Health Questionnaire

Health Questionnaire

Hello, let's get started
on your quote.

1. What we need

Honest and complete health information in order to provide a more accurate quote.

2. What you will get

We will review the information, prequalify your eligibility to apply, and email you personalized quotes.

3. After that

Let's talk to finalize a plan, answer your questions, and take your application.

4. Application

Once you are ready, your application is taken over the phone and signed and submitted electronically. 

Fast & Easy

Fast & Easy

Takes 5-10 minutes to complete about 30 questions
Good to have

Good to have

Make sure to have your prescriptions handy
The Insurance

The Insurance

Is available in the 50 U.S. states and D.C.
Important!

Important!

This questionnaire is
HIPAA compliant

About us

Our specialists make it easy to understand and own an insurance plan to help address what is important to you and your budget.

Karry Ballinger, CLTC

Specialist

Nancy Dykeman, CLTC, CSA

Specialist

Lori Gubash, CLTC

Specialist

James Haunroth, CLTC

Specialist

Rhonda Leach-Potter, CLTC

Specialist

Natalie Murch, CLTC, ChFC

Specialist

Elizabeth Quinn, CLTC

Specialist

Katherine Robbins, CLU

Specialist

Blaine Webb

Specialist

Maria Garcia

Sales Support

Pam Najdowski

Case Manager

Matthew Dean, CLTC, FLMI, HIA, ACS

Vice President

Steve Cain, CLTC

National Sales Leader