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The 2010 Employee Benefit Adviser of the Year Award

The Employee Benefit Adviser of the Year Award recognizes outstanding service to group benefit plan sponsors by their broker/consultants. It seeks to honor not just sales volume, but other factors that determine advisers’ true value to their clients.

All nominations must be submitted using this form. Please complete all items requested. Supporting information, such as documentation of achievements, or letters of support or endorsement from colleagues, clients or business contacts, are encouraged, and may be submitted in the online form or e-mailed to john.ortman@sourcemedia.com.

The deadline for nominations is July 9. The winner will be notified by July 23.

	Nominee’s Name
	Company/Organization
	Job Title
	Address
	City
	State

	Zip/Postal Code
	Phone
	E-Mail Address

1. Sales: Please outline the adviser's success in terms of number of plans implemented, amount of premium in force or other related metrics. Note increases for 2009.

2. Other measures of business success: Please outline success in such measures as annual revenue growth for the adviser firm and number of new clients added.

3. Performance against client expectations: Please describe how the adviser helped the client meet its objectives regarding specific criteria below.

(a) Cost savings: Year-to-year or multi-year comparisons of plan sponsor expenditures, actual and projected.

(b) Impact on employee health, satisfaction, financial security and related indicators: Please offer as many specific measures as possible, documented through health assessments, employee surveys or other tools.

(c) Employee engagement: Enrollment/participation/take-up rate, related measures of successful employee communication and education.

4. Other: Please add any other comments you feel are relevant to why this person should be recognized as Employee Benefit Adviser of the Year. In particular, please offer any other examples of the adviser’s innovation and creativity in presenting the products and services best suited to meeting employers' objectives.

Nominator (if other than the nominee)

	Nominator's Name
	Relationship To Nominee
	Company/Organization
	Job Title
	Address
	City
	State
	Zip/Postal Code
	Phone
	E-Mail Address

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The 2010 Employee Benefit Adviser of the Year Award

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Workplace Benefits Mania

25th Annual Benefits Forum & Expo

7th Annual Employee Benefit Adviser Summit

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