Group Benefits - Receive a Quote

Please fill out the fields below and we will bid your group to different carriers and help you get the best plan for your company.

Company Name:
Contact Person:
Phone:
Address:
City:
State:
Zip:
   

Please enter the following information for your employees. For groups more than 9, please call our office.

  • E 1
  • E 2
  • E 3
  • E 4
  • E 5
  • E 6
  • E 7
  • E 8
  • E 9
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:
Full Name:
Date of Birth:
Married:
Spouse's Birthday:
Number of Children:

 

 

 
Quick Links:
Washington Insurance Commissioner
Medicare Information
Lifewise Health Plan
Asuris
Premera Blue Cross
Mutual of Omaha
Washington Health Insurance Pool
Washington Dental Service
Assocatiation of Wahington Business
© 2007 Desert Insurance Benefits, Inc. - 1006 W Ivy, Moses Lake, WA 98837 - 509.765.5632