Exceptional Group Insurance Benefits

Group Benefits Insurance Health Life Employee

Employer Health Benefits - Retirement - Group Life - Disability - Long Term Care

There are four sections that need to be completed.

You will receive a thorough comparison of group life insurance products in an easy to read outline. You choose which you are most comfortable with and we can begin the application process and implement your group life efficiently.

1.) Company Informtion

Company Name
Contact Name
Address
City, State, Zip Code
Telephone
E-Mail Address
Occupation

2.) Current Group Life Plan

Current Group Life Plan
$ Life insurance per employee
$ Current Monthly premium

3.) Employee Information

Number of Employees

4.) Major Health Conditions

List any major health conditions your employees have or have
had in the past five years. You do not need to specify the employee.