THE DEADLINE FOR SUBMITTING A NOMINATION FORM IS: MARCH 1, 2010
??Risk & Insurance / Human Resource Executive
Power Brokers: Identifying the Best
The role of the employee benefit broker and consultant reflects the increasing importance of
human resources, risk management and compliance in a challenging economy. More and more,
the broker’s role isn’t defined by negotiating a health-insurance policy or obtaining better disability
coverage or surveying the landscape of 401(k) providers. Instead, the role of the broker becomes
one of a consultant, assisting the client in solving vexing problems that involve the need to
balance cost, coverage, competition and employee-retention issues. Those issues become even
more important because of the recession and the continuing high levels of unemployment. The
Risk & Insurance? and Human Resource Executive? Employee Benefit Power Broker? identifies the most outstanding brokers and consultants, i.e. those individuals who have done
extraordinary work for their clients in 2009. We look at client service, creativity and innovation in
problem-solving, cost-savings and quality improvements, along with insurance and benefits
expertise. We will profile what each Power Broker? has accomplished during the past year in
the June issue of Risk & Insurance? and June 2 issue of Human Resource Executive?. Please note that information in its entirety remains confidential but may be shared with judges
and your references. For the purpose of this form, we use the term “broker,” “agent” and “consultant” interchangeably, even if the person is not a registered broker.
City: State: Zip Code:
Telephone number (office):
Telephone number (cell):
Insurance license number: Resident State:
Date of Birth:
Educational background (includes college/university, degree and major):
Years of experience in insurance brokerage/consultancy: (specify name of firm, position and years of
tenure at each firm, beginning with current position):
Company Years Last Title
Check off appropriate category (Check only one
Health-Insurance Benefits - This category includes group health and dental insurance and
health-insurance-benefits administration. Because this category is so large, and the issue so timely,
we will identify the specialty of the designees. We will also have the option to run up to 12 winners
in this category.
Voluntary Benefits - This category includes life insurance, legal services, wellness programs
and other voluntary benefits—benefits that would be available to an employee at their discretion.
We will also identify the specialties among these designees. We will identify up to six winners.
Disability Benefits - including short and long-term disability insurance and management
programs. This category includes absence management programs and return-to-work program and
efforts to coordinate disability, workers’ compensation and related benefits. Again, we will name up
to six winners
Retirement Benefits - This includes 401(k) plans and other pension options, as well as
retirement-benefits administration. There will be up to six winners in this category.
Please provide the name and contact information (telephone number and e-mail address) for at least
one client recommendation, preferably two, but no more than three. The references will remain
confidential, but will be contacted.
Contact Company Title Telephone Email
Briefly explain the major accomplishment during the past year in your role as a broker or
consultant that you think qualifies you to be designated as one of the top players among
employee benefit brokers. Brokers are judged on three factors: client service including cost-
savings and quality improvements; creative problem-solving and innovation; and insurance
and benefits expertise
Please provide any additional experience, training or education, work related or otherwise,
outside the “normal” realm of brokering, that you bring to bear for your clients. This could include
public service contributions, community efforts and examples of strong, ethical behavior.
This designation honors those Employee Benefit Power Broker? winners who have gone above and beyond the call of duty, as “Responsibility Leaders.” A special panel of judges will review the
applications of the Power Broker? winners to identify eligible candidates. The editors of Risk & Insurance? will then select up to six as “Responsibility Leaders.”
If you would like to be considered for a Responsibility Leader? Award, please provide us with
information that will help us evaluate your candidacy. We are not looking for you to answer all the
questions; just use these questions as a guide to help us understand your commitment to your
organization, your profession and your community during the past year.
? Employee Benefits issues increasingly surround the current economic slowdown and
declining employment levels. How have you helped your clients, their employees and the
community-at-large confront and resolve these difficult issues in very tough times?
? How does your work as a broker or consultant go “above and beyond” in a way that
benefits clients or the community?
? How does your work as a broker, and your career as a broker, reflect a commitment to do
the “right thing” for your professional community, your clients and the community at
? How have you encouraged young people to consider brokerage and insurance as a career?
? What recognition have you received from your company, your profession and/or your
community? Please explain.
Don’t feel you are confined to this application form. Feel free to add additional information in another
“Word” document that you can submit along with the form. And, just a reminder, you need not answer
all the questions.
The application should be e-mailed to email@example.com. All applications must come attached with a high-resolution (300dpi) color head and shoulders photograph. We will be unable
to accept e-mail attachments greater than 1 MB in size. If you have large photos, we can direct
or to a file-sharing option.
All final applications, completed and accompanied by digital photographs, must be in our hands
no later than Monday, March 1, 2010.
If there are any questions, please contact Managing Editor Cyril Tuohy of Risk & Insurance
? at ? firstname.lastname@example.org or Editor David Shadovitz of Human Resource Executive at
Thank you for your time and effort!
?Cyril Tuohy, managing editor, Risk & Insurance
?David Shadovitz, editor, Human Resource Executive