Request a quote

Thank you for your interest in a free, no obligation quote from several currently competitive carriers.  Please print, complete and return by fax or email a census form.  Please complete the census as completely and accurately as possible, listing all full-time (30+ hours a week, W-2) employees. 

Once submitted the information will be kept confidential and will be used for quote purposes only.  We will contact you as soon as the quotes are completed and the results are inserted into a "quick view" spreadsheet format.  Thank you for the opportunity to be of service!

If you would prefer to discuss your current situation now, to "narrow the field" of options, please call me (614-850-8958) or complete the form below and I will contact you right away.

* Required fields
Name *
E-mail Address *
Phone Number *
Company Name *
Address
Current Medical Carrier *
Current Plan Deductible
Current Co-Insurance
Would you like to see dental or vision plan quotes?
Would you like to see Short or Long term disabiltiy quotes?
Health Savings Account (HSA) interest?


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