Vector Financial
Financial Services with a Unique Approach
Get a Quote
Sidebar
×
Home
About Us
Products
Life Insurance
Life Basics
Permanent Life Insurance
Term Life Insurance
Term Life Insurance Glossary
Universal Life Quote
Whole Life Insurance Quote
Second-To-Die Life Quote
Term Life Quote
Burial / Final Expense Quote
Health Insurance
Introduction to Health Insurance
Implementing A Cafeteria Plan
Individual Health insurance Quote
Employer Group Health Plan Quote
Group Health Employee
Medicare Plans
Introduction to Medicare
Medicare Advantage
Medicare Part A
Medicare Part B
Medicare Part D
Medigap Policies
Medicare Supplement Plan Quote
Long-Term Care
Introduction to Long-Term Care
Understanding Long Term Care
Long Term Care Quote
Disability Coverage
Introduction to Disability Insurance
Disability Statistics
Disability News Source
Council for Disability Awareness
Social Security Program Fact Sheet
Disability Insurance Quote
Articles
Contact
Careers
Producer Login
Group Health Plan Quote Request
Your Information
Last Name
*
First Name
*
Birth Date
*
What is your position?
*
Email Address
*
Street Address
*
City
*
State
*
Zip Code
*
Phone Number
*
Alternate Phone
Fax Number
Please let us know the best time to call and discuss your quote.
Morning
Afternoon
Evening
Anytime
No More Time? Submit Now!
next
Company Information
Company Name
*
Street Address
City
*
State
*
Zip Code
*
Does your company currently have an insurance carrier?
Yes
No
If so, name of current carrier
Anniversary Date of current plan
Total Number Of Employees
Number of Employees to be Insured
Are premiums paid by your company for employee only or spouse too?
Employee Only
Employee and Spouse
Current coverage is for:
Single
Husband & Wife
Single parent & child
Full family
Current rate for coverage is:
Please list the companies you would like quoted:
(500 chars left)
What type of plan do you want compared?
HMO Plan
Dual options (PPO/POS)
Please choose from the following co-payments:
$5
$10
$15
$20
$30
$40
Would you like a Prescription Plan?
Yes
No
Please choose a deductible:
$500
$1000
$1500
$2000
$3000
$4000
$5000
Please select from the following co-insurances:
100/0
80/20
70/30
50/50
What do you like or dislike about your current plan?
(1000 chars left)
back
next
Best Time To Contact You
Any Questions or Comments?
(1000 chars left)
Please type what you see
back
submit
Thank you for your Final Expense quote. One of our advisers will contact you soon.
Please turn on javascript to submit your data. Thank you!
Our Partners
Client Services
empty