Group InsurancePlease enable JavaScript in your browser to complete this form.1Step 1: Your Company2Step 2: Select your plan3Step 3: Send Quote The premium of an employee benefit plan is based on a number of factors including the makeup of your group (your employees), characteristics such as their age, gender, the type of work they do etc. Our aim is to simplify the process of receiving a quote for you by putting you in control. It only takes 2 steps: Step 1. Your Company: please provide information about your company and employees. Step 2. Your plan: please select either a pre-selected plan (Quick quote) or choose the details of your plan. We then take you to the market and provide you with a quote. Our turn around time is about 5 business days. Please answer questions in the next 2 steps and fell free to contact us, if you need help when completing the forms. Name *Email *PhoneCompany Name *Company AddressAddressNumber of Year in BusinessEmployees information Add1Name or InitialsGenderMaleFemaleOtherBirth DateFamilySingleFamilyCovered by SpouseJob TitleHire DateIncome(Year)*Add-22Name or InitialsGenderMaleFemaleOtherBirth DateFamilySingleFamilyCovered by SpouseJob TitleHire DateIncome(Year)*Add-33Name or InitialsGenderMaleFemaleOtherBirth DateFamilySingleFamilyCovered by SpouseJob TitleHire DateIncome(Year)*Add-44Name or Initials Gender MaleFemaleOtherBirth Date Family SingleFamilyCovered by SpouseJob Title Hire Date Income(Year)* Add-55Name or Initials Gender MaleFemaleOtherBirth Date FamilySingleFamilyCovered by SpouseJob Title Hire Date Income(Year)*Add-66Name or Initials Gender MaleFemaleOtherBirth DateFamily (copy) (copy) (copy) (copy) (copy) (copy)SingleFamilyCovered by SpouseJob Title Hire Date Income(Year)* Add-77Name or Initials Gender MaleFemaleOtherBirth DateFamily SingleFamilyCovered by SpouseJob TitleHire Date Income(Year)* Add-88Name or Initials GenderMaleFemaleOtherBirth Date Family SingleFamilyCovered by SpouseJob Title Hire Date Income(Year)* Add-99Name or Initials GenderMaleFemaleOtherBirth Date Family SingleFamilyCovered by SpouseJob TitleHire DateIncome(Year)* Add-1010Name or Initials Gender MaleFemaleOtherBirth Date Family SingleFamilyCovered by SpouseJob Title Hire DateIncome(Year)* Add-1111Name or Initials GenderMaleFemaleOtherBirth DateFamily SingleFamilyCovered by SpouseJob Title Hire DateIncome(Year)* Add-1212Name or Initials Gender MaleFemaleOtherBirth Date Family SingleFamilyCovered by SpouseJob Title Hire Date Income(Year)* Add1313Name or Initials GenderMaleFemaleOtherBirth Date Family SingleFamilyCovered by SpouseJob TitleHire DateIncome(Year)* (Add-1414Name or Initials Gender MaleFemaleOtherBirth DateFamily SingleFamilyCovered by SpouseJob Title Hire DateIncome(Year)*Add-1515Name or Initials Gender MaleFemaleOtherBirth DateFamily SingleFamilyCovered by SpouseJob TitleHire Date Income(Year)* Add-1616Name or Initials Gender MaleFemaleOtherBirth Date Family SingleFamilyCovered by SpouseJob Title Hire DateIncome(Year)* Add-1717Name or Initials Gender MaleFemaleOtherBirth Date FamilySingleFamilyCovered by SpouseJob TitleHire Date Income(Year)* Add-1818Name or Initials Gender MaleFemaleOtherBirth Date Family SingleFamilyCovered by SpouseJob TitleHire Date Income(Year)* Add-1919Name