Freeburg   |   Mascoutah   |   O'Fallon   |  Okawville   |  Waterloo
Home Page
Easy Quote
Home, Auto & More
Business Insurance
Life & Health
Specialty Programs
Companies We Represent
Education Center
License & Title
Claims
About Us
Employment
Contact Us
     
    
Locations

  Easy Quote - Health  
 

Concerned about your insurance?  We Can help with our new IPM EASY QUOTE.

Our “EASY QUOTE” is Fast, Simple and Secure

What’s more, you will get answers to your questions from a local licensed insurance professional.  Sine we directly represent more than 10 highly rated insurance companies, we will shop multiple carriers to develop the best plan for your specific needs.

Our clients choose to do business with us for a variety of reasons.  But the results are often very simple…

  • You save money
  • You sleep well knowing you are properly protected
  • You trust your local insurance professional

Please enter your zip code to be directed to the appropriate office:

((This does not yet work -- we want to make sure the form below is how you wish for it to appear))

_____________________________________________________________________

Name:  
Address:  
Phone:  
Date of Birth:  
Best Time to Contact:  
Have you filed bankruptcy?  



If so, in what year?  
SSN:  
DLN:  
Current Insurance Company:  
Current Insurance Premium:  
     
Gender:  



Weight:  
Height:
Currently Insured?  



Dental Coverage?  
Vision Coverage?  



Smoker?  



Maternity Coverage?  



Do you have any health issues?  



     
     
     
     

 

 

 

 

 

 
     
 

 

 
     
 2010 © Insurance Planning Management - All rights reserved | Sitemap

Designed, Hosted and Maintained by Image Excellence

counter for vBulletin