Quote Request

Health Insurance

For Health Insurance Quote for Companies, or Individuals we will need you to mail or fax us the following information:

  • Copy of most recent bill
  • Copy of current contract
  • Objective
  • Census for individual or all company employees:
    • Name
    • Zip Code
    • Coverage Status (single, married or family,etc)
  • Whether Waiving or Taking
  • What problems or concerns you currently experiencing with your health insurance plan/provider
  • What the strengths are with your current plan/provider
  • What, if anything, do you want to change
  • Any specific requests or needs

Retirement Plan Quote

We will need you to mail or fax us the following information to prepare a Retirement Plan Proposal.

  • What type of plan:
    • Defined Benefit Plan
    • Defined Contribution Plan
  • Corporate Name
  • Owner(s) Name
  • Percentage of Ownership
  • Owner(s) Date of Birth (mm/dd/yyyy)
  • Owner(s) Date of Hire (mm/dd/yyyy)
  • Owner(s) Salary
  • Deduction objective:
    • Quantity of Deduction
    • Duration of Deduction
  • Do you have employees?:
    • 1-10
    • 10-25
    • 25-50
    • 50-75
    • 75-100
    • + 100
  • To complete your quote we will need a census of your employees:
    • Name
    • DOB
    • DOH
    • Salary
    • FT or PT with hours.
    • Excel file for you to fill out your employee information and then e-mail to us