Disability Insurance Quotes for New York Business

Do you have questions about

for your New York business?

New York Group Employee

Disability Insurance Quote

Group Disability Insurance Coverage Information:

New York Business Information:

Business Name:
Premises Address:
City:     State:     Zip Code:
Contact Name:
Phone #:    Ext #:    Years in Business:
Email Address: (Required)
Description of Operations or SIC code:

Current Insurance Company:
Policy Expiration Date:          (mm/dd/yyyy)

Do you currently offer short term disability insurance to employees?
Do you currently offer long term disability insurance to employees?
Length of Group Disability Coverage Needed?

Group Disability Coverage For?
Type of Group Disability Coverage Needed?
How many employees to be insured?

Monthly Benefit Amount For Each Person Insured:
Or Enter a Different Monthly Benefit Amount:         $
Benefit Period Desired For Each Person Insured:
Elimination Period Desired For Each Person Insured:
Payment Mode:

Does any employee to be insured have a hazardous job? Yes No
If Yes, how many have hazardous jobs?

Are any employees to be insured active members of the military reserves? Yes No
If Yes, how many are active members of the military reserves?

Explain Any Recent Workers Compensation Claims Below.

Additional Information or Comments

Click on the "Submit Quote Information" button below to send
your New York Group Disability insurance quote request.**

**Information received from this Group Employee Disability Insurance
quote request form sent to Insurance Plus will be for our use only and will
not be sold, given to or distributed to any other parties. A quote will be
based on the group disability insurance policy information provided and
does not guarantee acceptance of the risk by us. The precise coverage
afforded is subject to meeting underwriting guidelines, and the terms,
conditions and exclusions of the policy as issued. By submitting this
request you acknowledge that this is neither an offer to insure nor a
guarantee of insurance. Completion of this form does not entitle you to a
New York Group Employee Disability Insurance Policy. We are licensed in
New York and will not provide quotes for other states.

We are your local Long Island, NY insurance agency, offering
affordable Group Disability Insurance plan services to businesses in
the following New York City area cities and counties: Oyster Bay,
Huntington, Glen Cove, Port Washington, Roslyn, Syosset, Jericho,
East Hills, Great Neck, South Huntington, Melville, Pinelawn,
Farmingdale, Bethpage, Levittown, Lindenhurst, Babylon, Bay Shore,
Islip, Northport, Hicksville, Westbury, Mineola, Garden City, Long
Island City, Manhasset, Massapequa, Freeport, Lynbrook, Rockville
Centre, Hempstead, Elmont, Valley Stream, Long Beach, Oceanside,
Amityville, Merrick, Bellmore, Jamaica, Brooklyn, Bronx, Flatbush,
Queens, Astoria, and everywhere else in Nassau County, Queens
County, Kings County, New York County, Bronx County,
Westchester County, and Suffolk County, NY.