Rapid Rates - Group Insurance

Group Life insurance is very similar to individual life insurance. The primary difference is there is usually less choice in the types of life insurance available in group policies. However, group life insurance is easier for people with health problems to get, much the same as group health insurance.

Group Health insurance is similar in form to individual health insurance. The primary differences are the conditions under which a person my apply and the requirements for acceptance. Before applying through a group a person must satisfy the waiting periods and employment requirements of the group. However, once an application can be made the conditions for acceptance are usually less strict than with an individual policy. Also, certain protections under the law are available for members of group policies that are not available to owners of individual plans.

Group Disability insurance similar in form to individual disability insurance. It covers a percentage of an insured's income upon a disabling accident or event. The two main differences are the conditions upon which a person may apply, and the requirements for acceptance. Before applying through a group a person must satisfy the waiting periods and employment requirements of the group. However, once an application can be made the conditions for acceptance are usually less strict than with an individual policy.

Please fill in this form as completely as possible in order to ensure a proper rating for your submission.

First Name
Last Name
Street Address
City
State
Zip Code
Day Phone
Evening Phone
E-mail Address
Birthday (mm/dd/yy)	19
Best time to call:

Employee / Family Member 1

Employee Name	M/F	Age	Status

Occupation	Salary	Currently Insured?	Plan type
	$

Employee / Family Member 2

Employee Name	M/F	Age	Status

Occupation	Salary	Currently Insured?	Plan type
	$

Employee / Family Member 3

Employee Name	M/F	Age	Status

Occupation	Salary	Currently Insured?	Plan type
	$

Employee / Family Member 4

Employee Name	M/F	Age	Status

Occupation	Salary	Currently Insured?	Plan type
	$

Employee / Family Member 5

Employee Name	M/F	Age	Status

Occupation	Salary	Currently Insured?	Plan type
	$

Would you like to submit an additional rate request for this group? If so what type?

Life Insurance
Annuities (Retirement Vehicle)
Disability Insurance
Long Term Care Insurance
Health Insurance
Auto Insurance
Homeowners Insurance
Home Loans