There are four ways you can submit a Quote Request: (1) You may call us at 713-956-5522, (2) email us your phone number and a good time to reach you, (3) fax your information to 713-956-0588 or (4) completing this form.  

This will require you to complete an employee listing/census. You might want to prepare this ahead of time. The information you submit is confidential and you will receive a confirmation notice once it has been submitted. 

Please complete the appropriate census or if you wish, we will be happy to fax over these forms. Should you have over 25 employees,  please call 713-956-5522 so we can email or fax additional information.

 

Group Census        |     Individual Census