Audits on Demand Form | Broker Builder Solutions

STEP 1 : Request Form

Complete Request Form. If additional Audits are needed, click the gray “+ADD NEW AUDIT” button for each new Audit.

Audits on Demand

Organization Name*

Audit Point of Contact Name*

Audit Point of Contact Phone*

Phone

Audit Point of Contact Email*

Audit Section : If you do not wish to submit all audits being purchased today, BBS will send you a link to submit future audits at the time of need.

STEP 2 : Upload Data

Upon Completion of Request Form, the site will redirect to a page with a link to BBS ShareFile to upload the data files to be used for audit. (Supported File types are .xlsx, .xls and .csv). You may also Click Here to Upload the files to BBS ShareFile. Please upload all data files and any helpful information such as group structures/plan correlation. Example if a plan audit is being completed and the carrier has the plan name as PPO 1234 and the comparison file to the Ben Admin system has 2023 Plan 1, we will need a document that allows us to understand the correlation between the two data points.

STEP 3 : We Will Contact You

Upon Receipt of the request form and the data, a member of our audit Team will review and reach out with any clarifying questions.

STEP 4 : Login Details

A login to our Data Validation platform where audit results will be retrieved will be sent to the Audit Contact email.

STEP 5 : Timeframe

Audits will be completed within 1-3 business days from receipt.

STEP 6 : Email Confirmation

An email will be sent to confirm audit completion with instructions on how to access the audit results.

STEP 7 : Questions

Audit on Demand Inquiries should be sent to datatool@BrokerBuilderSolutions.com

Select an Audit Plan

Please select the audit plan option that corresponds to your needs along with the billing option to be used. If choosing a Credit Card, a member of our Finance team will reach out to obtain the Credit Card information upon receipt of the form.

Plan	# Audits included	Cost	Per Audit
Audit 1	1	$139.39	$139.39
Audit 5	5	$499.39	$99.88
Audit 10	10	$749.39	$74.94
Audit 20	20	$999.39	$49.97

Select a Plan*

Audit 1

Audit 5

Audit 10

Audit 20

Pricing / Billing

Billing Contact Name*

Billing Contact Email*

Email Address

Billing Contact Phone*

Phone

Select a Billing Option*

Invoice : I understand and agree that a separate audit invoice will be provided to me on the 1st of the month following receipt of my request due upon receipt.

Credit Card* : I understand and agree that the card provided will be billed for my audit plan on the 5th of the month following receipt of my request. Should the 5th of the month not fall on a business day, payment will be executed on the business day immediately prior to the 5th.

*If Credit Card is selected, BBS Finance will contact you via secure email to obtain credit card information.

Service Agreement

Audit Terms : Unused Audits*

I understand that I will not be reimbursed for unused audits. The number of on demand audits in my package must be used within a one (1) year of the date requested.

Yes, I agree

Audit Terms : Audit Results*

I understand that I will be required to retrieve all audit results via my secure login to the Data Validation Platform unless otherwise specified by a member of the Data Management Solutions audit team.

Yes, I agree

Assurance : Authorized User*

By signing the below, I as the customer, certify I am an authorized user of the credit card provided and as such, there will be no disputed for these scheduled transactions with the bank or credit card company; so long as the transactions correspond to the terms indicated in this subscription form. In addition, as the customer, I will provide Broker Builder Solutions with updated payment information promptly. Failure to comply may result in a service interruption.

Yes, I agree

Stale Data : *

I understand that the data provided to the Data Management Solutions team should be dated within the week uploaded. This will allow for Optimal audit results.

Yes, I agree

Data Format: *

I understand that all data should be provided to the Data Management Solutions team in on of the following supported file types; xlsx, .xls or .csv

Yes, I agree

Professional Liability Insurance

Broker Builder Solutions LLC shall obtain and always maintain during the prosecution of the work under this Agreement Professional Liability insurance to include Errors and Omissions and Cybersecurity.

Signature for Terms and Conditions*

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Date*

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Data Management Solutions

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STEP 1 : Request Form

Audits on Demand

Audit Section : If you do not wish to submit all audits being purchased today, BBS will send you a link to submit future audits at the time of need.

STEP 2 : Upload Data

STEP 3 : We Will Contact You

STEP 4 : Login Details

STEP 5 : Timeframe

STEP 6 : Email Confirmation

STEP 7 : Questions

Select an Audit Plan

Pricing / Billing

Service Agreement

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