Request a Quote for Your School

Are you a school administrator or representative that is interested in receiving a quote for your students? Or, do you have an RFP that you would like us to respond to? Send us an email and attach your RFP now. Otherwise, for school administrators or representatives only, complete the Request a Quote form below.

If you are a student or a parent looking for student health insurance, please use Find My School’s Plan to determine the coverage available through your school.

*Required Fields

CONTACT INFORMATION:

Please complete your contact / school information:
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(i.e, 2008/2009)

REQUEST A QUOTE FORM

Do you have an RFP that you would like us to respond to? Send us an email and attach your RFP now. Otherwise, complete the Request a Quote form below.

ELIGIBILITY & ENROLLMENT INFORMATION:

 
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PPO INFORMATION:








MISCELLANEOUS INFORMATION:



PLAN INFORMATION:

To provide the most accurate quote, we would like the last three years’ of claim history as well as the last three years’ plan outlines (brochures).

Please send us an email and attach your claim history and plan outline information.