BCI Benefit Proposal Request Form
The Benefit Proposal Request Form is an Adobe
Acrobat "PDF" file. You will need Adobe
Acrobat Reader to read the file. If your computer does
not have it, you can get download it for free by clicking on the
image below:
To Print and/or Save The Form:
To print the file only,
click on the link below. After the form opens, use the print
icon on the Abode Acrobat menu, not the internet browser menu.
To save the file,
either:
- Click on the link below to open the file in
your internet browser. On your internet browser (Internet
Explorer), go to the File Menu option, and select "Save As" to
place the PDF document in a computer folder of your choice.
DO NOT SIMPLY PRESS "SAVE". On most computers, pressing SAVE
will not save this kind of file correctly. (It saves it to a temp
file that is difficult for the average person to find.)
- Right click on the link below and choose "Save
Target As". A Dialog Box will appear and give you a chance
to select the folder where you wish to save the file. There
will be a brief moment for the actual download.
BCI Benefit Proposal Request
Form
Submitting the Form:
You can submit the form using the method most
convenient to you.
- Print form and complete by hand. Mail or
fax to your local Benefit Choices, Inc. office.
If your computer has Acrobat Reader 5.0 or
above, you can fill in all fields in your downloaded form.
Then you can:
- Save completed file and email it to your local
office
- Print completed file and mail or fax to your
local office.
Contact information for our two locations are below.
BCI - Hunt Valley (Main Office)
BCI - Hagerstown Region
If you prefer, you can fax or mail a copy of your
employee census in the form of your current insurance bill or your
last Maryland Quarterly Unemployment Tax statement (make adjustments
for changes in employee census since last statement.)
An accurate census is crucial to giving an
accurate quote.
