NH Group Health Insurance Quote

Gorman Insurance and Risk
Management Services of
Somersworth, NH offers
affordable Commercial
Insurance coverage options
and experienced business
insurance services
throughout New Hampshire,
southern Maine, and
Massachusetts.

Contact us about
Commercial Auto Insurance
toll free at 1-800-678-3431,
as well as Group Life and
Group Disability Insurance
services for your NH, ME,
or MA business.

In addition to New
Hampshire Group Health
Insurance, we also offer
affordable Group Life
Insurance plan services.

We are your local southeastern New Hampshire, southern Maine
insurance agency, offering experienced group health insurance services to
businesses located in the following cities and counties: Somersworth,
Durham, Portsmouth, Dover, Rochester, Rollinsford, Barrington, Madbury,
Lee, Strafford, Farmington, Milton, Barnstead, Nottingham, Northwood,
Raymond, Newmarket, Newfields, Stratham, Rye, Hampton, Epping,
Exeter, Salem, Danville, Deerfield, West Rye, Derry, Chichester, South
Barnstead, Gilmanton, New Durham, Wolfeboro, Alton, Laconia, Berlin,
Lebanon, East Candia, North Hampton, Hanover, Littleton, Plymouth,
Claremont, Newport, Keene, Hampton, Rye Beach, Strafford County,
Rockingham County, Hillsborough County, Merrimack County, and
Belknap County, NH. We also offer group health insurance services
throughout the state of New Hampshire, including the Manchester,
Nashua, and Concord area. Our service area in southern Maine includes
the following cities and counties: South Lebanon, Kittery, Eliot, Berwick,
Sanford, Blaisdell Corners, Springvale, Emery Mills, Wells Beach, York
Beach, Kittery Point, Kennebunk, Saco, Biddeford, Alfred, Portland,
Scarborough, Westbrook, Waterboro, Shapleigh, Newfield, Buxton,
Goodwins Mills, South Sanford, Cape Elizabeth, South Portland, York
County, and Cumberland County, ME.

We provide experienced Group Health

Insurance services throughout New Hampshire!

Business Name:
Premises Address:
City:
State: (New Hampshire, Maine or Massachusetts)
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)

Employee Information:

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

New Hampshire 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 Information" button below to send
your New Hampshire Group Health Insurance quote request.**

**Information received from this New Hampshire Health Insurance quote request form sent to Gorman Insurance and Risk Management Services, 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 employee 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 New Hampshire Group Health Insurance Policy. We are licensed in New Hampshire, Maine, Massachusetts, and will not provide quotes for other states.

New Hampshire Business Information: