Page 4 - Applied Plastics - Post Enrollment Binder

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Colonial Life & Accident
Insurance Company
1200 Colonial Life Boulevard
Columbia, SC 29210
803.798.7000
ColonialLife.com
Blank fields represent information not provided or inapplicable to the account.
Account Information
Account Name: Applied Plastics
BCN: E5676481
D&B Number:
Associated With Another Account: No
Other Account Details:
Producer #: 775870
Producer Name: Tracy Jo-Beier Sabol
Authorizing Officer Name: Scott Peterson
Physical Address: 7320 S 6th St,
Oak Creek, WI 53154
Billing Address:
Business Phone: (414) 764-2900 Ext.
Billing Contact: Scott Petterson
Email: speterson@appliedplasticsinc.com / Title: Controller
Third Party Administrator: No
Public Sector: No
Nature Of Business: MANUFACTURING INDUSTRIES
Company Web Address: https://appliedplasticsinc.com/
Domestic Partner Allowed: Yes
Welcome Call: Yes
Preexisting relationship between agent and Yes
business:
Union or Association:
Flexible Payment Solution: No

Enrollment Information
Group Products: No
Pre-tax Deductions: Yes
Insurance Advisor:
Target Coverage Effective Date:
Target Premium Effective Date:
Payroll Input Date:
Target Enrollment Start Date:
Target Enrollment Stop Date:
Employer Paid: No
Number of Benefit Eligible Employees: 105
Preferred Billing Frequency:
FICA:

Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the
marketing brand.
AIF-Summary-2