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Group Health Insurance Quote
Health Insurance Basics
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Today, with health care costs rising dramatically each year, even relatively simple medical procedures can run into the thousands of dollars. However, it is not just the cost of medical care that is rising. The variety of care available is also increasing.

In order to reduce the risk of unexpected health care costs, private health insurance companies now offer an array of health insurance programs and plans, that vary widely in terms of coverage, costs and benefits

Would you like a FREE no obligation Small Group Health Insurance Quote?  Did you know different carriers can charge as much as 50% more for the same coverage!  What do you have to lose?  You could save substantially for two minutes of your time

The short form below should be filled out as completely as possible in order to receive an accurate quote.

First Name

 

Last Name

 

Street Address

 

City

 

State

 

Zip Code

 

Day Phone

 

Evening Phone

 

E-mail Address

 

Birthday (mm/dd/yy)

  19

Best time to call:

 

Employee / Family Member 1

Employee Name

M/F

Age

Status

 

 

 

 

Occupation

Salary

Currently Insured?

Plan type

 

$

 

 

Employee / Family Member  2

Employee Name

M/F

Age

Status

 

 

 

 

Occupation

Salary

Currently Insured?

Plan type

 

$

 

 

Employee / Family Member 3

Employee Name

M/F

Age

Status

 

 

 

 

Occupation

Salary

Currently Insured?

Plan type

 

$

 

 

Employee / Family Member 4

Employee Name

M/F

Age

Status

 

 

 

 

Occupation

Salary

Currently Insured?

Plan type

 

$

 

 

Employee / Family Member  5

Employee Name

M/F

Age

Status

 

 

 

 

Occupation

Salary

Currently Insured?

Plan type

 

$

 

 

Would you like an additional quote?

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