Business Name:    
Premises Address:
State:  Florida
Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    Years in Business:
Email Address: (Required) 
Description of Operations or SIC code:

Current Insurance Company: 
Policy Expiration Date:          (mm/dd/yyyy)

Florida Employee Information:

Do you currently offer health insurance benefits to employees?
Group Health Insurance Coverage For:
How many employees to be insured:    

Florida Group Health Insurance Coverage Desired:

HMO Group Health Insurance   HMO Co-Pay Amount Desired:  
PPO Group Health Insurance     PPO Deductible Amount Desired:
POS Group Health Insurance     POS Co-Pay Amount Desired:    
Fee-for-Service Insurance          Fee-for-Service Deductible:         

Choose Benefit Options:
Group Dental Insurance Coverage:
Group Vision Insurance Coverage:
Group Life Insurance Coverage:    

Has any employee to be insured experienced serious
health problems during the last 18 months?

Additional Question or Comment:

Click on the "Submit Quote Request" button below to send
your Florida Group Health Insurance quote request.**

**Information received from this Florida Group Health Insurance quote
request form sent to Optimal Insurance Group will be for our
use only and will not be sold, given to or distributed to any other parties. A
quote will be based on the Florida group health insurance policy information
provided and does not guarantee acceptance of the risk by us. The
precise coverage afforded is subject to meeting underwriting
guidelines, and the terms, conditions and exclusions of the policy
as issued. By submitting this request you acknowledge that this is
neither an offer to insure nor a guarantee of insurance. Completion
of this form does not entitle your business to a Florida Group Health
Insurance plan policy. We are licensed in Florida and will not provide
group health insurance quotes for other states.

Florida Group Health
Insurance Quote
We can provide affordable Florida Group Health Insurance
coverage in the Palm Beach County, Florida area!
Optimal Insurance Group
of Boca Raton, FL offers
comprehensive commercial
insurance coverage options
and affordable business
insurance services
throughout Florida.
Contact us about Florida
Group Health, Commercial
Auto, Commercial Property,
General Liability, and
Business Owners Insurance
at (561) 342-1695.
In addition to Florida
Group Health Insurance
quotes, we also offer
affordable Business Owners
Insurance policy quotes.
We are an independent Boca Raton, Florida insurance agency offering
affordable group health insurance quotes to mid-sized, large, and small
businesses in the following towns, cities and counties in south Florida:
Boynton Beach, Gulf Stream, Delray Beach, Lantana, Rainbow Lakes,
Atlantis, Lake Worth, South Palm Beach, Palm Springs, Greenacres,
Wellington, Haverhill, Palm Beach, Golden Lakes, Riviera Beach, Glen
Ridge, West Palm Beach, Lake Park, Royal Palm Beach, Jupiter, Coral
Springs, Fort Lauderdale, Parkland, Coconut Creek, Margate, North
Lauderdale, Lighthouse Point, Hillsboro Beach, Deerfield Beach, The
Hamptons, Highland Beach, Weston, Plantation, Playland Isles, Melrose
Park, Lauderhill, Sunrise, Tamarac, Wilton Manors, Oakland Park,
Lauderdale Lakes, Sea Ranch Lakes, Villages of Oriole, Pompano Beach,
Lauderdale-by-the-Sea, Boca West, Boca Pointe, Juno Beach, North Palm
Beach, Loxahatchee, Belle Glade, Palm Beach Shores, South Miami, Cutler
Ridge, Princeton, Perrine, Naranja, Homestead, Florida City, Leisure City,
Richmond Heights, Pinecrest, Howard, Coral Way Village, Westchester,
Westwood Lakes, Brownsville, Sweetwater, Key Biscayne, North Bay
Village, Miami Beach, Miami Springs, Virginia Gardens, Hialeah, El Portal,
Miami Shores, Medley, Indian Creek, Surfside, Bal Harbour, North Miami,
Biscayne Park, Pinewood Park, Opa Locka, Bunche Park, Hialeah Gardens,
Palm Springs North, Carol City, Norland, Ojus, Miami Lakes, Biscayne
Gardens, Hallandale, Sunny Isles Beach, Golden Beach, Aventura, Uleta,
Miramar, Pembroke Pines, North Miami Beach, Hallandale Beach, Ives
Estates, Pembroke Park, Coral Gables, Kendall, Dania Beach, Cooper City,
Davie, West Miami, Hollywood, Broward County, Martin County, Miami-Dade
County, and Palm Beach County, FL. We can also offer affordable Florida
group health insurance policy quotes throughout the Sunshine state,
including in Winter Haven, Lakeland, Miami, Orlando, Tampa, St.
Petersburg, Tallahassee, and Jacksonville, FL.
Florida Business Information:
Your Florida Group Health
Insurance Quote Source
Optimal Insurance Group
4800 North Federal Hwy
Suite D-100
Boca Raton, Florida 33431
Palm Beach County FL
(561) 342-1695
Fax: 866-314-4026
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Florida Since 2002!
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