PA Group Health Insurance Quotes

** Information received from this Pennsylvania Group Health Insurance quote request form sent

to JDC Benefits, LLC 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 group health insurance 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 you to Group Employee Health

Insurance. We are licensed in Pennsylvania, New Jersey, and Delaware. We will not provide

quotes to businesses located in other states.

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)

Employee Information:
Do you currently offer health insurance benefits to employees?
Group Health Insurance Coverage For:
How many employees to be insured:

Pennsylvania Group Health Insurance Coverage Desired:
HMO Group Health Insurance   HMO Co-Pay Amount Desired:
PPO Group Health Insurance     PPO Deductible Amount Desired:
POS Group Health Insurance     POS Co-Pay Amount Desired:
Fee-for-Service Insurance          Fee-for-Service Deductible:

Choose Benefit Options:
Group Dental Insurance Coverage:
Group Vision Insurance Coverage:
Group Life Insurance Coverage:

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 Pennsylvania Group Health insurance quote request.**

We are your local Allentown, PA area insurance agency, offering affordable
employee group health insurance plan premiums and services for
businesses in the following Pennsylvania cities and counties: Philadelphia
County, Delaware County, Montgomery County, Chester County, Bucks
County, Lehigh County, Berks County, Lancaster County, York County,
Emmanus, Hellertown, Whitehall, Cetronia, East Texas, Lanark, Dorneyville,
Wagnersville, Catasauqua, Walbert, Farmersville, Stiles, Friedensville,
Mechanicsville, Hanover, North Catasauqua, Stroudsburg, King of Prussia,
Springfield, Woodlyn, Chester, Norwood, Ridley Park, Prospect Park, Folcroft,
Darby, Swarthmore, Drexel Hill, Rutledge, Yeadon, Upper Darby, Secane,
Milmont Park, Garden City, Wallingford, Morton, Aldan, Primos, Pilgrim
Gardens, Colwyn, Lester, Essington, Eddystone, Landsdowne, Fernwood,
Milbourne, Havertown, Broomall, Penn Wynne, Merion Station, Wynnewood,
Haverford, Penn Valley, Bala-Cynwyd, Ardmore, Rosemont, Overbrook,
Belmont Hills, Villanova, Rebel Hill, Gulph Mills, Gladwyne, Conshohocken,
Kings Manor, Swedeland, Swedesburg, Bridgeport, Norristown, Lafayette
Hill, Plymouth Meeting, Erdenheim, Oreland, Flourtown, Ardsley, North Hills,
West Conshohocken, La Mott, Cheltenham, Melrose Park, Elkins Park,
Glenside, Wyncote, Roslyn, Abington, Huntingdon Valley, Rydal,
Meadowbrook, Jenkintown, Hollywood, Rockledge, Somerton, Bustleton,
Torresdale, Holmesburg, Tacony, Kensington, Feltonville, Frankford, Olney,
Andalusia, Cornwells Heights, Bridgewater, Croydon, Bensalem,
Nottingham, Bristol, Edgely, Newportville, West Bristol, Strafford, Devon,
Berwyn, Port Kennedy, Newtown Square, Gradyville, Cheyney, Concordville,
Narberth, Milltown, Westtown, Trainer, Marcus Hook, West Chester,
Lancaster, York, Reading, Bethlehem, Pottstown, Coatesville, Kulpsville,
Warminster, Montgomeryville, Levittown, Valley Forge, Malvern, Green Tree,
Paoli, Devault, Chatwood, Goshenville, Sugartown, Glenloch, Chester
Springs, Audubon, Eagleville, Evansburg, Worcester, Blue Bell, Center
Square, Fort Washington, Philadelphia, Doylestown, Chalfort, Quakertown,
Perkasie, Sellersville, Soudertown, Willow Grove, Warrington, Morrisville,
Ambler, Lower Gwynedd, Washington Crossing, New Hope, Richboro,
Feasterville, Southampton, Langhorne, Holland, Newtown, and Yardley, PA.

We also offer affordable group health insurance services to businesses located in the following Delaware
counties and cities: Castle County, Kent County, Sussex County, Newark, Claymont, Middletown, Dover,
Milford, Georgetown, Seaford, Yorklyn, Centerville, Talleyville, Greenville, Newport, New Castle, Hillcrest,
Elsmere, Penny Hill, Graylyn Crest, Ardentown, Hockessin, Delaware Heights, Devonshire, Arden, Fairfax,
Dunleith, Meadowood, Sherwood Park, Wilmington Manor, Lancaster Village, Ashland, Penn Acres, Green
Acres, Darley Woods, Wilmington Gardens, Ogletown, Delaware City, Woodland Beach, Bay View Beach,
Wilmington, DE; as well as offering group health insurance services in the following New Jersey counties
and cities: Mercer County, Burlington County, Camden County, Gloucester County, Salem County, Cumberland
County, Atlantic County, Camden, Vineland, Ewing, Cherry Hill, Pennsauken, Willingboro, Collingswood,
Palmyra, Delran, Cinnaminson, Moorestown, Riverside, Gloucester City, Bellmawr, Runnemede, Burlington,
Edgewater Park, Haddonfield, Maple Shade, Princeton, Mercerville, Slackwoods, Yardville, White Horse,
Mansfield, Atlantic City, Margate City, Ocean City, and Trenton, NJ.