or Initials Gender MaleFemaleOtherBirth Date FamilySingleFamilyCovered by SpouseJob TitleHire Date Income(Year)* Add-2020Name or Initials GenderMaleFemaleOtherBirth Date FamilySingleFamilyCovered by SpouseJob Title Hire Date Income(Year)*Tick the last box to add more employees NextSelect your plan: Choose PlanQuick QuoteCustom PlanCheckboxesQuote based on industry benchmarkLife Insurance& AD&DSalary-based1 x2 x3 x4 x5 xor Flat10,00025,00050,000100,000Max NEMMaxOtherDependant Life (Spouse/Child)Dependent Life (Spose/Child)5,000 / 2,50010,000 / 5,00015,000 / 7,50020,000 / 10,00025,000 / 12,500Critical IllnessTypeBasicEnhancedSalary-based1 x2 x3 x4 x5 xor Flat10,00025,00050,000100,000Max NEMMaxOtherSTDBenefit Coverage55 %60 %66.67 %GradedBenefit Coverage15 Weeks17 Weeks26 WeeksWaiting Period Accident1 Day8 Days15 DaysWaiting Period Illness1 Day8 Days15 DaysFirst-Day HospitalYesTaxableYesMax2505007501000LTDBenefit Coverage55 %60 %66.67 %GradedBenefit Coverage15 Weeks17 Weeks26 WeeksWaiting Period Accident1 Day8 Days15 DaysWaiting Period Illness1 Day8 Days15 DaysFirst-Day HospitalYesTaxableYesMax2505007501000HealthcareCoinsurance50 %60 %70 %80 %90 %100 %Deductible0 / 025 / 2525 / 5050 / 5050 / 100100 / 100100 / 200250 / 250250 / 500Paramedical1502002503003504005007501000Paramedical Coins50 %60 %70 %80 %90 %100 %Per Visit Max1020253035Reasonable CustomaryHospitalWardSemi-PrivatePrivatePrivate Duty Nursing5,00010,00015,000Diagnostic Services5001,000UnlimitedVisionEye Exams OnlyYesCoverage (Glasses, Contacts)100150200250300Max150200250300Prescription DrugsReimbursementPaperDrug CardDeferred Card (QC Only)Coinsurance50 %60 %70 %80 %90 %100 %MaximumUnlimited1,0001,5002,0003,0004,0005,00010,00015,000DispensingBrandEnhanced GenericGenericDeductible12510Disp. FeeDispensing Limit345678910Smoking Cessation IncludedYesVaccines IncludedYesFormularyBy LawOver the CounterNational FormularyProvincial FormularyAcute/Specialty MaintenancePharmacy Network Value Plan Health Insurance Life Insurance UncategorizedTherapeutic Class PricingYesDentalcareDeductible0 / 025 / 2525 / 5050 / 5050 / 100100 / 100100 / 200250 / 250250 / 500Combined W/HealthRoutine Coinsurance50 %60 %70 %80 %90 %100 %Routine Max1,0001,5002,0002,500UnlimitedMajor Coinsurance50 %60 %70 %80 %Major MaxCombined W/Routine1,0001,5002,0002,500UnlimitedOrthodontic Coinsurance*50 %60 %* Minimum # of employees requiredOrthodontic Max*1,0001,5002,0002,500* Minimum # of employees requiredRecall Exams2 / Year1 / 9 Months1 / 12 MonthsScaling Units61014 CoverageCoveragePlan APlan BLife Insurance $25,000 $25,000 AD&D Insurance $25,000 $25,000 Critical Illness insurance $25,000 $25,000 Health Care 80% coverage 80%coverage -Paramedical Practitioners Chiropractor $350 /yr $500 /yr Physiotherapist $350 /yr $500 /yr Osteopath $350 /yr $500 /yr Podiatrist $350 /yr $500 /yr Masseur $350 /yr $500 /yr Speech therapist $350 /yr $500 /yr Acupuncturist $350 /yr $500 /yr Naturopath $350 /yr $500 /yr Psychologist $350 /yr $500 /yr Drug CareEnhanced $1500 with80% coverage $2000 with80% coverage Vision Care (per 24 months) $200 with80% coverage $250 with80% coverage Dental Care Basic $1500/yr with80% coverage $2000/yr with80% coverage Major 50% 50% PreviousNextCommentsPreviousSubmit
