Are electronic signatures legally binding?

Yes. Electronic signatures meet legal standards under the ESIGN Act (15 U.S.C. §7001) and UETA in most states when intent, consent, attribution, and retention are present.

When is a consumer disclosure required?

Consumer-facing records often require an ESIGN consumer disclosure and consent process per 15 U.S.C. §7001(c); include a clear right-to-paper disclosure for affected parties.

Do proposals need notarization?

Typically not. Most Employment Practices Proposal Forms do not require notary acknowledgement unless a carrier or state law specifically requests notarized attestations.

How do I correct a submitted form?

Submit an amended form with a clear revision date and reference to the original. Note corrections in the cover message and maintain both versions for audit trails.

How long must I keep records?

Retain proposal forms and attachments per federal and industry standards—for example, IRS records three years (IRC §6501(a)) and HIPAA records six years (45 CFR §164.530(j)).

What if signer information differs?

Mismatched signer names or missing authority can void representations. Provide corporate resolutions or power-of-attorney documentation to confirm signatory authority.

Electronic Signature
Templates
Project Management
Employment Practices Proposal Form

Employment Practices Proposal Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

EMPLOYMENT PRACTICES PROPOSAL FORM

Name of Company:

Street Address:

City, State, Zip:

Internet Web site address:

Nature of business:

Years in Operation:

Number of:

Locations - Within the US Outside the US

Employees - Within the US Outside the US

1. Total number of:

(a) full time employees: (b) part time employees:

(c) leased_contract_employees: (d) union employees:

2. Does the Company make use of independent contractors? Yes No

3. Total salary expense for the most recent year-end:

4. Most recent annual turnover rate: Historical average annual turnover rate:

5. List the three states with the largest number of employees:

(a) State: Number of employees:

(b) State: Number of employees:

(c) State: Number of employees:

6. Provide the number of employees and officers terminated by the Company in the past two years:

Most recent year: Number of employees: Number of Officers:

Year prior: Number of employees: Number of Officers:

7. Has the Company completed within the last 12 months, or is the Company considering within the next 12 months, any layoffs or early retirement programs including those resulting from company reorganizations or facility closings? Yes No

If “Yes”, provide details in an attachment to this Proposal Form.

8. Does the Company have outplacement programs for terminated employees? Yes No

9. Are there any planned transactions or events that would significantly increase the number of employees stated above? Yes No

If “Yes”, provide details in an attachment to this Proposal Form.

10. Does the Company require the submission of an employment application for all applicants? Yes No

If “No”, please explain in an attachment to this Proposal Form.

11. Does the Company use tests, including but not limited to drug, alcohol, and psychological tests, for screening applicants or for continued employment? Yes No

If “Yes”, please attach the Company’s policy or provide details.

12. Does the Company have a Human Resources Department? Yes No

If “No”, describe how human resource functions are administered in an attachment to this Proposal Form.

13. Does the Company have a human resources manual? Yes No

If “Yes”, does this manual contain policies and procedures addressing the following areas:

(a) Compliance with the Americans with Disabilities Act; Yes No

(b) Compliance with Title VII of the Civil Rights Act of 1964 and the 1991 Civil Rights Act; Yes No

(c) Compliance with the Family Medical Leave Act; Yes No

(d) Prohibited discriminatory practices in hiring, promotion, and compensation; Yes No

(e) Employee performance evaluations; Yes No

(f) Employee disciplinary actions and discharge; Yes No

(g) Sexual harassment and the work environment; Yes No

(h) Employee grievance reporting and resolution processes. Yes No

If “No” to any of the above, please provide details in an attachment to this Proposal Form.

14. Do all managerial and supervisory personnel:

(a) have a copy of the human resources manual? Yes No

(b) receive training in the implementation of these policies and procedures? Yes No

If “No”, explain how human resources policies and procedures are communicated to managers and supervisors in an attachment to this Proposal Form.

15. Are all employees provided with and required to acknowledge receipt of a handbook that addresses the areas detailed in item 13. above? Yes No

If “No”, explain how human resources policies and procedures are communicated to employees in an attachment to this Proposal Form.

16. Have there been during the last five years, or are there now pending, any employment related civil, criminal, administrative or arbitration proceedings (including any proceeding initiated before the Equal Employment Opportunity Commission) brought against:

(a) the Company or its Subsidiaries? Yes No

(b) any person proposed for this insurance in their capacity as either Director, Officer, or employee of the Company or its Subsidiaries? Yes No

If “Yes” to either of the above, in an attachment to this Proposal Form, provide details including the nature of the allegations, the date the proceeding was initiated, the current status, and loss (including defense costs) incurred.

