TPA Systems Inc.
Flexible Compensation Specialists!
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Dovetail Plan HRA
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If you would like for TPA Systems to prepare a quote for flexible compensation plan administration, setup, and maintenance for your company, please provide the information below. We will respond promptly and professionally!
First Name
Last Name
Company Name
Address Line 1
Address Line 2
City
State
Zip Code
Daytime Phone
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)
-
Fax
(
)
-
E-mail Address
total number of employees
Does the employee count include all commonly controlled affilates?
quote HRA?
anticipated # HRA employee enrollees
quote FSA?
anticipated # FSA employee enrollees
quote HSA?
anticipated # HSA employee enrollees
List plans already in place (HRA, FSA, HSA)
Would any in-force plans be taken over mid-year?
Business Consultant Name
Anything else we should know?
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