Cancellation
You have decided to cancel your request for an offer.
Please note: if your confirm the cancellation, all the data you have entered will be lost.
Confirm
Request for a corporate insurance offer.
Information on the company
*
Legal status:
Public limited company (SA)
Limited liability partnership (Sàrl)
Sole proprietorship
Do you have any employees?
Yes
No
*
Corporate name:
*
Address:
*
Postcode / Town:
*
Language:
French
German
Italian
English
*
Title:
Mrs
Mr
*
Owner:
*
Date of birth:
*
Private address:
*
Postcode / Town (private address):
*
Activity:
Noga Code:
Number IDE:
CHE-
Contact person in the company
The owner is also the contact person?
*
Title:
Mrs
Mr
*
Name:
*
Phone:
*
Email:
Please select your insurance needs
Daily allowance for illness:
Supplemental accident insurance:
Accident insurance (LAA/UVG):
Pension fund (LPP/BVG):
Our solution for the self-employed
Challenge
, Groupe Mutuel´s all-in-one solution for the self-employed:
The preselections suggested in the various insurance branches represent our standard sales advice.
Request for a corporate insurance offer.
*
Does your company already have
daily allowance insurance for illness
?
with the following insurer:
Expiry date:
Policy n°:
Required coverage for employees
*
Salary coverage:
80%
90%
100%
*
Waiting period:
3 days
7 days
14 days
30 days
60 days
*
Annual salary expenditure (max. CHF 250,000 per person):
Optional coverage for the employer
*
Show information on coverage for employer:
*
Salary coverage:
100%
*
Waiting period:
3 days
7 days
14 days
30 days
60 days
*
Annual salary of employer (maximum CHF 250,000):
*
Do you also wish to include accident coverage?
Entry into force of contract
*
Beginning date:
*
Duration of contract:
3 years
5 years
Request for a corporate insurance offer.
*
Does your company already have an
accident insurance under LAA/UVG
?
With the following insurer:
Expiry date:
Policy n°:
Compulsory coverage for employees
*
Annual salary expenditure / Occupational accident (Up to CHF 148,200 per year and per person):
*
Annual salary expenditure / Non-occupational accident (Up to CHF 148,200 per year and per person):
Optional LAA/UVG for employer
*
Show details regarding coverage for employer:
*
Waiting period :
2 days
14 days
30 days
*
Employer´s annual salary expenditure:
Entry into force of contract
*
Beginning date:
*
Duration of contract:
3 years
5 years
Request for a corporate insurance offer.
*
Does your company already have
supplemental accident insurance
?
With the following insurer:
Expiry date:
Policy n°:
*
Is your company a member of Suva?
*
Please indicate your final premium rate for occupational accidents with SUVA:
Choose your coverage
Treatment and hospitalisation costs in a private ward:
Gross negligence cover (cannot be taken out alone):
Supplemental daily allowances:
*
Salary taken into account:
LAA/UVG salary (annual maximum of CHF 148,200 per person)
AVS/AHV salary (LAA/UVG salary and excess salary)
*
Salary coverage:
90%
100%
*
Waiting period:
2 days
14 days
30 days
Lump-sum disability benefit:
*
Coverage:
1 X the annual salary
2 X the annual salary
3 X the annual salary
*
Progression:
Without progression
Traductions manquantes!
With a progression of 350%
Lump-sum death benefit:
*
Coverage:
1 X the annual salary
2 X the annual salary
3 X the annual salary
Salary information
*
LAA/UVG annual salary expenditure
(Max. CHF 148,200 per person)
:
*
Excess annual salary expenditure
(salaries > CHF 148,200 and max. CHF 351,800 per pers.)
:
Entry into force of contract
*
Beginning date:
*
Duration of contract:
3 years
5 years
Request for a corporate insurance offer.
*
Does your company already have an
occupational pension plan LPP/BVG
?
*
With the following insurer:
*
Expiry date:
Policy n°:
*
Since when has your company had employees covered by occupational pension plans?
*
Is your company already subject to a collective work agreement?
*
Please indicate which one:
*
Is there an insurance against loss of income due to illness, with a min. coverage of 80% for 720 days?
Please select the requested coverage(s)
Pension plan according to the statutory minimum:
Enhanced LPP/BVG pension plan:
Other plan: I wish to be contacted by a Groupe Mutuel LPP/BVG specialist:
List of insureds
Do you wish to include the degree of employment in the coordination deduction?
Please enter the following information for each employee
You can enter up to 7 employees. If you wish to enter additional employees, please send us the relevant information in the next step of this form or by email (Excel).
*
Name and first name
*
Date of birth
Gender
*
Gross annual salary
Accumulated LPP/BVG capital
Of which mandatory portion
*
Occupancy rate
Choose
Men
Women
-
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Add an employee
Delete this employee
Entry into force of contract
*
Beginning date:
Request for a corporate insurance offer.
*
Do you have a
daily allowance insurance for illness
?
*
With the following insurer:
*
Expiry date:
*
Policy N°:
Requested coverage
*
Salary coverage:
*
Waiting period:
14 days
30 days
60 days
*
Standard wages (max. CHF 250,000):
*
Do you also wish to include accident coverage?
Other requested coverages - risks covered under a life insurance plan
Disability lump-sum benefit:
*
Coverage:
1 X the annual salary (as a lump-sum)
60% of the annual salary (as a pension)
80% of the annual salary (as a pension)
Lump-sum death benefit:
*
Lump-sum death benefit:
1 X the annual salary
2 X the annual salary
3 X the annual salary
Retirement capital:
*
Monthly savings:
CHF
I wish to be contacted by a Groupe Mutuel life insurance specialist:
*
Do you smoke?
Entry into force of contract
*
Beginning date:
*
Duration of contract:
Request for a corporate insurance offer.
Document transmission
Total size of attached files may not exceed 5MB.
Document transmission
Along with your request for an offer, you can attach any type of document, such as the list of your employees, the certificate(s) of your previous insurer, or the costs and benefits table(s).
Add a file
Delete a file
Comments
You can also leave us a message here.
Sales Adviser
Is this request handled by a Sales Adviser?
*
Agent N°:
*
Email:
Receiving preferences for your offer
*
I wish to receive my offer by email:
*
I wish to receive my offer by post: