Ready for a quote? Let us help you get started. Simply download our 2-25 Small Group RFP template and fill in the required fields. Then email to SmallGroup@LifeMapCo.com. Include the group name in the subject line and make sure to attach any information regarding current coverage (if applicable) including benefit summaries and current coverage elections.

2-25 Small Group RFP Census Template

The following LifeMap products are available to your Small Group clients:

• Basic Life with Accidental Death and Dismemberment (AD&D)
• Voluntary Life with AD&D
• Short Term Disability (STD) (not available in Washington)
• Long Term Disability (LTD)
• Dental (for Oregon, Idaho, and Utah)
  • 2-9 Employees
  • 10-25 Employees
• Dental (for Washington only)
  • 2-9 Employees
  • 10-25 Employees (Active PPO Plans)
  • 10-25 Employees (Passive PPO Plans)
• Vision
• LifeMap Protect Plans **
  ** A bundled offering that includes Basic Life/AD&D, Critical Illness, Accident and EAP.

Know which plans you'd like quoted for your group client? Review our RFP Requirements above and submit a request to SmallGroup@LifeMapCo.com today! Once a plan design has been chosen, you can build a benefit summary on the Ongoing Services page.

Congrats! You’ve received a proposal for your 2-25 group client and now you would like to move forward with coverage from LifeMap. You can start the implementation process right away by providing the following completed documents in a secure email to our team at SmallGroup@LifeMapCo.com:

If you are interested in our LifeMap Protect product (for groups of 2-50 employees), please reach out to SmallGroup@LifeMapCo.com to request the implementation paperwork.

Small Group Implementation Forms:

• Group Master Application (2-9 Employees)
• Group Master Application (10-25 Employees)
• Group Insurance Implementation Worksheet (2-25 Employees)
• LifeMap Enrollment Census Template
• Evidence of Insurability (EOI) and Authorization Form NOTE: Only needed for Voluntary Life coverages
• Beneficiary Designation Form NOTE: The completed Beneficiary Designation form is only required for Basic and Voluntary Life/AD&D coverage and must be retained by the group (policyholder) and the member for their own records. Do not send to LifeMap, except for claim purposes.
• Voluntary Life/AD&D Enrollment Form (2-9 Employees)
• Voluntary Life/AD&D Enrollment Form (10-25 Employees)
• Dental & Vision Enrollment Form
• Dental & Vision Waiver Form

You can then visit the Ongoing Services page for benefit summary templates and other helpful forms and information.

Renewals for 2-9 employees and Voluntary Life/AD&D for 2-25 employees

For Life/Disability coverages with LifeMap, there is no annual renewal for those lines of coverage for groups under 9 employees or on Voluntary Life/AD&D coverage for 2-25 employees. The benefits automatically renew with the age banded rates and the group will only see a change in premium if someone goes into a different age bracket as of the group anniversary. Underwriting does not review these lines of coverages.

For Dental/Vision coverages with LifeMap, you will receive the annual renewal at least 90 days prior to the effective date of change.

Renewals for 10-25 employees

For your coverages with LifeMap, you will receive the annual renewal at least 90 days prior to the effective date of change.

Click here for a list of all Small Group and Regence Life Solutions benefit summaries.