For your convenience, a list of information we need to provide a self-funded medical quote is listed below. We recommend a minimum of 250 employees for self-funding.

• Formal Request for Proposal or questionnaire, if available (Please submit in Microsoft Word or Corel WordPerfect.)
• Current plan effective date and proposed plan effective date
• Copy of current SPD
• Copy of current plan design
• Current health care network affiliations
• Employee census information including sex, birth date, coverage type (individual only or family), and employee zip codes (Please submit in Microsoft Excel or Access.)
• Average number of employees on payroll each month for the past three years
• Three years of claims experience, if available, by month (Include billed, eligible, discount, and paid.)
• Stop-loss quote specifications (Click here for a list of stop-loss quote requirements.)

Outsourcing Services Quote

If you’re interested in obtaining a quote for any of our outsourcing services, please include the following information:

• Service(s) requested
• Number and location of employees
• Current plan effective date and proposed plan effective date

Submit Request for Proposal

To submit your RFP and census information electronically, click here. Or you can mail hard copies and diskettes to us at:

AmeriHealth Administrators
Corporate Headquarters
720 Blair Mill Road
Horsham, PA 19044
Attn: National Sales Department