Not Sure Which Plan Is Right for You?
Click here

CONTACT US:


Azimuth Risk Solutions sm , LLC
8520 Allison Pointe Blvd, Suite 220, Indianapolis, IN 46250 USA

service@azimuthrisk.com

P: 888-201-8850 or 317-644-6291
F: 888-201-8851 or 317-423-9620
 
 
US Short Term Medical

 
Trip Protection Plan

 
PROVIDERS

 
COMPLAINTS

 
About Us
Quotes/Products
ARS Client Center
Forms/Downloads
New at Azimuth
Get Contracted
      Azimuth Risk Solutions, LLC BBB Business Review
 
THE CONTOUR GROUP MEDICAL PLAN
REQUEST FOR PROPOSAL
 
Group/Organization Name:* Contact Person:*
Telephone:* Fax
Email* Nature of Industry:*
Street Address:* Postal Code:*
Country:* State/Province:*
City:* Requested Effective Date:*
(MM/DD/YYYY)
*Total number of international assignees (expatriates, third country nationals, key local nationals)
Of the international assignee population, total number of U.S citizens
Is the company/organization a subsidiary or division of a U.S. or Canadian corporation?
  
Are any employees/dependents currently residing in the U.S. or Canada?
  
If any employees/dependents reside in the US, is any located in Florida?
  
Does applicant currently have group medical insurance?
  
Has another insurance company refused to quote on this group?
  
Are any employees or dependents presently on COBRA?
  
 
REQUESTED PLAN OF BENEFITS
Deductible Max. Deductible
$250
$500
$1000
$2500
$5000
$10500
$20000
2 per family
3 per family
Lifetime Maximum
$1000000
$2000000
$5000000
Coverage in the US: Include Exclude
  

 

 


Copyright © 2024 Azimuth Risk Solutions sm , LLC. All rights reserved.