17. Have there been during the last five years, or are there now pending, criminal, administrative or arbitration proceedings by any customer, client or other third party against the Company, its subsidiaries or any person proposed for this insurance alleging discrimination, harassment or violations of civil rights based upon discrimination or harassment? Yes No

If “Yes”, provide details in an attachment to this Proposal Form.

IT IS AGREED THAT ANY CLAIM ARISING FROM ANY PRIOR OR PENDING PROCEEDING DESCRIBED IN 16. OR 17. ABOVE IS EXCLUDED FROM THE PROPOSED COVERAGE.

18. Is the undersigned or any Director or Officer proposed for this insurance aware of any fact, circumstance or situation involving the Company or its Subsidiaries which he or she has reason to believe might result in any future Employment Practices Claim under the policy to which this Proposal Form will be attached? Yes No

If “Yes”, please provide details in an attachment to this Proposal Form.

IT IS AGREED THAT IF KNOWLEDGE OF ANY SUCH FACT, CIRCUMSTANCE OR SITUATION EXISTS, ANY CLAIM SUBSEQUENTLY ARISING THEREFROM SHALL BE EXCLUDED FROM COVERAGE.

19. Current or prior Employment Practices Liability Insurance (stand-alone or incorporated into some other coverage):

Insurer Limit Retention Premium Policy Period

(a) has any claim been made or has any notice been given to any insurer? Not Applicable Yes No

(b) has any insurer cancelled or non-renewed the above coverage? Not Applicable Yes No

If “Yes” to any of the above, provide details in an attachment to this Proposal Form.

NOTICES AND DECLARATIONS

NOTICE TO ARKANSAS APPLICANTS: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit, or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

NOTICE TO COLORADO APPLICANTS: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.

NOTICE TO DISTRICT OF COLUMBIA APPLICANTS: Warning: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was reported by the applicant.

NOTICE TO FLORIDA APPLICANTS: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

Also provide: Agent name License number

IOWA APPLICANTS:

Submitted by Date

NOTICE TO KENTUCKY APPLICANTS: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime.

NOTICE TO MAINE APPLICANTS: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.

NOTICE TO NEW MEXICO APPLICANTS: Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.

NOTICE TO NEW JERSEY APPLICANTS: Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.

NOTICE TO NEW YORK APPLICANTS: Any person who, knowingly and with intent to defraud any insurance company or other person, files an application for insurance containing any materially false information, or conceals for the purpose of misleading and fact material thereto, commits a fraudulent insurance act, which is a crime and shall also be subject to a civil penalty not to exceed five thousand dollars ($5,000.00) and the stated value for each such violation.

NOTICE TO OHIO APPLICANTS: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

NOTICE TO PENNSYLVANIA APPLICANTS: Any person who knowingly and with intent to injure or defraud any insurer files an application or claim containing any false, incomplete or misleading information shall, upon conviction, be subject to imprisonment for up to seven years and payment of a fine of up to $15,000.

The undersigned Officer of the Company declares that to the best of his or her knowledge the statements set forth herein are true and correct and that reasonable efforts have been made to obtain sufficient information to facilitate the proper and accurate completion of this Proposal Form. The undersigned further agrees that if any significant adverse change in the condition of the applicant is discovered between the date of this Proposal Form and the effective date of the Policy, which would render this Proposal Form inaccurate or incomplete, notice of such change will be reported in writing to the Insurer immediately. The signing of this Proposal Form does not bind the undersigned to purchase the insurance.

It is agreed by the Company and the Insured Persons that the particulars and statements contained in this Proposal Form and any information provided herewith (which shall be on file with the Insurer and be deemed attached hereto as if physically attached hereto) are the basis of this Policy and are to be considered as incorporated in and constituting a part of this Policy. It is further understood and agreed by the Company and the Insured Persons that the statements in this Proposal Form or any information provided herewith are their representations, they are material, and this Policy is issued in reliance upon the truth of such representations; provided, however, that except for material facts or circumstances known to the person who signed this Proposal Form, any misstatement or omission in this Proposal Form or information provided herewith in respect of a specific Wrongful Act by a particular Insured Person or his or her cognizance of any matter which he or she has reason to believe might afford grounds for a future Claim against him or her shall not be imputed to any other Insured for purposes of determining the validity of this Policy as to such other Insured.

This Proposal Form must be signed by the Chairman of the Board, President, Chief Executive Officer, Chief Operating Officer, or Chief Financial Officer of the Company.

