What brings you here today?
Choose the option that fits and we'll show you the right questions. Every submission goes straight to our operations team.
Share an Update
Tell us who you are, choose what's changed, and add the details. Your account team will be notified so we can keep everything current.
Select all that apply, then add details below — or just fill in the operational details further down.
Fill in only what's changed — leave the rest blank.
Rate sheets, agreements, ID cards, or anything supporting your update.
Click to upload or drag and drop
PDF, DOC, DOCX, XLS, XLSX, PNG, JPG · Up to 20 files, 50 MB each
Have more documents or files larger than 50 MB? Email them to david.dodd@southernbenefitsystems.com.
Company & Primary Contact
Thank you for your interest in partnering with Southern Benefit Systems. Please complete this intake form in full so our operations team can properly evaluate your products and services. All submissions are reviewed by our VP of Operations before any further conversation takes place.
Select all that apply.
What do you offer and why is it a fit for employer group benefits? 2–4 sentences.
What do you do differently to mitigate claims and be a true long-term partner?
Size, SIC code, and demographic make-up. What is an immediate DTQ (disqualifier) for you?
What can we present in an RFP that will set us apart and drive different rates for us than our competitors?
Licensing & Compliance
SBS operates across multiple states and is committed to full regulatory compliance. Please answer each question accurately. Our team verifies all licensing and appointment details before any group is quoted.
Timeline, required documents, E&O requirements, NIPR vs. direct, etc.
Implementation & Underwriting
Our account management team handles all implementation and renewals. We need to understand exactly what they will experience before any group goes live with your product.
From signed enrollment to ID cards / effective date. Be specific.
What data is required? Who underwrites? How long from census submission to preliminary rates?
What percentage change in enrolled lives is permitted before rates are re-underwritten? This must be stated clearly.
At what stage are rates considered firm? What triggers a re-rate after preliminary rates are issued?
Support & Technology
Day-to-day responsiveness and technology capabilities are critical factors in our evaluation. Please be specific about what brokers and employers actually experience — not just what is available in theory.
When something goes wrong during implementation, who do we call and how fast do we get resolution?
Broker References
SBS speaks directly with broker references before placing any group with a new carrier. Please provide two broker contacts — not clients — who have implemented your product within the last 12 months and can speak to the real-world experience.
Reference #1
Reference #2
If you have written broker references or testimonials, you may upload them here.
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PDF, DOC, DOCX, PNG, JPG
Boilerplate Documents
Please upload any available boilerplate documents below. Our team reviews all materials before scheduling a follow-up conversation. The more complete your submission, the faster we can move through evaluation.
Upload any of the above documents. You may select multiple files at once.
Click to upload or drag and drop
PDF, DOC, DOCX, XLS, XLSX, PNG, JPG · Up to 20 files, 50 MB each
Have more documents or files larger than 50 MB? Email them to david.dodd@southernbenefitsystems.com and we'll add them to your submission.
List any documents you are unable to provide today and when you expect them to be available.
Submission Received
Thank you. Your submission has been received by our operations team and will be reviewed within 3–5 business days.
If we have follow-up questions or would like to schedule a call, a member of our team will reach out to the contact information you provided.
Southern Benefit Systems · Member of Choice Financial Group
southernbenefitsystems.com