Quote Forms

1796Please complete the appropriate form below. If you are not prompted to submit your quote form via e-mail, please save the form to your desktop and e-mail to admin@benefit-design.com as an attachment. If you have any questions, please don’t hesitate to contact us using the information below, or click here to complete our contact form.

 

Group Forms

Group Quote
Group Census

Individual Forms

Life Insurance Quote
Long Term Care Quote
Individual Health Quote
Disability Income Quote

Short Term Health

Apply Here

Health Insurance

Apply for Blue Cross® Blue Shield®

Please complete the appropriate form above. If you are not prompted to submit your quote form via e-mail, please save the form to your desktop and e-mail to admin@benefit-design.com as an attachment.

We can help you

If you have any questions, please don’t hesitate to contact us using the information below, or click here to complete our contact form.

Benefit Design Associates, Ltd.
7975 N. Hayden Rd., Ste. D261
Scottsdale, AZ 85258

Phone: 480.998.0096
Fax: 480.998.7264
Email: admin@benefit-design.com