Castle Group Health Inc.
899 Skokie Blvd. - Northbrook, IL 60062
Local Phone: 847-559-8100 Toll Free: 877-559-8100

 
 
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From Our Blog

5/13/2010 3:04:00 AM
Small Business Health Insurance Credit Info
Companies with less than 25 employees who provide employer sponsored health insurance plans may be eligible for tax credits of up to 35% of the...
 

Group Health Insurance Form

* Required

Please indicate the total number of employees, including yourself, who are eligible for this group health insurance plan:*
 
Do you currently offer health insurance?*
 
What types of health insurance plans are you considering offering?*
 
In addition to primary medical, what types of coverage would you like to offer?*
 
In what states do you have employees residing in?*
 
How many years has your company been in business?*   
 
How many eligible employees do you have within each of the following groups?*
Single Employees:
Married / Legally Cohabiting:
Single employees with one or more children:
Employees with families: 		 
 
Your Name*
 
Your Title/Position*
 
 - 
Your Phone Number*
 
Your E-mail Address*
 
Additional Comments
 
 
 
 
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