To begin your quote application for group health insurance from a licensed agent in the Cleveland,Ohio area please start with the health insurance quote application form below:
Completing one quick easy form is all it takes to obtain group health insurance for your small business from a respected licensed group health insurance agent from Cleveland,Ohio. Quotes available for Aetna, United Healthcare, Medical Mutual, Kaiser, Anthem Blue Cross Blue Shield and Summacare. Work with an agent that cares about your health insurance needs and understands the group health insurance requirements for small business owners from Cleveland,Ohio and the surrounding Northeast Ohio area small business community.

Group Health Insurance Quote Form

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All fields marked with a * are required:

1.) Please indicate the total number of employees including yourself who are eligible for this group health insurance plan
*Answer with numbers only above.
*Please indicate the exact number.
2.)Do you currently offer group health insurance coverage?
Yes. Please provide the health plan and expiration date.
Your health plan and expiration date
No
3.)How many years has your company been in business?
4.)Zip code.
5.)Email Address*
6.)Health plans with higher up front employee paid deductibles may also include lower premiums and greater flexibility Which would you prefer for this type of plan?
Not sure please help me select the plan that best meets my needs.
Yes we would prefer a plan with higher deductibles.
No we would like to offer a plan with lower deductibles.
Census: If 10 or fewer employees will be enrolled in the small business health insurance plan please complete the following census for each employee indicating sex, age, type of coverage needed and the employees home zip code.
Sex    Age             Coverage               Home Zip Code 1  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 2  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 3  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 4  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 5  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 6  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 7  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 8  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 9  MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily 10MFEmployee Employee Plus SpouseEmployee Plus ChildrenFamily
7.)Name*
8.)Company Name*
9.)Address*
10.) City*
11.)Phone *
12.)Fax

Serious requests and inquiries only! You will receive complete quotes directly from our health insurance providers via phone and/or email. Please respect the efforts of these agents by keeping them informed of your purchasing intentions and estimated timeframe.

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You're almost done! If you have answered all of the required questions above, click the "Submit" button below to finish and send your group health insurance quote request.

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~ The Cleveland,Ohio Insurance Quote Team