Small Business

Let’s get started with your Small Business quote

By completing the form below, you will receive a detailed group proposal including rate and coverage information within 24 hours. This is not an application for insurance.

Small Business

Contact Information

First Name

Last Name *

Address

City

State

Postal Code

Daytime Telephone

Email Address

Census Information

Total Employees

How many participate in insurance plan?

How many are Minnesota residents?

Employees whom work over 20 hours per week

Of those, how many deny coverage?

Percentage of company contribution

Type of Quotes Requested

Major Medical 80/20 with deductible

Co-Payment

Health Savings Accounts

Defined Contribution Plans

Type of quotes desired

Dental

Disability

Life Insurance

Vision

When you fill out this form, we'll also need the birth dates of participating employees, their spouses, and children whom will be covered by this plan. We'll contact you to get this information if you could be prepared for that call. It does make it easier.

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