Federal Benefit Portal

1-800-233-1773 Ext 10

COMPLETING THE FORM

1. Advisor Name: That’s you

2. Client Name: Federal Employee Name

3. Client Age: Federal Employee Age (Numeric Only) Example: 60

4. FEGLI Coverage: Amount of Option B Coverage the Federal Employee has (No $ signs, commas or periods) Example: 100000

5. Advisor Insurance Company: The Carrier whose rates you are quoting

6. Advisor Insurance Company Premium: Your Carriers rates for the Term of Coverage (No $ signs, commas or periods) Example: 1000

7. Term of Coverage: How many years do you want to compare your rates Vs FEGLI (usually 20) Example: 20

8. Premium Savings: The total amount the Federal Employee will save during the Term of Coverage.