MDSIS - Spring Insurance Group, LLC

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Telephone: 800.821.6033

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Mass Division of Insurance Rate Cap

The health insurance new business and renewal rates for January 1, 2011 effective date have been filed by the carriers to the Massachusetts Division of Insurance. Rulings are due out by November 15, 2010. If you plan renews on Jan, Feb or March 1, 2011, the ruling will affect the renewal rates. All new business rates for Jan-Mar 2011 are also awaiting a final ruling.

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HIRD/Fair Share Filing

Businesses in Massachusetts are required to file a HIRD/Fair Share report to the Commonwealth as part of the Massachusetts Health Care Reform law of 2006. There are four filing timeframes. Failure to file can result in fines by the Commonwealth. The deadline for the fourth quarter is November 15, 2011.

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Get a Quote

Please complete the following form to request a quote for an insurance benefit plan. Upon receipt of this form, MDSIS-Spring will contact you within 24 hours to discuss your quote. There is no cost, enrollment, or obligation when obtaining a quote. All information received by MDSIS-Spring is strictly confidential.

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Coverage Provided Through:

Complete for all Eligible Employees. Note: Salary and Position information is required ONLY when requesting Short-Term Disability, Long-Term Disability, or Life Insurance.
First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

First Name: Last Name: Home Zipcode:	Gender: M F Smoker? Yes No	Type of Plan: Individual Family Waiving Coverage If Waiving, State Reason:	Date of Birth: Salary (see note):	Weekly Work Hours: Position (see note):

Note: Salary and Position information is required ONLY when requesting Short-Term Disability, Long-Term Disability, or Life Insurance.

MDSIS-Spring Insurance Group, LLC | 200 Friberg Parkway, Suite 2006 | Westborough, MA 01581

Phone: 800.821.6033 | Fax: 508.898.0068