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1. What is the number of full-time employees participating in your group health insurance policy?     1-20   21-50   51-100   More than 100   2. What month does your current group health insurance renew?   Health -- Please Select -- Not Applicable January February March April May June July August September October November December Life -- Please Select -- Not Applicable January February March April May June July August September October November December Disability -- Please Select -- Not Applicable January February March April May June July August September October November December Dental -- Please Select -- Not Applicable January February March April May June July August September October November December Vision -- Please Select -- Not Applicable January February March April May June July August September October November December   3. Who is your company’s group health insurance carrier/broker?     4. Would you like:   A NO-OBLIGATION premium/benefit comparison from all available insurance carriers in your area for: (Check plans you would like provided)   Health Life Disability Dental Vision Information on alternative insurance funding options such as Health Savings Accounts or Health Reimbursement Accounts?   Yes   No     To speak to a Patton Group Insurance Professional about your company’s employee benefits program?   Yes   No   If you have other questions or comments, please type them here.         Your Name:   Your Company's Name:   Daytime Phone Number:   Email Address:   For security reasons, please enter the code below exactly as it is shown.       Home  |  Free Quote  |  Our Agents  |  Our Products  |  Our Carriers  |  Contact Us       The Patton Group   ::   1041 S. Queen Street, York, PA 17403   ::   Phone: 717.812.1982   ::   Fax: 717.812.9929     © 2008 The Patton Group