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You can use the form below to submit a request for information, or you can contact us at the address and phone numbers at the bottom.
Employer Name:
Contact Person:
Address:
City:
State:
Zip:
Phone Number:
Email:
Number of Employees:
Renewal Date for Benefits:
Current Number of Paticipating Employees:
Type of Benefits You Are Looking For:
Section 125 Plan - Premium Only
Section 125 Plan - Medical and Dependent Care Spending Accounts
Section 125 Plan - Cafeteria Plan
Group Sponsored Insurance
Customized PPO Network
Administrative Solutions, Inc.
806 Commerce Drive, Suite 2
P.O. Box 410
Decorah, IA 52101
(319) 387-0789 or 877-461-1424
richjay@rconnect.com
