Business Plans

Complete the information below and tell us what you’re looking for. Attached is a census form (for who you are requesting insurance for) for you to download and upload securely. You can also call us to talk about your options at 505-830-2191.

Securely upload the completed census form here.

Census Form

Name*
First Last
Phone*
Email*
Company / Business Name
Total Number of Employees*
Employer Contribution*
# of Pay Periods*
- 26 - Bi-Weekly
- 24 - Semi-Monthly
- 52 - Weekly
HPW (Eligible hours per week)*
Waiting Period*
Contact Names / Titles*
Describe your ideal plan.*
Questions? Other comments?
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