Signature

Title

Date

Please include a copy of the Company’s employment applications, Human Resources Manual, Employee Handbook, or, if these do not exist, a copy of the Company’s documentation on human resources policies and practices, the most recent EEO-1 report, and the most recent annual report for the Company. These materials will be considered part of the Proposal Form.

NOTE: This Proposal Form including any material submitted herewith shall be treated in strictest confidence.

Please submit this Proposal Form including appropriate documentation to: Great American Insurance Companies, Executive Liability Division, P.O. Box 66943, Chicago, IL 60666

What the Employment Practices Proposal Form Is

The Employment Practices Proposal Form is a standardized document employers or brokers complete to request coverage, provide underwriting data, or propose employment-practices terms to an insurer or third party. It collects company identification, workforce size, claims history, loss control measures, policy limits sought, and representative contact details. The form supports consistent risk assessment by underwriters and creates a single record for negotiation, pricing, and internal approvals. While completing this form does not itself bind coverage, the information contained directly affects quotes, underwriting decisions, and the terms of any final insurance contract or internal approval.

Why a Clear Proposal Form Matters

A complete Employment Practices Proposal Form reduces underwriting delays, minimizes follow-up requests, and improves quote accuracy. It standardizes information across submissions, helps identify underwriting issues early, and provides a defensible record of representations and disclosures for both employers and insurers.

Step-by-step: Completing and Submitting the Form

Follow a clear sequence: gather documents, complete fields, attach evidence, then sign and submit to the intended recipient to avoid common delays.

01

Collect Documents: Assemble payroll, loss runs, and policies for reference and attachment.
02

Fill Sections: Complete required fields precisely and use MM/DD/YYYY for dates.
03

Attach Evidence: Upload loss runs, handbooks, and safety protocols where requested.
04

Sign & Submit: Authorize as a representative and send to broker or insurer portal.

Who Typically Prepares and Reviews This Form

Several internal and external roles commonly complete or review Employment Practices Proposal Forms depending on whether the submission is for insurance, internal review, or vendor screening.

HR Managers: Prepare workforce data, policies, and employee classification details for accuracy.
Insurance Brokers: Consolidate client information, attach supporting documents, and submit to carriers for quotes.
Legal or Compliance Teams: Review representations, disclosures, and consent language before signing.

Align the form’s preparer with the document purpose—for insurance quotes use broker or risk manager; for internal proposals use HR and legal to ensure completeness.

Core Sections to Include for a Professional Proposal

A well-structured Employment Practices Proposal Form groups essential topics into clear sections so underwriters can evaluate risk quickly and consistently.

Company Details

Legal name, doing-business-as entries, FEIN, primary address, corporate structure, and contact information for the authorized signer.

Workforce Profile

Headcount by full-time, part-time, temporary, and independent contractors plus geographic breakdown and key executive titles.

Claims and Loss Runs

Detailed history of employment-related claims, reserves, outcomes, and certified loss runs for the requested reporting period.

Policies and Procedures

Summary of hiring, termination, harassment prevention, anti-discrimination, and internal complaint-handling procedures.

Coverage Request

Requested limits, deductible layer, retroactive dates, and any endorsements or exclusions sought by the applicant.

Attestations

Authorized representative statements confirming accuracy, plus signature, title, and date to bind representations.

Security and Compliance Data to Provide or Verify

Encryption: TLS 1.2/1.3 in transit

Data at Rest: AES-256 encrypted storage

Audit Trail: Timestamped action logs

Regulatory Certs: SOC 2 Type II available

Health Data: HIPAA BAA on request

eSignature Law: ESIGN and UETA compliant

Consequences of Inaccurate or Incomplete Information

Misstated Employee Count: Premium adjustment or denial

Omitted Claims: Coverage rescission risk

Unsigned Attestation: Submission rejected

Incorrect Dates: Coverage gap exposure

Insufficient Documentation: Underwriting delay

Noncompliant Signatures: Legal enforceability risk

Common Preparation Errors to Avoid

Using an informal or abbreviated company name that does not match tax records, which triggers verification requests and slows processing.
Failing to attach certified loss runs or providing incomplete claim descriptions that force multiple underwriter inquiries.
Providing inconsistent workforce counts across sections or attachments, producing premium recalculations or rescinded offers.
Leaving attestations unsigned or signed by unauthorized individuals, leading carriers to refuse the submission as incomplete.

Real-world Examples of Use

These examples show how organizations completed and used Employment Practices Proposal Forms to support underwriting and internal approvals.

Optica Ventures LLC

Optica needed a simple, consistent process for submitting employment-practices information to brokers.

