To help our insurance representatives
better understand your Group Health insurance needs, please complete the
following form below and click the “Submit” button for a free, no-obligation
quote. A PaulBalep representative will call you to set up a meeting to
discuss your insurance and financial goals. Please provide the information
for every eligible employee: name, residence address, date of birth, coverage
type (employee - employee plus one - family). An eligible employee is an
active, full-time employee who works at least 30 hours per week on a regular
scheduled basis and is included on the employer's payroll for Social Security
and Federal Income Tax Withholding, regardless of whether he/she is covered
on a current Group Health Insurance Plan.
Privacy Notice: All information you provide is solely
used for the purpose of providing you with quotes. We will never sell,
give, or otherwise transfer your personal information to any person or
entity other than the insurance companies, agents, and representatives
selected. In some cases insurance companies we work with may request credit
score.
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