Bennett & Bennett Insurance Inc - Phone: 812 - 738-2233

Health Insurance

Bennett & Bennett Insurance Inc. offers individual, family, and group health insurance coverages. Fill out the form(s) below and hit the "Submit" button, and we will get back to you as quickly as possible with a quote for coverage to meet your needs.

Individual or Family

First Name
Last Name
Address
City
State
Zip Code
Phone
What Deductible
Doctor Co-Pay
Prescriptions
	Yes
	No
Age
Smoker
	Yes
	No
Gender
	Male
	Female
Occupation
Height
Medical Conditions
Medications
Group Coverage
Bennett & Bennett Insurance Inc. can quote as few as 2 people to provide a group health quotation. Please provide the following information for all employees participating in the plan.
Employee 1 Name
Employee 1 Age
Employee 1 Gender
Employee 1 Dependent Coverage (Spouse/Children/Family)
Employee 1 Medical Issues
Employee 2 Name
Employee 2 Age
Employee 2 Dependent Coverage (Spouse/Children/Family)
Employee 2 Medical Issues
Employee 3 Name
Employee 3 Age
Employee 3 Gender
Employee 3 Dependent Coverage (Spouse/Children/Family)
Employee 3 Medical Issues
Employee 4 Name
Employee 4 Age
Employee 4 Gender
Employee 4 Dependent Coverage (Spouse/Children/Family)
Employee 4 Medical Issues