Group Enrollment Questionnaire
 
To enroll in a group with CompManagement, please fill out the form below with the required information then click on the Submit button. You will be linked to a secured PayPal site where your payment can be processed online. If you have any questions, please call CMI’s Customer Support Unit at 1-800-825-6755, option 3.
 
Note: Required fields are designated with an asterisk (*).
 



* Contact Name:  
* Contact Phone #:  
Contact Email:  
* Company Name:  
* BWC Policy Number:   ***Located on your CMI Invoice
CMI Invoice #:   ***Located on your CMI Invoice
* Fee Amount: $   ***Located on your CMI Invoice  


* 1) Please indicate which option below best describes your organization operating under this policy.


    


* 2) In the past 5 years has this organization operating under this policy purchased, acquired, merged with or bought the assets of another Ohio organization?
    


* 3) In the coming year, does this organization plan to acquire all or part of another Ohio operation or the assets of another operation?


* 4) A PEO (Professional Employer Leasing Organization) provides human resources management services to other business owners. Please select the option that best describes your company.

By submitting this form electronically, I certify that the above information is true to the best of my knowledge and that this form will allow CompManagement to validate my enrollment qualifications.
 
Note: No further documentation is required to be sent for enrollment. A confirmation email will be sent to you if you entered an email address above.