Serving Palm Beach, Martin, St. Lucie, Broward and Miami-Dade Counties in South Florida

Providing Universal Life Insurance, Whole Life Insurance, Term Life Insurance, Individual Health Insurance, Group Health Insurance, Employee Benefits, Dental Insurance, Disability Insurance, Vision Insurance, Section 125 Documents in the following towns/cities in Palm Beach County: Aberdeen, Belle Glade, Belle Glade Camp, Boynton Beach, Bryant, Canal Point, Cypress Lakes, Delray Beach, Golden Lakes, Golf, Greenacres, Hamptons at Boca Raton, Highland Beach, High Point, Juno Beach, Juno Ridge, Jupiter, Jupiter Inlet Colony, Kings Point, Lakeside Green, Lake Clarke Shores, Lake Harbor, Lake Park, Lake Worth, Lake Worth Corridor, Lantana, Loxahatchee Groves, Mission Bay, North Palm Beach, Okeelanta, Pahokee, Palm Beach Gardens, Riviera Beach, Royal Palm Beach, Royal Palm Estates, Sandalfoot Cove, South Bay, Tequesta, Twentymile Bend, Wellington, West Palm Beach.

We also serve the following towns/cities in Martin County: Arundel, Hobe Sound, Hutchinson Island South, Indiantown, Jensen Beach, Jupiter Island, North River Shores, Ocean Breeze Park, Palm City, Port Mayaca, Port Salerno, Sewall's Point, Stuart, William Field.
Additional counties we serve in South Florida are Miami-Dade, Broward and St. Lucie.

Forms are provided below for your convenience. Completed forms must be printed out as they cannot be saved on your computer.

BLUE CROSS

New Business:
Employee Health Enrollment Form
Employer Application

Renewal:
Employee Health Change Form
Enrollment Summary
Small Group App Amendment

Medical Questionnaires:
Small Group Medical Questionnaire 4-50
Large Group Medical Questionnaire 51+
Individual Medical Questionnaire

Florida Combined Life:
Employee PPO Dental Change Form