Health Insurance Quote

Providing “Low Cost - Best Value" Health, Medical and Health Savings Account Insurance Quotes for the self-employed, family, individual, student, dependent only or COBRA recipient.

IMPORTANT NOTE: We cannot provide a quote unless ALL " * " fields are completed!

Name:
Address:
City/State/Zip:
Phone:	Eve: Day:
Fax:
E-mail:

Type of product
Self Employed	Yes No
Individual / Family Health	Yes No
Health Savings Account	Yes No
COBRA Replacement	Yes No
Dependent Only	Yes No
Short Term Medical	Yes No
College Student Health	Yes No
International Medical Insurance	Yes No

Type of policy
Individual	Yes No
Spouse	Yes No
Children	Yes No
Sex	Individual: Spouse:
Individual D.O.B.: Spouse D.O.B.:
Tobacco Use:	Individual: Spouse:
Number of Children	Ages:

Home | Site Map

Health of America Insurance Agency
2901 S Wayzata Blvd., Minneapolis, MN 55405-2126
Phone: 612-377-3222 or Toll Free 1-800-868-2333
Fax: 612-377-3444
Business hours: M-F 8:30 am - 5:00 pm CST