Florida Group Health Insurance Quote

Quote Fill out the following form for a free quote for Florida Group Health Insurance Plans. .

Florida Group Health Insurance Quote
Please enter the information of your contact person.

First Name:

Last Name:

Email address:

Daytime phone:

Evening phone:

Street address

City:

Zip code:

Is your company currently insured?

Yes No

If yes, who is your insurance provider?

For how long has your company been insured?

When does your company's current policy expire?

Please enter the following information about this business.

Company name:

Legal classification:

Years in business:

Annual revenue:

Number of owners:

Number of full-time employees:

Number of part-time employees:

Four digit SIC code
(enter 9999 if you can't find it):

Select Plan Type(s)

	Preferred Provider Org (PPO)
Insurance plan, usually with a deductible and co-insurance, with full benefits.

	Health Maintenance Org (HMO)
Available to group and individuals, plans offer payment of benefits with co-pays required.

	Point of Service (POS)
Insurance usually like HMO, with co-pays, but allows the insured to obtain medical service out of network, usually by paying a deductible and co-insurance.

	Health Savings Account (HSA)
A two-component health plan consisting of a tax-deductible, high deductible catastrophic health insurance account.

	Medicare Supplement
Primarily for individuals 65 and over. It is usually requested by the Medicare recipients. It covers costs and expenses that are not covered by the Medicare

Select Optional Coverage
Dental Coverage Inexpensive coverage to assist in the cost of cleaning and maintaining teeth.	Vision Care Covers some costs associated with vision care and correction.	Maternity Coverage Covers Maternity under the same benefits as an illness.	Prescription Coverage Covers Prescription Drugs with a co-payment.

The Census
Please copy and paste the details of your employes or e-mail me the file.

Please provide the following information for each employee to be quoted in this group policy:
• First and Last Name of each person
• ZIP Code where the employee resides
• Birth Date and Gender
• Spouse/Children: whether the employee's spouse and/or children
should be included in the quote

Additional comments or information that will help us serve you better

Best time to call: Daytime Evenings

Florida Group Insurance Quote