Business Name:    
Premises Address:
State:  Texas
Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    Years in Business:
Email Address: (Required) 
Description of Operations or SIC code:

Current Insurance Company: 
Policy Expiration Date:          (mm/dd/yyyy)

Texas Employee Information:

Do you currently offer health insurance benefits to employees?
Group Health Insurance Coverage For:
How many employees to be insured:    

Texas 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 Question or Comment:

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

**Information received from this Texas Group Health Insurance quote
request form sent to Texans Insurance & Financial Group 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 Texas 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 Texas Group Health
Insurance plan policy. We are licensed in Texas and will not provide
group health insurance quotes for other states.

Texas Group Health
Insurance Quote
We can provide affordable Texas Group Health Insurance
coverage in the Fort Bend County area and throughout Texas!
Texans Insurance &
Financial Group of Sugar
Land, TX offers
comprehensive commercial
insurance coverage options
and affordable business
insurance services
throughout Texas.
Contact us about Texas
Commercial Auto,
Commercial Property,
Group Health, Workers
Comp, and General
Liability Insurance toll
free at 800-747-6140.
In addition to Texas Group
Health Insurance, we also
offer low cost Group Life
Insurance plan services.
We are a Sugar Land, TX insurance agency offering affordable Texas
group health insurance quotes to mid-sized, large and small businesses
in the following towns, cities and counties in southeast Texas: Meadows,
Town West, Four Corners, Crabb, Booth, Thompsons, Fresno, Manvel,
Pleak, Kendleton, Eagle Lake, Sandy Point, Beasley, Rosenberg,
Richmond, Orchard, Fulshear, Juliff, Arcola, Needville, Frydek, Rosharon,
Bonney, East Bernard, Lissie, Elm Grove, Spanish Camp, Wharton, Guy,
Bellville, Wallis, Pasadena, Deer Park, Houston, Pearland, Galena Park,
Jacinto City, La Porte, Bellaire, West University Place, Cloverleaf,
Beaumont Place, Spring Valley, South Houston, Iowa Colony, Hilshire
Village, Humble, Houmont Park, Friendswood, League City, Alvin,
Mission Bend, Stafford, Missouri City, Texas City, Webster, Dickinson,
Baytown, Channelview, Highlands, Seabrook, Bacliff, La Marque, Jersey
Village, Lake Jackson, Surfside Beach, Algoa, Santa Fe, Barker, Katy,
Sealy, Dayton, Angleton, Freeport, Bammel, Kohrville, Bay City,
Brenham, Addicks, Brookshire, San Felipe, Hockley, Waller, Prairie
View, New Caney, Beach City, Nassau Bay, North Houston, Hempstead,
Tomball, The Woodlands, Burr, Iago, Boling, Peters, Cat Spring, Burleigh,
Waller County, Wharton County, Brazoria County, Harris County, and
Fort Bend County, TX. We can also offer affordable Texas group health
insurance policy quotes to businesses throughout the Lone Star state,
including in Beaumont, Austin, Waco, Fort Worth, Dallas, and San
Antonio, TX.

Texas Business Information:
Texans Insurance
& Financial Group
101 Southwestern Blvd.
Suite 230
Sugar Land, Texas 77478
Fort Bend County, TX
Office: (281) 277-7800
Toll Free: (800) 747-6140
Fax: (281) 277-7801

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