Copy of Get A Quote

Get A Quote

This page provides several forms helpful in gathering the required information to quote and eventually apply for health benefits. Below is a list of our forms. Please select the one that fits your needs, download and print the form. After filling out the form, you can e-mail, mail or fax the form to our office


Health Insurance

This form is for an individual or family requesting a quote for health benefits

This form is for companies with up to 1 employee that wish to look into rates for a group plan. If you have an excel spreadsheet with the employees that you would like quoted, please email that file to [email protected].

Please feel free to run your own Humana Medical, Dental &/or Vision quotes, as well as Life and Supplemental plans. Click on the Humana image. If you have any questions feel free to contact us at 1-800-798-6772


Dental Insurance

Click on the Spirit Dental logo to obtain an individual quote. If you have any questions feel free to contact us at 1-800-798-6772.


Vision Insurance

Click on the Direct Vision logo to obtain an individual vision quote. If you have any questions feel free to contact us at 1-800-798-6772.

Click on the UnitedHealthcare button to obtain an individual vision quote. If you have any questions feel free to contact us at 1-800-798-6772. Click on the following link to look up providers in your area https://www.myuhcvision.com/MWP/Landing


Healthy Paws Pet Insurance covers everything that matters including injuries, illnesses, genetic conditions, and emergency care. With unlimited lifetime benefits, protect your pet with the #1 customer-rated pet insurance plan! Get a free quote and let Healthy Paws pay your vet bills while you care for your pet.