Do you have questions about
Health Savings Account
Quote Request
Business Name:    
Premises Address:
City:     State:     Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    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 Health Savings Account options to employees?
Want Health Savings Accounts For:
How many employees to be insured:

Has any employee to be insured experienced serious health
problems during the last 18 months?
If "Yes", please explain below.



Additional Information or Comments



Click on the "Submit Quote Information" button below to send
your New York Health Savings Account quote request.**



New York Business Information:
**Information received from this Group Health Savings Account 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 health savings account 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 your business to a New York Group Health
Savings Account. We are licensed in New York and will not provide quotes
for other states.

We are your local Long Island, NY insurance agency, offering Health
Savings Account 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,
Cove Neck, Bayville, Locust Valley, Lattingtown, Matinecock, Mill Neck,
Sea Cliff, Centre Island, Brookville, Locust Grove, Muttontown, East
Norwich, Old Westbury, North Massapequa, Seaford, Manorhaven,
Huntington Station, Huntington Bay, Greenlawn, Commack, Plainview, Deer
Park, Farmingdale, West Babylon, Brentwood, Central Islip, East Northport,
Centereach, Coram, Riverhead, Lido Beach, New Suffolk, Port Jefferson,
and everywhere else in Nassau County, Queens County, Kings County, New
York County, Bronx County, Westchester County, and Suffolk County, NY.

Insurance Plus
15 W. Main Street
Oyster Bay, New York 11771
(516) 922-1200
(212) 268-4473
Fax: (516) 922-5900
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New York
In addition to Group
Health Savings Accounts,
we also offer affordable
Group Long Term Care
Insurance plan services.
Contact us today
about Group Health,
Life, Disability, Long
Term Care Insurance,
and other insurance
services for your New
York business.
516-922-1200
212-268-4473

Insurance Plus offers
affordable Group
Health Insurance
coverage options and
experienced business
insurance services
throughout New York.
Employee Health Savings
Account Plan Quote
Group Insurance
Quotes
Obtain information about NY Health Savings Accounts for businesses
New York Health Insurance Specialists
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Plus