Business Name:    
Premises Address:
Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    Years in Business:
Email Address: (Required) 
Explanation of Business Operations:

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 Information:

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

**Information received from this Florida Group Health Insurance quote
request form sent to FCI Insurance Agency 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 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 are a Davie, FL insurance agency offering Florida group health
insurance quotes to small, mid-sized and large businesses located in the
following cities and counties: Coral Springs, Fort Lauderdale, Parkland,
Coconut Creek, Margate, North Lauderdale, Lighthouse Point, Hillsboro
Beach, Deerfield Beach, Boca Raton, 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, Delray Beach, Boca Pointe, Boynton Beach, Lantana, Rainbow
Lakes, Atlantis, Lake Worth, Miami, 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, 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, West
Miami, Hollywood, Broward County, Palm Beach County, and Miami-Dade
County, FL. We can also offer Florida group health insurance quotes to
small businesses throughout the Sunshine state, including in Orlando,
Tampa, St. Petersburg, Sarasota, Tallahassee, Gainesville, Pensacola,
Ocala, and Jacksonville, FL.

FCI Insurance Agency of
Davie, FL offers affordable
and comprehensive
business insurance coverage
services throughout Florida.
Contact us about Florida
Business Liability, Group
Health, and Commercial
Auto Insurance at (954)

In addition to Florida
Group Health Insurance
quotes, we also offer
affordable Business
Liability Insurance policy
We offer small business Florida Group Health
Insurance policy services throughout Broward County, FL!
Florida Business Information:
Your Florida Group Health
Insurance Quotes Connection
FCI Insurance Agency
& Auto Tag Service
8230 Griffin Road
Davie, Florida 33328
Broward County FL
(954) 434-6515
Fax: (954) 434-6524

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