Improved customer signing experience.
"The interface is simple and easy-to-use for our team; more importantly, it is just as easy for our customers."

Brian Fitzgibbons, COO, Optica Ventures LLC.

Fertility Centers of Illinois

A healthcare provider centralized HR disclosures and claims attachments to support renewal negotiations.

Reduced back-and-forth with carriers.
"The airSlate SignNow team has been exceptional, responsive, the API has been great, and we're extremely happy that we chose airSlate SignNow as a company."

John Butler, Founder, Fertility Centers of Illinois.

Where to Send the Completed Form

Routing depends on intent: insurer underwriting portals, brokers, or internal records. Confirm the recipient and preferred method before submission.

To Carrier: Submit via insurer portal or broker email.
To Broker: Attach supporting documents and loss runs.
Internal Records: Save to HR or risk manager repository.
Third-Party Review: Provide access to legal or compliance reviewers.

Distribution Channels and Technical Considerations

Choose a submission channel that preserves attachments, signatures, and audit trails to ensure a verifiable record.

Email: Encrypted attachments preferred
Secure Portal: Preserves audit trail
API / Integrations: Salesforce, NetSuite, Google Workspace

Typical Timelines and Processing Expectations

Submissions follow standard underwriting cycles; providing complete data up front reduces the likelihood of requests for additional information and speeds decisions.

Submission Timing:

Submit with application to avoid delays

Underwriting Response:

7–14 business days typical review window

Premium Due:

Often within 30 days of binder or invoice

Coverage Effective Date:

Set as requested; insurer may require binding steps

Renewal Cycle:

Begin 60–90 days before policy expiration

Key Milestones from Submission to Coverage

A typical lifecycle includes discrete milestones that move a proposal from intake through decision and binding. Expect coordinated actions across several teams.

01

Intake and Validation

Verify completeness, contacts, and attachments.

02

Underwriting Review

Assess claims, policies, and risk controls.

03

Negotiation and Terms

Carrier issues terms; applicant reviews adjustments.

04

Binding and Issuance

Finalize signature, accept premium, and issue policy.

eSignature Vendor Pricing Snapshot for Form Submissions

Compare common vendor pricing and capabilities relevant to submitting Employment Practices Proposal Forms; signNow is listed first per comparative data.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Supporting Documents to Attach

Attaching standardized supporting documents prevents underwriter delays and reduces requests for additional information during review.

Loss Runs

Provide certified loss runs for the requested period showing claims, reserves, payments, and status to support underwriting evaluation.

Employee Handbook

Attach the current handbook or key policy excerpts covering hiring, discipline, anti-harassment, and complaint procedures.

Organizational Chart

Submit a leadership and HR reporting structure to clarify supervision and delegated authorities affecting employment decisions.

Safety and Training Records

Include evidence of training programs, investigations, or corrective actions relevant to employment-practices risk.

Practical Tips for Accurate, Efficient Completion

Adopt consistent procedures and templates to reduce errors, support audits, and speed underwriting review.

Use a Template

Standardize forms and fields to avoid omissions; maintain a master copy with version control and required attachments.

Verify Names

Cross-check legal entity names and FEIN with tax records to prevent mismatches that trigger backup withholding or underwriting flags.

Attach Evidence

Always include loss runs, personnel policies, and training records to reduce follow-up questions from underwriters.

Keep Signed Records

Store signed submissions with audit trails and access controls to support later claims investigations or compliance reviews.

Frequently Asked Questions and Quick Answers

Answers to common questions about signature validity, consumer disclosures, notarization, record retention, and correcting submissions.

Need help? Contact support

Are electronic signatures legally binding?
Yes. Electronic signatures meet legal standards under the ESIGN Act (15 U.S.C. §7001) and UETA in most states when intent, consent, attribution, and retention are present.
When is a consumer disclosure required?
Consumer-facing records often require an ESIGN consumer disclosure and consent process per 15 U.S.C. §7001(c); include a clear right-to-paper disclosure for affected parties.
Do proposals need notarization?
Typically not. Most Employment Practices Proposal Forms do not require notary acknowledgement unless a carrier or state law specifically requests notarized attestations.
How do I correct a submitted form?
Submit an amended form with a clear revision date and reference to the original. Note corrections in the cover message and maintain both versions for audit trails.
How long must I keep records?
Retain proposal forms and attachments per federal and industry standards—for example, IRS records three years (IRC §6501(a)) and HIPAA records six years (45 CFR §164.530(j)).
What if signer information differs?
Mismatched signer names or missing authority can void representations. Provide corporate resolutions or power-of-attorney documentation to confirm signatory authority.

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