CLICK HERE FOR A PRINTABLE BROCHURE:
Oregon & Washington | Idaho
Three Ways To Submit Your Request for a Quote:
- Complete this form on-line
- Print this form and fax it to us at (503) 968-2817
- Print this form and mail it to us
Note: To provide you a quote we need a census of all participating employees and their dependents.
Minimum census information required for a quote is:
– Last Name / Initial / Employee, Spouse or Dependant? / Birthdate xx/xx/xxxx
Census Form to complete:
Share a Census of all your eligible employees for rating or a quote.
Employee Census Form | Group Life & Disability Census Form
Here is the information we need to prepare your quote:
Quote Request Form
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