Free Quote Step 1 of 6 16% Name of School*Affiliation/Division:*Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Information Provided By:PhoneFax: Number of ParticipantsMenWomenTotal # of Participants Previous Insurance Information2022 - '23DeductibleMedical MaximumBenefit PeriodAD&DPremium# Claims PaidAmount of Benefits PaidName of Insurance CompanyName of Claims Payor/TPA 2023 - '24DeductibleMedical MaximumFull Coverage for HMO/PPO Denials Yes No Full Coverage for Pre-existing Conditions Yes No Benefit PeriodAD&DPremium# Claims PaidAmount of Benefits PaidName of Insurance CompanyName of Claims Payor/TPA 2024 - '25DeductibleMedical MaximumFull Coverage for Expanded Medical(wear and tear injuries) Yes No Full Coverage for Heart & Circulatory Yes No Full Coverage for HMO/PPO Denials Yes No Full Coverage for Pre-existing Conditions Yes No Benefit PeriodAD&DPremium# Claims PaidAmount of Benefits PaidName of Insurance CompanyName of Claims Payor/TPA 2025 - '26DeductibleMedical MaximumFull Coverage for Expanded Medical(wear and tear injuries) Yes No Full Coverage for Heart & Circulatory Yes No Full Coverage for HMO/PPO Denials Yes No Full Coverage for Pre-existing Conditions Yes No Benefit PeriodAD&DPremium# Claims PaidAmount of Benefits PaidName of Insurance CompanyName of Claims Payor/TPAIn order to obtain quotes, we must have copies of your detailed, loss/claims reports for the last 4 years (back to 12-13) (true losses-excluding admin fees)
