Company name (required)

Number of Employees in your company
1-5 Employees6-10 Employees11-50 Employees51-100 Employees100+ Employees

First Name (required)

Last Name (required)

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Are you aware of the Department of Labor's ERISA requirements for your business?
YesNo

Have you ever had an advisor mention to you that your benefit plans need to be ERISA compliant?
YesNo

Are you aware of the penalties that the DOL can impose for non-compliance?
YesNo

Are you aware that all employer offered benefit plans can be subject to ERISA?
YesNo

Are you aware that it is the responsibility of the employer to be ERISA compliant?
YesNo

Are you aware that the DOL can start an audit without cause or action?
YesNo

Are you aware that a simple employee request can spark a DOL ERISA investigation?
YesNo

Are you aware that the insurance carrier SPD are not ERISA compliant?
YesNo

Do you know what an SPD or SMM document is?
YesNo

Would you like us to contact you to learn more about ERISA Compliancy and your obligations?
YesNo