Compensation Solutions
human resource outsourcing (hro)
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Company Details

Company Name
Type of Business
Address
Contact Person
Title
Phone
Fax
Federal ID#
Years in Business
E-Mail Address
Website
# Full Time Employees
# Part Time Employees
Any Worksite Locations outside of NY, NJ, CT or PA
If Yes, what states are you located in? How many employees do you have in each of those states? 
 

Payroll Details

Payroll Company
Payroll Costs
Gross Payroll Per Period
or Annually
Pay Period:
Amount of Gross Payroll that is Guaranteed Bonus Payments
Amount of Gross Payroll that is Non-Guaranteed Bonus Payments
401 (k) Vendor
Approx. $ Assets
Current PEO
Current PEO Fee
 

Health Information

Do you currently provide health benefits to your employees?
Health Carrier
Health Renewal Date
Number of Employees (Full-Time) on Health
Do you sponsor all/part of employee's costs?
Employer contribution %:
Employer contribution $:
 

Monthly Health Rates

Single
Husband/Wife
Parent/Child
Family
 

Does your company currently offer:

Section 125 'Pre-tax' Cafeteria Plan?
Dental Insurance?
Vision?
Employee Assistance Program?
Flex-Spending & Dependent Care Plan?
Group Long-Term Disability (LTD)
Group Life?
Group Life Amount
 

SUI-DIS-WC

Current State Unemployment Tax Rate (SUI)
Number of unemployment claims in the past 12 months
Workers Compensation Carrier
Premium
MOD
Limits
Num of Claims (Past 3 Years)
 

Misc. Sales Info

Estimated costs of personnel administration as a percent of gross wages?
How did you hear about Compensation Solutions?
Referral Contact
Network Event
Mailer
Internet
Other

 

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