Please use the following form to request a quote from EBS. A representative will contact you within the next business day regarding your request.
Name *
Company Name *
Phone *
E-mail *
Please click on the Yes button to request a quote for the desired EBS service(s). You may request a quote for more than one service.
Want to request a quote for WORKTERRA? Yes No
Want to request a quote for FSA? Yes No
Currently have an FSA Yes No
If yes, # of current participants
Want to request a quote for Commuter Benefits? Yes No
Transit Yes No
Parking Yes No
Currently Have Commuter Benefits Yes No
Want to request a quote for COBRA? Yes No
Current number of participants
# of eligible participants in the last 12 months
Want to request a quote for Retiree Administration? Yes No
Current number of retirees
Want to request a quote for Invoice Reconciliation? Yes No
# of benefit plans
# of eligible employees
Thank you for your request. An EBS representative will contact you regarding your quote.