Peter Briggs Insurance | Health Insurance Online Quote

We offer group health insurance to businesses with 2 or more employees. Please fill out as much of the information below as possible and one of our highly trained staff will contact you with any additional questions.

Request a Business Health Insurance Quote

Please fill out this form and submit it. This will e-mail the info to Peter Briggs Insurance and we can begin preparing a quote for you.

Your Name (required)

First Name:
Last Name:
Name of Business:
Email Address:
*Phone:

Prefer Contact by?

By Phone
By E-Mail

Current Plan

Brief description of current plan (if any):

Employee Information

	Age	Coverage Type
Employee 1
Employee 2
Employee 3
Employee 4
Employee 5
Employee 6
Employee 7
Employee 8
Employee 9
Employee 10

Please note, coverage cannot be bound by an email or fax until we are able to respond to you with a confirmation of coverage.

Peter Briggs Insurance Agency

Request a Business Health Insurance Quote