Group Insurance Quote Request:

Please complete this short questionnaire (along with a Group census) for your FREE no obligation quotes. Your quote request will be submitted to the appropriate insurance carriers and quotes provided promptly to you upon receipt from the insurer (averages two to four business days).

* = Required Information

Business & Contact Information:

Contact name*
Company*
Address*
City*
State*
Zip*
Phone*
Fax
Email*
Send quotes via
 Phone Fax Email Mail
Industry
Industry SIC code
Total time in business
Type of plan(s) desired
HMO PPO HSA Dental

Current Health Insurance (if any):

Insurer
Deductible $
Office Copay $
RX
Plan #
Current premium
Renewal premium
Renewal date
Premium includes
Vision Dental STD LTD
Employer contribution %
Section 125 Cafeteria plan set up for company? Yes No

Employee Count :

Total number of employees
Number of employees covered by health plan
Number insured thru spouse
Number that reside outside NH
Additional Comments
 

Direct Contact Information

Mailing Address

ABS LLC
P.O. Box 16234
Hooksett, NH 03106

Phone Numbers

Nashua, NH:
603-598-2596

Hooksett, NH
603-622-5700

Toll Free:
1-877-842-1546

Fax Number

603-218-6447

Email

Email Affordable Benefit Solutions