Free Group Health Quote Request

Remember that ALL information used for your quotes will be kept strictly confidential and secure. Please allow 1-2 business days for a representive from Health Insurance Depot to contact you.

Basic Information

* Indicates a Required Field

Group Name:

A value is required.*

City:		State:
Zip Code:	* A value is required.Invalid format.	Country:
Day Phone:	* A value is required.	Evening Phone:

Best Time to Call:

Email Address:

A value is required.Invalid format.*

Desired Benefits

Effective Date:

Plan Type:

HSA Plans
Copay Plans

Deductible Amount:

$250 - $1,000
$1,250 - $3,500
$5,000 - $10,000

Coinsurance Level:

100/0
80/20
70/30
50/50

Vision Coverage::

Yes
No

Supplemental Accident:

Yes
No

Dental Coverage:

Yes
No

Short-Term Disability:

Yes
No

Long-Term Disabiltiy:

Yes
No

Life Insurance:

Yes
No

Employee Census Information

Last Name

First Name

Age

Gender

Spouse Age

# of Dependents

Occupation

+ Add Employees

Last Name

First name

Age

Gender

Spouse Age

# of Dependents

Occupation

For Groups Larger Than 25, Please Download Our Cenus Form Here and Fax to (843) 875-2265.


Additional Comments:

"Thanks guys, you saved our family a great deal of money on our health insurance premiums while still getting us better coverage. After meeting with you I now have a much better understanding of how health insurance works!”

- Jane

Summerville, SC

"I couldn't have asked for a better deal. Because of our Health Insurance Depot representive, I was able to lock in my rate for 4 years. Now that's what I call peace of mind!"

- Gary

Columbia, SC