Statement of Revenue

For Employee Benefit Clients

Conner Strong & Buckelew is committed to ensuring a positive customer experience in all we do. We pride ourselves on maintaining client relationships that are built on trust and transparency. To that end we have adopted a Statement of Revenue. In addition, we provide our benefit clients information about the annual compensation we receive in consideration for the brokerage and consulting services we provide to them. It is one way we help our clients understand the value they are getting for the compensation we earn.

To ensure requested information is distributed in a safe and confidential manner, we ask you to complete the short survey below. When completed, we will send the requested information as quickly as possible.

We value your business and appreciate the opportunity to work together as partners.

* Indicates Required Field

Name of Person Requesting Information*
Group Name*
Address of Group*
Street Address Address Line 2 City State ZIP Code
Title*
Direct Phone Number*
Email*
Verification*
- I agree that I am an employee of the above "Group" and am authorized to request this information. I also agree that upon receipt of the information, I will store it and destroy it in an appropriate fashion that protects the privacy of my employer and their insurance programs.
CAPTCHA

Please be advised that upon receipt of this request, Conner Strong & Buckelew may notify the Group to validate this request. Upon such confirmation, Conner Strong & Buckelew will process your request and send the compensation information within 10 business days. The compensation information will outline the commissionable and/or fee income received by us in exchange for the brokerage and consultancy services we provide to the Group. If you have any questions related to this request or the compensation information, please contact your Conner Strong & Buckelew service representative.