GROUP HEALTH CARRIERS
We offer a variety of competitive health plans available through the carriers listed below. CLICK ON THE CARRIER LOGO TO GET PLAN DETAIL, APPLICATIONS, AND OTHER NEEDED FORMS.
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WHATS NEEDED TO GET QUOTES AND SUBMIT BUSINESS
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QUOTES (2-50 ee's)
1. Group information:
- Name
- Address including city, state, zip code and county
- Standard Industry Code (SIC)
2. Proposed benefit design
3. Proposed effective date
4. Census information including:
- Employee’s and spouse’s dates of birth
- Number of children
- Contract type (e.g. single, employee/spouse, employee/child(ren), full family)
- Indicate if any employees are eligible for Medicare.
5. *Employee applications including medical information. (WE NEED THIS TO PROVIDE YOU WITH AN ACCURATE RATE)
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51+ Group Quoting Requirements CLICK HERE
SUBMIT BUSINESS (2-50 ee's)
1. Group and Employee Application Forms
2. ODJFS (Ohio Department of Job and Family
Services) Employers Report of Wages Form
3. Copy of Current Carriers Most Recent Billing
Statement
4. Copy of Quote Sold
5. Check for the First Month's Premium
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*We will use any carriers application to get you a prescreened rate. On submission, Anthem and Medical Mutual will require their own employee apps.
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SEND QUOTE REQUESTS AND NEW BUSINESS TO...
Packard Agency
P. O. Box 514
Richfield OH 44286
Email - quotes@packardagency.com
Email - newbusiness@packardagency.com
Fax - 330-659-9337
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