Health-Powered Payroll Tax Reduction Intake

The IRS-backed SIMERP Program allows you to provide additional preventative healthcare benefits to your employees while also reducing your payroll taxes... with no out of pocket costs! Minimum Qualifications: Your business/organization must have at least 5 employees making $17k or more annually. Fill out the form below and we'll schedule a free call!

Business Information

* Required field

Business Name*

Type of Industry (please choose the best option)*

How many locations do you have?*

Approximately, what is the total number of full-time W-2 employees your business has?*

If unsure, an estimate is perfectly fine.

Regarding the above number of total W-2 employees, how many have health coverage within the company?

If unsure, an estimate is perfectly fine.

Business Address

Business Website (if applicable)

Brief Description of Your Business (or anything you'd like us to know)

Your Contact Details

Full Name*

Business Email Address*

Best Contact Number*

Your Role / Decision-Making Authority*

To make the most of this call, the person who can make the final decision for the company should be present. If that isn't you, you'll have an opportunity to share their information below.

How did you hear about the SIMERP Program?

Who referred or introduced you? First name is fine if that's all you know.

Scheduling Your Free Assessment

If you appear to qualify, a specialist will reach out to schedule your complimentary assessment call. Please share the days and time windows that generally work best for you.

Preferred Days*

Preferred Time Frames (select all that apply)*

Additional Comments or Information

Human verification *