Stamford Group Life Insurance Quote

We provide affordable employee benefits life insurance premiums to
businesses in the following Connecticut counties and cities: Fairfield
County, New Haven County, Litchfield County, Middlesex County, New
London County, Hartford County, Tolland County, Windham County,
Stamford, Norwalk, Greenwich, Darien, Riverside, Belltown, Springdale,
Round Hill, Old Greenwich, East Norwalk, New Canaan, Glenville, Byram,
Cos Cob, Mianus, North Stamford, Glenbrook, Wilton, Weston, Long
Ridge, Noroton, West Norwalk, Westport, High Ridge, Southport, North
Wilton, Winnipauk, Cannondale, Turn of River, South Wilton, Lyons Plains,
Georgetown, Ridgefield, Branchville, Redding, Topstone, Ridgebury,
Redding Ridge, Branchville, Dodgingtown, West Redding, Titicus,
Hattertown, Bethel, Danbury, New Fairfield, Newtown, Hawleyville,
Botsford, Monroe, Bridgeport, Stepney, Shelton, Huntington, Upper
Stepney, Long Hill, Trumbull, Stratford, Easton, Fairfield, Greenfield Hill,
Stratfield, Nichols, Oronoque, Rivercliff, Devon, Lordship, and East
Bridgeport, New Haven, Hartford, Torrington, Waterbury, Meriden, New
Britain, New London, Norwich, Manchester, East Hartford, Suffield,
Granby, West Haven, West Hartford, Branford, East Haven, Hamden,
Woodbridge, Orange, North Haven, Groton, Rocky Hill, Newington,
Wethersfield, Glastonbury, Bloomfield, Blue Hills, South Windsor,
Naugatuck, New Hartford, Chesire, East Lyme, Old Mystic, Wallingford,
Southington, Middletown, Bristol, Laurel Beach, Litchfield, Pleasure
Beach, Mystic, North Westchester, Double Beach, Willimantic, Storrs,
Canaan, East Windsor, Vernon, South Canaan, Putnam, Guilford,
Windham, South Britain, Willington, Windsor, East Hampton, Brooklyn,
and Westchester, CT.

"Your local Connecticut group life insurance agent specialist!"

In addition to a Connecticut Group Life Insurance Quote,
we can also offer your business affordable Group Health
Insurance premiums or choose another CT commercial or
group insurance coverage from the menu below.

Information received from this Connecticut group life insurance quote form sent to Stamford
Insurance 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 group life insurance 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 you to Connecticut Group Life insurance.
We are licensed in Connecticut, New York, New Jersey, Massachusetts, and Rhode Island. We will
not provide quotes for other states.

Group Term Life Insurance Coverage Information:

Connecticut Group Life

Insurance Quote

Employee Information:

Business Name:
Premises Address:
City:     State:     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)

Group Term Life Insurance Objective:
Amount of Life Insurance Desired Per Employee:    Other Amount:$

How many employees to be insured:

Did any employee to be insured have health problems during
the past 18 months?
If "Yes", please list information below.

Does any employee to be insured have a hazardous job? Yes No
If Yes, how many have hazardous jobs?

Are any employees to be insured active members of the military reserves? Yes No
If Yes, how many are active members of the military reserves?

Additional Information or Comments

Click on the "Submit Quote Information" button below to send
your Connecticut Group Life insurance quote request.

Connecticut Business Information: