Vendor_Selector

VendorSelector

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First Name:	Required
Last Name:	Required
Company Name:	Required
Telephone Number:	Required
Fax Number:
Street Address:
City:
State:	Required
Zip Code:
Email Address:
Website:
Notes:
What is the total number of employees who are eligible for this group health insurance plan 1 - I need personal coverage 2 or more - Please indicate the exact number below
Specify Exact Number If 2 or more Option Selected:
Do you currently offer group health insurance coverage? Yes No
What types of health insurance plans are you currently considering? (check all that apply) Not sure - please help me to determine the best plan for our needs HMO - managed care system with fairly strict in-network regulations PPO - more flexible system permits out-of-network visits with higher co-pay or deductible POS - most flexible managed care system open access to providers with plan covering a lower percentage of costs from out-of-network providers Self-insured - employees deposit premiums into company health insurance fund
How soon would you like health insurance coverage to begin? ASAP In 1 month In 2 months In more than 2 months
What is your estimated annual budget for health insurance? $2,000 - 5,000 $5,000 - 10,000 $10,000 - 20,000 $20,000 - 50,000 $50,000+
What type of industry are you in?:

Testimonials


	"VendorSelector.com is a breath of fresh air and long overdue in the state of Connecticut. It's simple, easy to use, and has become an invaluable resource for finding quality workmanship. Kudos!" David Piersol United Technologies

	"My experience with Vendor Selector has been very positive. What a concept...a one stop shop for trusted vendors. So far each vendor has provided valued direction and been a pleasure to do business with. Thanks again." Jonathan Doleac Ingersol & Rand

	"Well, what do you know. A web tool that really works. I must admit I was a little sceptical at first, but within an hour of filling out a simple form at Vendor Selector I was in contact with an expert who understood my business model, took the time to listen, and of course got the job done right the first time. I whole-heartedly endorse this product." Michael Conrad Cigna Communications Group

Vendor Selector