Group Plan Quote Form

Insurance plans of Florida is an independant agency representing the leading major medical insurance carriers. We can provide companies who would like to control costs but maintain an attractive benefit package for their employees. Please fill out the following information so that we can assist you.

Business Name*:

Nature of Business:

Present Insurance Company:

Renewel Date of Current Plan:

Coverage Types:
(check all that apply)

Contact Name*:

Email*:

Day time Phone*:

Address:

City:

Zip*

HMO

PPO

POS

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