Group Health Insurance Lead Sample
Group health insurance leads are similar to business insurance leads in that they require some detailed information that will require a more lengthy questionnaire and can be varied based upon the type of business and the number of employees.
Our group health form requires all contact information and company information as well as details regarding the business, number of employees and an employee census (age|gender|spouse|children). We also ask for the types of coverage that the group is seeking, such as, HMO, PPO, Dental, Vision, Disability and Life. The group health insurance lead can become much more than just group health.
As always, we include room for comments or a description of the exposure.
Group health insurance quote - lead sample
This quote was submitted on: 09/30/2003
CONTACT INFORMATION:
Business Name: ****
Contact Name: ****
Address: ****
City, State Zip: blacksburg, va 24060
Phone: (540) ****
Alternate Phone: n/a
EMail: ****
COMPANY INFORMATION
Number of employees: 12
Business description: coffee shop/retail
Length of time in business: 7 1/2 years
Company contribution toward the plan: 50%
Currently insured: No
BENEFITS DESIRED
HMO: Not Sure
PPO: Not Sure
DENTAL: Yes
VISION: Yes
DISABILITY: Not Sure
LIFE: No
EMPLOYEE INFO (CENSUS)
Age: 35 | Gender: Male | Spouse: No Children: No, Number:
Age: 21 | Gender: Female | Spouse: No Children: No, Number:
Age: 18 | Gender: Female | Spouse: No Children: No, Number:
Age: 20 | Gender: Female | Spouse: No Children: No, Number:
Age: 35 | Gender: Male | Spouse: No Children: No, Number:
ADDITIONAL COMMENTS, NEEDS OR SPECIAL REQUIREMENTS:
we would like to offer health
benefits to all our full time employees, and maybe an option for part time
ones as well.
Alternate contact: **** @ same phone # |
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Insurance Leads
