Proposal Request:

PlanGen Benefit Services

PlanGen.com

PlanGen.com 768 S. Main St PO Box 418 Bethel, VT 05032
802-234-4049 (v) 802-234-9308 (fax) PGServices

Instructions: NEXT

You will need the following information before you can submit the Request For Proposal:

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Contact Information:NEXT

*Your First Name:

*Your Last Name:

*Your Email:

*Day Phone:

**Additional Recipient Emails For The Proposal:

Comments or Instructions::

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** Separate multiple email addresses with semicolons (example: name1@abc.com;name2@xyz.com)

Case Information:NEXT

Employer Name:

Corporate Entity:

PBGC Coverage:

Addr Line 1:

Addr Line 2:

City:

State:

Zip:

Phone:

Fax:

Email:

Comment:

Questionnaire: NEXT

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Confirmation:

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Upon submittal, you will receive a confirmation e-mail with the details of your request and the contact information of the Advisor handling your request.