Benefits Management Group - Medical Insurance, Human Resources, Employee Benefits, NewYork, Vermont, Massachusetts


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Phone: 845-691-4945 508-821-2995 E-Mail: info@your-medical-insurance.com

Here you may request a quote from us on Health, Dental and Life Insurance. For all other lines contact us directly.

For Groups of 2 or more please use the quoting tool below.

For groups of 1, either sole proprietor, 1099, or working uninsured living in NY State please e mail us at info@your-medical-insurance.com with your name, address, zip code age, gender and number of dependants and we will send you information on several available plans.

For multiple quotes you need not repeat information such as number of employees. For single quotes please fill in the fields under the product you wish to see. For all quotes please begin with General Information.

We will contact you if we need more information to quote and when the quote is prepared for you. Quote requests will be responded to in a timely fashion.


General Information
Name of Business: (required)
Street Address:
City:
State:
Zip:
Contact Person: (required)
Title:
Email:
Business Phone: (required)
Fax:
I Heard About BMG:
Nature of Business:

For Group Health
Number of employees:
Number of Eligible:
Current Carrier:
Contract Renewal Date:
Current Plan:
Please describe what type of plan you'd like, desired Co-Pays, Deductible, Coinsurance, etc and the reason you desire a quote (e.g. save money, better plan, just shopping):

For groups of over 51 a census including Date of Birth, Gender, Zip Code of residence, family status is required.

Group Dental Coverage
Number of employees:
Number of Eligible:
Current Carrier:
Current rate:
Deductible Coinsurance:
Preventive:
Basic:
Major:
Annual Maximum Benefit:
Orthodontia:	Yes No Both
Please describe the type of plan you want (DMO, PPO, Indemnity, Voluntary) and any other information of request for your dental plan.


Group Life and Ad&d
Number of employees:
Number of Eligible:
Current Carrier:
Current rate:
Death Benefit Amount:
Supplementary:	Yes No
Dependant:	Yes No
Census data including date of Birth, Gender, Job title/earnings is required.

For disability and Long term care please contact us