(If Applicable)
Use Tobacco  *(If Applicable) Past Five Years
Prescriptions? *(If Applicable)
Hospitalized? *(If Applicable) Past Five Years
Asset $ *(If Applicable) $ Estimate of Iowa Medicaid Protection Desired per Individual Only

I am licensed, certified or practice as a:

 Human Resources Officer 
CEO or Company Officer 
Business Consultant
CPA/Banker/Attorney/Estate 
or Financial Planner/Financial
Advisor/Insurance Agent/Stockbroker
Other  
*Applicable Only For Individual Quote Request Employer/HR: Please Fax or E-mail Group Census to 515.986.4148

 

 TRANSACTIONS  SUBJECT TO THE  U.S.A. PATRIOT ACT

 

 SPECIALTY BENEFITS

K. B. (Ken) Wheeler 

310 North Ewing Street

Grimes (Des Moines), Iowa 50111-3002

E-mail 

Voice Phone-National: 800.333.0801 Local: 515.986.9266

You may Fax your questions/information to 515.986.4148

 

February 19, 2005
FEC Web Consultants

R. Hutcheson

M. Rahmanovic

Copyright 2000 - 2005 Kenneth Wheeler-Specialty Benefits.  All rights reserved

 

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