Health Insurance for Small Businesses

Why Health-Saver.com?

*Quality Plans - compare leading health insurance companies

*Best Prices - carrier-direct rates real-time quotes

*Fast Process - online applications up to 50% faster

	FAX 1-408-245-8899
	EMAIL ycj99@msn.com
	MAIL 10680 S. De Anza Blvd. Suite B, Cupertino, CA 95014

HEALTH INSURANCE SPECIALIST

	Blue Shield Authorized On-line Service - 4 Hours Completed
	We come to your home to help fill out application forms
	Agent for all major health insurance companies

A) Your Company Information

*Company Name:

*Contact Person Information:

First Name Last Name

Email Address

Day Time Phone Number

( ) - Ext

*When was your company started?

mm	/	dd	/	yyyy
	/		/

*When would you like this coverage to start?

mm	/	dd	/	yyyy
	/		/

Start Now to Get Health Insurance:

*Enter your company's 5 digit ZIP code:

*Number of enrolling employees: