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[ Individual Quotes ] [ Census Update ] [ Group Quotes ]
If
you have Microsoft Word, and would like
to type in the information, please use
the Word Version. Otherwise, please
print the PDF, fill it out by hand and
fax or mail it back to us.
Master
Census
(Please use this one only for new group
submit, or if requested by a B.S.G.
employee. Otherwise, please use one of
the census updates below.)
Medical,
Dental & Vision Census
Medical & Rx
(Only use this if
your Med. & Rx are provided by different
carriers & no other coverage's are being
quoted. Otherwise, please use the
Medical, Dental & Vision Census.)
Dental & Vision
Census
Life, STD & LTD Census
Voluntary Benefits
Pension Census
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Census Update