GROUP QUOTE/PROPOSAL FOR OVERSEAS MEDICAL INSURANCE

QUOTE FORM FOR GROUP INSURANCE

Download Census/Group Insurance Quote Forms - PDF file format

The first step in getting an international group health insurance quote is to fill in a “Request for Group Quote” and a “Census.” These two forms are included on the pdf file on this page. Once we receive this information we will approach several companies for a group health quote.

THE “REQUEST FOR GROUP QUOTE” FORM

This form will ask for contact information, deductibles requested, maximum amounts of coverage, etc., and also information on any major medical concerns in the group such as cancers, heart problems, pregnancies.

THE “CENSUS” FORM

The census will ask for the employee’s name, age, employment date, country of citizenship and country of residence. The insurance company will also need a list of dependents with their ages. This is important because group insurance always considers the average age of the group. Also the country of residence is needed because some companies do not provide group coverage in certain countries.

It is important that all employees be listed on the census form, not just the ones that want insurance. That doesn’t mean that someone who has insurance through another source, e.g., Medicare will be required to take out insurance. But the insurance companies do want everyone listed.

THE PDF FILE

The PDF file on this page contains both the “Census” and “Request for Group Quote.” After filling out these forms, please mail or fax them back to Good Neighbor Insurance, or you may scan and send them to us as an email attachment.

Good Neighbor Insurance
690 E. Warner Rd. Suite 117
Gilbert, AZ 85296

Fax: 480-813-9930