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
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