Request a Proposal

Please complete the form below to request a proposal from Group Dynamic

We will send you the information requested above via email within 24 hours of receiving your request. Thank you for considering Group Dynamic.

Fields marked with “*” are required.

Prospective Client Information

Name of prospective client *

Number of employees enrolled in your health plan(s) *

Please leave this field blank

Anticipated effective date *

Your Information

Name of individual requesting proposal *

Name of your organization (if different than above)

Mailing Address

City

State

Zip

Phone Number

Fax Number

Email Address *

GDI Service Proposals

Please select those services for which you would like a proposal:

Account-Based Plans

FSA

Limited Purpose FSA

Transit / Parking Accounts

HRA

HSA

Qualified Small Employer HRA

Retiree HRA

Individual Coverage HRA

Compliance Services

ERISA Wrap Documents

Non-Discrimination Testing

Premium Only Plan

Direct Billing Solutions

COBRA Administration Service

Retiree Solutions