Organization Information
Organization Name
Contact Name
Contact Phone
Contact Email Address
Number of Employees**
Anticipated Start Date
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2025
2026
2027
Detroit Chamber #
Lookup ID
Agent Name
Agency Name
Agency Phone
Authorized Rep #
** - Number of employees on a COBRA eligible healthcare plan