For New York State Business Only

CONTACT INFORMATION

11 Broadway Suite 440
New York, NY 10004

Phone: 212-825-0055
Main Fax: 212-825-0955
Fax: 718-980-5676 (S.I.,NY)
Toll Free: 800-711-4911

 

APPLICATION PAGE - Health Insurance - Request For Quote

Congratulations for taking an active roll in helping your company and yourself!  The average ANNUAL rate increase Nation Wide for companies in the *CDHP is 2.5%. In case you have not taken the time to review the information on the *CDHP, please revisit that decision.

* Consumer Driven Health Plan -

A Healthcare Savings Account (HSA) serves as a medical and retirement-planning savings account that gains tax-free interest. Your employees can withdraw money tax-free to spend on medical expenses or save the money for retirement. Vimo brokers can help you find the right health plans to use with HSAs.

Please advise us if you would like a free quote for an HSA plan.

 Step 1: Contact Information: it only takes one step to get a free quote.
In order for us to provide you with an accurate quote, please provide all required information in the form below. You will be contacted shortly by telephone or e-mail by an Executive Planning Concepts, Inc. company representative. Our company's representatives are uniquely qualified to help you find the health plan as well as the tax savings account that best fits your needs.

Note that * denotes a required field.

Contact Information for Employer Quote
 
Company Name: *
Contact Name: *
Mailing Address:
Zip: *
Contact Method:
Day Phone: *
Fax:
Email Address: *
Business Type:
Number of Employees: *
Comments:

In the comment section enter the employee census. For example 1. employee 2. employee and spouse 3. employee and child(ren)            4. family.  This is all that is required!

So an example would be:

1. Employee  3. Family   5. Employee & Child

2. Employee  4. Family  6. Employee & Spouse

The very best way for your company to proceed is to send us a copy of your existing health insurance invoice and benifit booklet. 

Our  other brokerage (Marquis Brokerage) firm offers personal  insurance, such as homeowners, rentals, coops, condos, auto, umbrella, life  (and many other personal services for the benefit of employers, employees and partners).

 www.Marquisbrokerage.com

                                               email address: marquisbkg@aol.com